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Medicines designed to kill pathogenic bacteria are antibiotics. Invented at the beginning of the 20th century, they have saved millions of human lives. In the past 11 years, these drugs have been widely used to treat a wide variety of diseases. There are 100 groups that include more than XNUMX types of antibiotics of organic or synthetic origin.
However, there is still no universal remedy that effectively acts on all types of pathogenic bacteria. Therefore, the doctor selects an antibiotic against a specific pathogen, the dosage and frequency of use, takes into account side effects and contraindications. The correct choice of an antibacterial drug is especially important during lactation, when the relationship between mother and child is closest.
Indications for taking antibiotics while breastfeeding
The main indication for taking drugs of this pharmaceutical group is a pronounced inflammatory process. Infection of the body with streptococcus or staphylococcus cannot be overcome without antibiotics. Breastfeeding cannot be a contraindication for such complex forms of infectious diseases.
Conditions in which antibiotics are used without fail:
Infections of the gastrointestinal tract;
Inflammation of the birth canal, as a result of complicated childbirth;
Bacterial lesions of the ENT organs, the respiratory system;
Infectious diseases of the kidneys, urinary system, pelvic organs.
Properly selected drugs will help you quickly recover, bring your well-being back to normal. A significant disadvantage of treating a nursing mother with antibiotics is the effect of the components of the drug on the child’s body through breast milk. Therefore, it is so important to choose an antibiotic for a lactating woman that is safe for the baby.
How does the antibiotic affect the body of infants?
If there is an urgent need to take an antibiotic during lactation, the risk of toxic effects on the baby should be minimized. So that a nursing mother does not worry about the negative effect of the drug on children’s health, it is necessary to take into account the peculiarities of the metabolism of such drugs.
According to a study by American professor D. Newman, presented in his article “Myths about Breastfeeding”, no more than 10% of the dose of the drug taken by the mother enters the body of the infant. According to a well-known pediatrician, such an amount cannot cause significant harm to the baby due to the minimum concentration. Practitioners of pediatrics do not agree with this point of view, and warn of the dangers of using antibiotics during lactation.
Modern drugs have a minimum time for the decomposition of the active substance and its removal from the body. If for antibiotics taken in the last century, it was several days or even weeks, then new generation drugs are removed in a few hours. You can find out this indicator in the instructions for use, section “Pharmacokinetics”. Knowing the duration of the half-life of the active substance, you can calculate the time of taking the therapeutic dose so as not to combine it with feeding and not jeopardize the health of the baby. For example, there is enough time before bedtime to take the medicine and meet the deadline for the morning feed.
According to the classification of the American Federal Food Commission (FDA), antibiotics that are acceptable for breastfeeding women are classified as A-C. In group 1 of this classification are drugs, the toxicity of which was carried out on humans and animals. Means of groups 2 and 3 also showed an effective effect, but their tests were carried out exclusively on animals, and safety for humans was not tested. Russian pharmaceuticals do not use this classification, although FDA compliance is still indicated in the instructions for use.
3 groups of approved antibiotics for lactation
The pharmaceutical industry offers several groups of antimicrobial agents approved for use by women during breastfeeding.
Permitted drugs:
Penicillins – the first antibiotics used in medicine, most often used in the treatment of lactating and pregnant women, infants up to a year. Penicillins that have a powerful antimicrobial effect are Oxacillin, Ampicillin, Ticarcillin, Piperacillin, etc. Possible side effects for an infant whose mother is being treated with such antibiotics are allergic reactions in the form of a skin rash and diarrhea in 8% of children. According to a study conducted in 2008 by the American Academy of Pediatrics using the example of Ampicillin, the dose of the antibiotic in breast milk reaches less than 0,1% of the dose consumed by the mother. Such a concentration, in principle, is not capable of causing any significant reactions.
Cephalosporins are officially recognized as safe, non-toxic medicines. These are drugs such as Cefazolin, Ceftibuten, Cefuroxime, Cefepime, Ceftriaxone. If they penetrate into breast milk, then this happens to a minimal extent, in a concentration that is completely safe for the baby. The lack of antibiotics of this group is the ability to influence the absorption of calcium and the hematopoiesis of the child due to the provocation of dysbacteriosis by drugs in children with impaired vitamin K synthesis.
