Is Cefazolin safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Cefazolin. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Limited information indicates cefazolin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Occasionally disruption of the infant's gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. Cefazolin is acceptable in nursing mothers.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. After a single 500 mg dose of cefazolin intramuscularly to 4 women, cefazolin was barely detectable in the mother's milk and not detected in their breastfed infants' serum.[1]
After intramuscular doses of cefazolin 500 mg three times daily in 10 women, the peak concentration of cefazolin in milk was 0.9 mg/L.[2]
Twenty women were given 2 grams of cefazolin intravenously over 10 minutes. Average milk levels were 1.25 mg/L at 2 hours, 1.51 mg/L at 3 hours and 1.16 mg/L at 4 hours after the dose.[3]
After a single dose of 1 gram of cefazolin given intravenously to 15 women who were 1 month postpartum, milk cefazolin levels averaged 0.75 mg/L 2 hours after the dose.[4]
Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
“No published information” means the studies do not exist yet — not that Cefazolin is known to be harmful, and not that it is known to be safe. Your prescriber or pharmacist can weigh your baby's age and whether a better-studied alternative would do the same job. Worth asking before stopping a medicine you need.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Cefazolin” (LM43). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.