Excretion into breast milk is highly unlikely due to an almost nil systemic absorption through the skin, vaginal mucosa and even the intestine, with non-significant plasma levels (< 1 mcg/ mL) observed.
In case of use on the nipple, let it be done after the feed and wipe it out any excess of cream before the next feed.
Do not apply creams, gels and other products that would contain paraffin (mineral oil) to avoid absorption by the infant since it is a hydrocarbon-derived substance.
Miconazole has not been found to be more effective than pure lanolin for treatment of sore or cracked nipples.
List of Essential Medicines by WHO 2002: compatible with breastfeeding.
We do not have alternatives for Miconazole since it is relatively safe.
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
- μικοναζόλη (Greek)
- ميكونازول (Arabic)
- Миконазол (Cyrillic)
- 咪康唑 (Chinese)
- ミコナゾール (Japanese)
Drug trade names
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- 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)
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- Brent NB. Thrush in the breastfeeding dyad: results of a survey on diagnosis and treatment. Clin Pediatr (Phila). 2001Abstract
- Timonen H. Shorter treatment for vaginal candidosis: comparison between single-dose oral fluconazole and three-day treatment with local miconazole. Mycoses. 1992Abstract
- Dhondt F, Ninane J, De Beule K, Dhondt A, Cauwenbergh G. Oral candidosis: treatment with absorbable and non-absorbable antifungal agents in children. Mycoses. 1992Abstract
- Daneshmend TK. Systemic absorption of miconazole from the vagina. J Antimicrob Chemother. 1986Abstract