Is Fluorescein 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 Fluorescein. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Because absorption from the eye is limited, fluorescein would not be expected to cause any adverse effects in breastfed infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.
After intravenous use in a nursing mother, milk levels and the dose received by the infant are much higher than with ophthalmic use. It is unlikely that these higher levels are problematic for most infants, but exposure to intense light, such as phototherapy, should probably be avoided for a few days after the maternal dose. Fluorescein injection is transferred into human milk for up to 4 days following IV administration.
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. A woman received 5 mL of 10% fluorescein (500 mg) injection shortly after delivering a set of twins. Milk samples were obtained periodically by manual expression for 76 hours after the dose. The highest concentration of 372 mcg/L was obtained in the first sample 6 hours after the dose. By 76 hours after the dose, the milk fluorescein concentration was 170 mcg/L. The half-life of fluorescein in milk was 62 hours.[1]
A mother nursing a 3-month-old infant had 2% fluorescein drops applied into each eye. Blood and milk samples were taken 3 times at 30-minute intervals after the dose. Milk levels at these times were 20, 22 and 15 mcg/L, respectively.[2]
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 Fluorescein 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 “Fluorescein” (LM537). 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.