Is Cefotaxime 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 Cefotaxime. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Cefotaxime is no longer marketed in the United States. Limited information indicates that cefotaxime 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. Cefotaxime 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. Five postpartum women were given 2 grams of cefotaxime twice daily for 4 days. The average peak milk level on day 4 was 0.68 mg/L (range 0.29 to1.57 mg/L). By 12 hours after the dose the drug was undetectable in milk of all 5 women.[1]
After a single 1 gram dose of cefotaxime to 12 women, average peak levels of 0.32 mg/L occurred 2 hours after the dose. The highest milk level recorded was 0.52 mg/L in one woman at 3 hours after the dose.[2,3]
After a single 1 gram dose of cefotaxime to 5 women, the drug was not measurable (<0.1 mg/L) in the mothers' milk at any time up to 6 hours after the dose.[4]
After a single 1 gram intravenous dose in 2 women, cefotaxime milk levels were not measurable at any time up to 6 hours after the dose.[5]
Infant Levels. Relevant published information was not found as of the revision date.
“No published information” means the studies do not exist yet — not that Cefotaxime 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 “Cefotaxime” (LM49). 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.