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Breastfeeding on doxycycline

07/02/1999

Question:

Is it safe to breastfeed on Doxycycline? It was prescribed to treat Brucellosis for a 23 year old 1st time mom. The treatment is to be for 6 weeks. The mom was breastfeeding exclusively until the diagnosis.

Answer:

This must be a very trying situation for this mother, her baby and those who care about both of them. Brucellosis is very uncommon in the United States; there are only about 100 cases diagnosed per year in this country. Because of this, it can be difficult to make an accurate diagnosis. Furthermore, optimal antibiotic therapy for this infection continues to be debated. Since this mother needs to be well to care for her active baby, effectively treating the infection is the most important thing she can do.

Doxycycline (Vibramycin) is one of the antibiotics frequently used to treat brucellosis, but references indicate that extreme caution should be used if a mother takes doxycycline when breastfeeding. The amount of doxycycline that gets into an infant`s system via breast milk is greater than with the base tetracyclines. (A more technical explanation is that doxycycline binds much less to calcium than most other tetracyclines and has a longer half-life [15-25 hours].) Hale indicates that “no harmful effects have yet been reported in breastfeeding infants,” at least with short-term use, so doxycycline is not always contraindicated during breastfeeding. However, prolonged maternal use of this medication has the potential to cause grave effects in a baby. It could alter the baby`s gastro-intestinal (GI) flora, stain the baby`s teeth, and/or inhibit the baby`s bone growth.

The mother may want to discuss with her own and her baby`s health care providers the possibility of using one of the other antibiotics, or antibiotic combinations, that have been mentioned in the medical literature as being effective for the treatment of brucellosis. (Among antibiotic therapy combinations mentioned were other tetracyclines, rifampicin, and quinolones.) Most of the other antibiotics used for brucellosis are less available to, or absorbed by, a baby through breast milk, and some are antibiotics prescribed for infant use.

If alternative antibiotic therapy is not possible, this mother could choose to “pump and dump” her milk for the weeks she must take doxycycline. This would allow her to maintain milk production, so she and her baby can resume breastfeeding in several weeks. If the mother chooses this option and is uncertain how to go about it, she might want to contact Net Wellness again for suggestions.

References: 1. Hale, TW (1998). Medications and mothers` milk 1998-1999. Amarillo, TX: Pharmasoft Medical Publishing.

2. Lawrence, RA & Lawrence, RM (1999). Breastfeeding: A guide for the medical profession (5th ed.). St. Louis, MO: CV Mosby.

3. National Center for Infectious Diseases/Centers for Disease Control and Prevention (NCID/CDC)Link below.

Related Resources:

Brucellosis: An overview

For more information:

Go to the Breast Feeding health topic.