Can breastfeeding mothers take Macrobid (Nitrofurantoin)?

From the Guidelines

Breastfeeding mothers can generally take Macrobid (nitrofurantoin) safely, as it is considered compatible with breastfeeding by most medical authorities, with only small amounts of the medication passing into breast milk. The typical dosage for urinary tract infections is 100 mg twice daily for 5-7 days. While taking Macrobid, continue breastfeeding as normal, as the benefits of breastfeeding typically outweigh any minimal risk. The small amount that reaches the infant is unlikely to cause problems in healthy, full-term babies. However, Macrobid should be avoided if your baby has G6PD deficiency or is under one month old, as these infants may be more susceptible to side effects. Macrobid works by killing bacteria in the urinary tract and is commonly prescribed for urinary tract infections in breastfeeding women because of its favorable safety profile. Always inform your healthcare provider that you are breastfeeding when receiving any prescription. Some key points to consider when taking Macrobid while breastfeeding include:

• The medication is generally considered safe for use during breastfeeding, with minimal risk to the infant 1
• The typical dosage for urinary tract infections is 100 mg twice daily for 5-7 days
• Continue breastfeeding as normal while taking Macrobid, as the benefits of breastfeeding typically outweigh any minimal risk
• Avoid Macrobid if your baby has G6PD deficiency or is under one month old, as these infants may be more susceptible to side effects
• Inform your healthcare provider that you are breastfeeding when receiving any prescription. It's also important to note that most systemic antibiotics, including Macrobid, will be present in breast milk and could cause falsely negative cultures in febrile infants or produce gastroenteritis due to alteration of intestinal flora 1. However, the benefits of breastfeeding and the favorable safety profile of Macrobid make it a commonly prescribed medication for urinary tract infections in breastfeeding women.

From the Research

Breastfeeding and Macrobid (Nitrofurantoin) Use

• The use of nitrofurantoin in breastfeeding mothers is generally considered safe, as only small amounts of the drug transfer into breast milk 2.
• However, there is a risk of hemolytic anemia in newborns exposed to nitrofurantoin, especially in infants with glucose-6-phosphate dehydrogenase (G6PD) deficiency 2, 3.
• Some studies suggest that nitrofurantoin be avoided in infants younger than 1 month, but if an alternative antibiotic is not available, the use of nitrofurantoin would not be a reason to avoid breastfeeding 2.
• It is recommended that the suckling infant be monitored by their physician if the mother is taking nitrofurantoin 2.
• The risk of hemolytic reactions to nitrofurantoin is considered rare, with an estimated incidence rate of 1 in 100,000 courses of therapy 3.

Safety Precautions

• Mothers taking nitrofurantoin while breastfeeding should be aware of the potential risks and monitor their infant for any signs of hemolytic anemia 2.
• If an alternative antibiotic is available, it may be preferred for infants younger than 1 month 2.
• The use of nitrofurantoin in breastfeeding mothers should be accompanied by appropriate advice and monitoring 4.