Is Amoxicillin compatible with breastfeeding? Do we have alternatives for Amoxicillin?

Amoxicillin

February 28, 2018 (Very Low Risk)

It is excreted in breast milk in insignificant amounts and no problems have been observed in the majority of infants of mothers who took it (Golstein, 2000, Kafetzis 1981, Ito 1993, Nau 1987) except for occasional episodes of mild diarrhea, rash or drowsiness that did not require medical attention (Goldstein 2009, Benyamini 2005, Ito 1993).

It is considered medication compatible with breastfeeding by relevant authors and scientific societies (Rowe 2013, Nahum 2006, Mahadevan 2006, Bar-Oz 2003, CDC 2001, Chin 2000, Fulton 1992).

It is a medication commonly used in Pediatrics and considered an essential medicine for pediatric use by WHO (WHO 2013).

The possible negativity of cultures in febrile infants whose mothers take antibiotics should be taken into account, as well as the possibility of gastroenteritis due to altered intestinal flora (Benyamini 2005, Ito 1993, Kafetzis 1981).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).

Alternatives

We do not have alternatives for Amoxicillin since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Amoxicillin Sodium
  • Amoxicillin Trihydrate

Writings

  • Αμοξυκιλλίνη (Greek)
  • أموكسيسيلين (Arabic)
  • Амоксициллин (Cyrillic)
  • 阿莫西林 (Chinese)
  • アモキシシリン (Japanese)
  • Amoxicilline (French)
  • C16 H19 N3 O5 S (Molecular formula)
  • (6R)-6-[α-d-(4-Hydroxyphenyl)glycylamino]penicillanic acid (Chemical name)
  • J01CA04 (ATC Code/s)

References

  1. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  2. Goldstein LH, Berlin M, Tsur L, Bortnik O, Binyamini L, Berkovitch M. The safety of macrolides during lactation. Breastfeed Med. 2009Abstract
  3. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  4. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006Abstract
  5. Benyamini L, Merlob P, Stahl B, Braunstein R, Bortnik O, Bulkowstein M, Zimmerman D, Berkovitch M. The safety of amoxicillin/clavulanic acid and cefuroxime during lactation. Ther Drug Monit. 2005Abstract
  6. Bar-Oz B, Bulkowstein M, Benyamini L, Greenberg R, Soriano I, Zimmerman D, Bortnik O, Berkovitch M. Use of antibiotic and analgesic drugs during lactation. Drug Saf. 2003Abstract
  7. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  8. Centers for Disease Control and Prevention (CDC). Update: Interim recommendations for antimicrobial prophylaxis for children and breastfeeding mothers and treatment of children with anthrax. MMWR Morb Mortal Wkly Rep. 2001Abstract Full text (in our servers)
  9. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  10. Chin KG, Mactal-Haaf C, McPherson CE. Use of anti-infective agents during lactation: Part 1--Beta-lactam antibiotics, vancomycin, quinupristin-dalfopristin, and linezolid. J Hum Lact. 2000Abstract
  11. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993Abstract
  12. Fulton B, Moore LL. Antiinfectives in breastmilk. Part I: Penicillins and cephalosporins. J Hum Lact. 1992Abstract
  13. Nau H. Clinical pharmacokinetics in pregnancy and perinatology. II. Penicillins. Dev Pharmacol Ther. 1987Abstract
  14. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981Abstract