Is Ceftriaxone Sodium compatible with breastfeeding? Do we have alternatives for Ceftriaxone Sodium?

Ceftriaxone Sodium

October 15, 2016 (Very Low Risk)

Third generation cephalosporin for injection or parenteral administration.

Like most cephalosporins for which data are available, it is excreted in breast milk in clinically non-significant amount (Kafetzis 1983, Hirabayashi 1988, Bourget 1993) with no problems being reported in infants whose mothers were treated with it.

Because a low oral bioavailability the absorption from ingested milk to infant’s plasma would be zero or negligible, except in case prematurity and immediate neonatal period, when intestinal absorption may be increased.

It is a medication which is approved for use in infants and neonates.

Be aware of the possibility of false negative results of cultures in febrile infants whose mothers are taking antibiotics as well as the possibility of gastroenteritis (Ito 1993) by altering the intestinal flora.

American Academy of Pediatrics 2001: Medication usually compatible with breastfeeding.
WHO List of Essential Medicines 2002: compatible with breastfeeding.


We do not have alternatives for Ceftriaxone Sodium 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.


  • Натрий Цефтриаксон (Cyrillic)
  • セフトリアキソンナトリウム (Japanese)
  • C18H16N8Na2O7S3,3½H2O (Molecular formula)


  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. 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)
  3. 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)
  4. Scott A, Forsyth S. Breast feeding and antibiotics. Mod Midwife. 1996Abstract
  5. Bourget P, Quinquis-Desmaris V, Fernandez H. Ceftriaxone distribution and protein binding between maternal blood and milk postpartum. Ann Pharmacother. 1993Abstract
  6. 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
  7. Fulton B, Moore LL. Antiinfectives in breastmilk. Part I: Penicillins and cephalosporins. J Hum Lact. 1992Abstract
  8. Hirabayashi K, Okada E. [Pharmacokinetic and clinical studies on ceftriaxone in the perinatal period]. Jpn J Antibiot. 1988Abstract
  9. Cho N, Fukunaga K, Kunii K, Deguchi K. [Bacteriological, pharmacokinetic and clinical studies on the use of ceftriaxone in the perinatal period]. Jpn J Antibiot. 1988Abstract
  10. Kafetzis DA, Brater DC, Fanourgakis JE, Voyatzis J, Georgakopoulos P. Ceftriaxone distribution between maternal blood and fetal blood and tissues at parturition and between blood and milk postpartum. Antimicrob Agents Chemother. 1983Abstract Full text (link to original source) Full text (in our servers)
  11. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981Abstract