Breastfeeding mothers, like anyone, may need to take antibiotics for a bacterial infection.
One common reason why breastfeeding mothers may need antibiotics is for infective mastitis.
When a breastfeeding mother has to take antibiotics, she may worry about how they may impact her, her breastmilk or her baby.
The good news is that the use of antibiotics is generally safe when breastfeeding, and does not necessitate the need to ‘pump and dump' or to cease breastfeeding.
According to Australia’s National Health and Medical Research Council: ‘It is safe to continue breastfeeding when taking antibiotics’.
Hopefully antibiotics are prescribed much less often these days as we now know more about:
- Their lack of benefit in self-limiting conditions
- Their impact on gut flora
- Increasing antibiotic resistance
However, there are times when the use of antibiotics is important and even life-saving.
Antibiotics and Breastfeeding
Here are 5 things that mothers need to know about antibiotics and breastfeeding.
#1: Your Baby’s Poos May Temporarily Change
If you need to take antibiotics while breastfeeding, you may notice that your baby has runnier poos than usual and that her poos may be more of a green colour.
This does not require any treatment and should resolve soon after you’ve finished taking the antibiotics.
#2: Your Baby’s Temperament May Temporarily Change
If taking antibiotics while breastfeeding, you may notice your baby becomes temporarily a bit more unsettled with colic like symptoms.
This does not require any treatment and should resolve soon after the antibiotics are finished.
Your baby’s poos and temperament temporarily changing are not serious and don’t mean you should cease breastfeeding or the antibiotic course, or pump or dump your milk while taking antibiotics.
Anecdotally, some mothers have found that their antibiotic use can set up some signs of secondary lactose intolerance in their baby. This is possible since anything that causes gut irritation (such as antibiotic use by its effect on gut flora) has the potential to cause secondary lactose intolerance. Once the antibiotic course has finished and with continued breastfeeding, the gut will return to normal.
#3: Your Breastmilk Is Important For Your Baby’s Gut
While it is possible that antibiotics you take can impact your baby’s gut flora, it is important to remember that your breastmilk contains a host of factors that can assist in healing your baby’s gut and re-establishing a healthy balance of gut flora.
For example, oligosaccharides (there are over 200 kinds in human milk) are the third most abundant substance in breastmilk. Oligosaccharides are prebiotics. Prebiotics are the food for the good bacteria in one’s gut.
Breastmilk also contains probiotics including the beneficial lactobacilli and bifidobacteria that support a healthy gut flora in your baby.
It is also important to remember that while your antibiotic use could change the range of bacteria in your baby’s gut, giving formula will do this too. Actually, your baby’s gut flora is likely to be affected less by the tiny amounts of antibiotic that pass through your breastmilk than the change that occurs when formula is given.
#4: Probiotics May Be Helpful
A course of antibiotics for most healthy people is usually tolerated well and the gut flora typically recovers quickly. One common side effect of antibiotic use is diarrhoea. This is partly due to antibiotics killing not only the unwanted bad bacteria but also beneficial bacteria.
The theory behind the use of probiotics is to improve or rebalance gut flora after an upset (e.g. after antibiotic use).
More research is needed but so far the use of probiotics has had a good safety record in clinical trials of moderate quality. These studies suggest they may be helpful at reducing the risk of diarrhoea associated with the use of antibiotics.
More research will help us determine which species and strains are most effective, the optimal dosing, and when and for how long probiotics should be used.
This point is referring to the potential use of probiotics in mothers taking antibiotics, not about giving them directly to breastfed (particularly exclusively breastfed) babies. To date, there has been no research done on the use of probiotic supplements given directly to exclusively breastfed babies. For this reason, we cannot comment on their benefit in this regard, or potential harm.
If you are interested in taking probiotics, please speak with a healthcare provider familiar with probiotic use.
#5: The Development Of Thrush Is Possible
Large doses of antibiotics may encourage overgrowth of thrush (candida) in the mother by killing beneficial gut flora, which normally keep these organisms under control.
Thrush may cause symptoms in the vagina, the mouth or the nipples.
For individual advice about the use of antibiotics or probiotics while breastfeeding, always seek medical advice.
It can be concerning to take medications while breastfeeding, but at times it could be necessary. If your doctor has prescribed a medication it is because they feel the benefit outweighs the possible risks such as a temporary change in baby's poos or temperament.
If you have concerns about the safety of a medication during pregnancy or while breastfeeding, the Infant Risk Center keeps up-to-date information regarding medication during pregnancy and while breastfeeding.