From the Guidelines
Amoxicillin is generally considered safe during breastfeeding, posing minimal risk to the breastfed infant, as supported by the most recent guidelines 1.
Key Points to Consider
- The amount of amoxicillin that passes into breast milk is small, typically less than 1% of the maternal dose, which is well below therapeutic doses for infants.
- Mothers can continue to breastfeed while taking amoxicillin at standard prescribed doses (typically 250-500 mg three times daily for most infections) 1.
- No special timing of doses relative to breastfeeding is necessary.
- While some infants might experience temporary changes in bowel flora that could lead to mild diarrhea or thrush (yeast infection), these side effects are uncommon and usually mild.
- Amoxicillin is actually one of the antibiotics commonly prescribed directly to infants and young children, further supporting its safety profile.
Clinical Recommendations
- If you notice any unusual symptoms in your baby while taking amoxicillin, such as rash, persistent diarrhea, or signs of thrush, contact your healthcare provider, but there is typically no need to interrupt breastfeeding during treatment.
- For breastfeeding patients with conditions requiring systemic antibiotics, such as hidradenitis suppurativa, oral amoxicillin/clavulanic acid is suggested 1.
Safety and Efficacy
- The safety of amoxicillin during breastfeeding is well-established, with minimal risk of adverse effects on the infant 1.
- The benefits of breastfeeding, including the transfer of antibodies and nutrients, outweigh the potential risks associated with amoxicillin use.
From the FDA Drug Label
- 3 Nursing Mothers Penicillins have been shown to be excreted in human milk. Amoxicillin use by nursing mothers may lead to sensitization of infants. Caution should be exercised when amoxicillin is administered to a nursing woman.
Amoxicillin use in breastfeeding: The FDA drug label advises caution when administering amoxicillin to a nursing woman, as it may lead to sensitization of infants.
- Key points:
- Penicillins, including amoxicillin, are excreted in human milk.
- Caution should be exercised when using amoxicillin in breastfeeding women.
- There is a potential risk of sensitization of infants. Based on the information provided in the drug label 2 and 2, it is recommended to exercise caution when using amoxicillin in breastfeeding women.
From the Research
Amoxicillin Safety in Breastfeeding
- The safety of amoxicillin during lactation has been evaluated in a study published in 2005 3, which found that amoxicillin may be safe during lactation.
- In this study, 40 breastfeeding women were treated with amoxicillin, and only 3 infants (7.5%) had adverse effects, which were minor, self-limiting, and did not necessitate interruption of breastfeeding.
- The study suggests that amoxicillin can be used during lactation, but larger studies are needed to confirm these findings.
Penicillin Allergy and Breastfeeding
- A review published in 2019 4 discusses the evaluation and management of penicillin allergy, which is relevant to the use of amoxicillin during breastfeeding.
- The review notes that many patients report allergies to penicillin, but clinically significant reactions are uncommon, and the rate of IgE-mediated penicillin allergies is decreasing.
- However, this review does not specifically address the safety of amoxicillin during breastfeeding.
Cephalosporin Allergy and Breastfeeding
- Studies on cephalosporin allergy 5, 6, 7 provide information on the cross-reactivity between penicillins and cephalosporins, which may be relevant to the use of amoxicillin during breastfeeding.
- However, these studies do not directly address the safety of amoxicillin during breastfeeding, and their findings may not be directly applicable to this context.
Key Findings
- The available evidence suggests that amoxicillin may be safe during lactation, but larger studies are needed to confirm these findings 3.
- The risk of cross-reactivity between penicillins and cephalosporins is lower than previously reported, but this information may not be directly relevant to the safety of amoxicillin during breastfeeding 4, 7.