Macrolides– antibiotics from group C (according to the FDA classification), used for allergies to other antimicrobial drugs. The macrolide group includes Erythromycin, Azithromycin, Midecamycin, Clarithromycin, Spiramycin. Prescribing macrolides may carry risks to the health of the mother and child.
In international practice, there are discrepancies with these recommendations. For example, Ofloxacin (an antibiotic from the fluoroquinolone group) is recognized as safe in the United States and is used for breastfeeding, and in the UK it is banned due to its effect on the growth of children and the condition of interarticular cartilage.
List of prohibited drugs while breastfeeding
Sometimes it happens that the disease and its treatment cannot be combined with breastfeeding. These are severe infections (meningitis, sepsis) or diseases requiring specific antibiotic therapy. In this case, you have to interrupt breastfeeding for a course of treatment.
Drugs prohibited during lactation:
Aminoglycosides – penetrate into milk in a meager amount, however, even in such a minimum concentration they can affect the kidneys, optic nerve, hearing organs, and the vestibular apparatus of the child. Such negative side effects have Gentamicin, Streptomycin, Kanamycin, Netilmicin, Amikacin – antibiotics that are prohibited for use during breastfeeding.
Tetracyclines – drugs in this group require a particularly balanced approach, as they have many side effects. One of them is the so-called “tetracycline teeth” with a characteristic damage to tooth enamel, a violation of the growth of bone tissue. Drugs – Tetracycline, Doxycycline.
Fluoroquinolones – Levofloxacin, Norfloxacin, Moxifloxacin, Ofloxacin, Ciprofloxacin, banned in Europe for use during lactation. In the US, ofloxacin is approved for use during breastfeeding.
Lincosamides – Clindamycin, Lincomycin, disrupting the child’s digestive system.
Sulfanilamides – have a toxic effect on the baby’s liver, are fraught with the appearance of nuclear jaundice. These are Biseptol, Sulfacyl sodium, Streptocid, Etazol, Sulfadimezin, Ftalazol.
After the course of treatment, the mother should refrain from feeding for the time of complete removal of the active substance from the body. This period is indicated in the instructions for use of the product, usually it ranges from 2 to 7 days.
7 rules for choosing and taking antibiotics
Self-medication with antibiotics is unacceptable, and it is also very dangerous for a nursing mother! The selection of an effective drug for lactation can only be done by the attending physician. He must be aware that the woman plans to continue breastfeeding, and select the safest option.
Rules for choosing and taking antibiotics during lactation:
You can not take any antibiotics if the baby was born prematurely. Children with underweight react to any medication in a completely different way than full-term babies. There may be dangerous side effects for a weak child’s body.
A nursing mother cannot take medication if the child has congenital malformations, a history of allergies. It is impossible to predict the reaction of a child’s organism with complex pathologies to the action of an antibiotic.
When treating, the feeding regimen is necessarily taken into account. To reduce the concentration of the active substance in breast milk, the doctor prescribes the optimal time for taking the therapeutic dose.
The age of the baby should be taken into account. Metabolic processes in 1 month and in 8-10 months proceed differently. What is dangerous for a newborn, a one-year-old child may not bring much harm.
For self-regulation of the amount of the drug in breast milk, nursing mothers follow simple recommendations:
It is necessary to clarify in the instructions for use the time of the highest concentration of the drug in the blood and adjust the time of medication so that this peak does not occur during breastfeeding.
Short courses of treatment with the most modern antibiotics should be used. Drugs with such properties cannot accumulate intensively in the blood and other tissues, and, most likely, will not cause an allergic reaction.
The introduction of complementary foods will reduce the concentration of the antibiotic in the child’s body. If the child is 6 months old, you can replace part of the breastfeeding with complementary foods in the form of vegetable and fruit puree, various cereals.
In each specific case of prescribing antibiotics during breastfeeding, the potential risk to the health of the child and mother should be objectively assessed.