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

Neomycin

July 2, 2015 (Very Low Risk)

Aminoglycoside antibiotic which is used in creams, eye drops, and otologic preparations for topical use, and, also orally used for intestinal disinfection.

At latest update, relevant published data on excretion in the breast milk were not found.

Like other aminoglycoside antibiotics, Neomycin is not absorbed by the gut. Absorption from other sources like skin, nose, ear and eye mucosa by means of topically used preparations (creams, drops, etc.) is very poor which causes excretion into breast milk in significant amount, unlikely.

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.

In case of use of Neomycin on the nipple, let it be done after the feed and wipe it out any excess of cream before the next feed.

Be aware of false negative results of microbial cultures done from samples of febrile infants whose mothers are treated with antibiotics. Also, due to imbalance of intestinal flora a diarrheal disease can occur in the breastfed infant.

List of Essential Medicines by WHO 2002: compatible with breastfeeding.

Alternatives

We do not have alternatives for Neomycin 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.

Writings

  • νεομυκίνη (Greek)
  • نيوميسين (Arabic)
  • Неомицин (Cyrillic)
  • 新霉素 (Chinese)
  • ネオマイシン (Japanese)

Drug trade names

References

  1. AEMPS. Oftalmowell. Ficha técnica. 2013 Full text (in our servers)
  2. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008Abstract
  3. 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
  4. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006Abstract
  5. WHO Pharmaceuticals Newsletter. 2005 Full text (link to original source) Full text (in our servers)
  6. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 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. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001Abstract
  9. Niebyl JR. Use of antibiotics for ear, nose, and throat disorders in pregnancy and lactation. Am J Otolaryngol. 1992Abstract
  10. Fulton B, Moore LL. Antiinfectives in breastmilk. Part II: Sulfonamides, tetracyclines, macrolides, aminoglycosides and antimalarials. J Hum Lact. 1992Abstract