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Question: I have a breastfeeding patient with bronchitis and I need to put her on antibiotics. What antibiotics are safe for her 3-month-old?Answer:
Almost all antibiotics get into breastmilk to some small extent (usually less than 2 % of maternal dose). There are no antibiotics that are absolutely contraindicated for breastfeeding mothers, but it is better to use older, more frequently used drugs whenever possible, as we have more experience with them in breastfeeding mothers, and more research available as to how much gets into breastmilk. As a general rule, any antibiotic given to infants or children is safe for your breastfeeding patient to take. To minimize the amount that enters breastmilk, recommend your patient take the medication right AFTER feeding her baby, so that the blood level has a chance to peak and fall before the next feeding. If the medication is a single daily dose, which can be taken at any time, recommend she take it before the |
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infant's longest sleep period. A good, current reference regarding drugs and breastmilk is: Thomas Hale PhD, Medications and Mothers' Milk, updated yearly, available from www.perinatalpub.com.
Dr. Wight is an attending Neonatologist at Children's Hospital and Sharp Mary Birch Hospital for Women, San Diego, and Medical Director, Sharp HealthCare Lactation Services. (IBCLC=International Board Certified Lactation Consultant) She can be reached at www.breastfeeding.org. |
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Nancy E. Wight MD, FAAP, IBCLC
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This sounds like a wonderful scenario, but what has happened in our society today? Babies are often carried around in hard seats that have no warmth and no heart beat. Sometimes they are not even held when they are fed! Today, babies are often cared for by someone other than the parents of the child. Someone who may pour a strange flavored liquid down their throat with a rubber nipple that is much different from their mother's skin.For many years, the presence of readily available mother's milk substitutes has robbed mothers of the assurance of their ability to provide everything their baby needs through their breasts. Many mothers (especially first time mothers) often make negative assumptions about their breastfeeding abilities: "My baby is not satisfied; I don't have
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enough milk; my milk is too thin; I don't feel anything; the baby would sleep if I give her a bottle; etc."May our wish for the new millennium be to increase awareness of the importance of breastfeeding and its positive impact in so many lives. Not only can breastfeeding decrease children's' morbidity and mortality rates around the world, but it can be a pivotal experience that provides optimum conditions for a healthy and complete development of a child. The breastfeeding experience may provide a strong foundation of inner happiness and security for a baby, something that can only come from being loved unconditionally. Martha A. Lee is a Parent Educator and a Lactation Consultant at the Paradise Valley Hospital in San Diego.
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