Is Tetracycline 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 Tetracycline. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
A number of reviews have stated that tetracycline is contraindicated during breastfeeding because of possible staining of infants’ dental enamel or bone deposition of tetracyclines. However, a close examination of available literature indicates that there is not likely to be harm in short-term use of tetracycline during lactation because milk levels are low and absorption by the infant is inhibited by the calcium in breastmilk. Although the manufacturer recommends avoiding breastfeeding during administration of tetracycline, short-term use of tetracycline is probably acceptable in nursing mothers. As a theoretical precaution, avoid prolonged or repeat courses during nursing. Monitor the infant for rash and for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash).
Effects on the breastfed infant
No adverse effects were noted in an unspecified number of breastfed infants whose mothers were taking oral tetracycline 1, 1.5 or 2 grams daily for 3 days. Ages of the infants and extent of breastfeeding were not stated.[1] In one study, 5 infants breastfed during maternal therapy with tetracycline 500 mg 4 times daily with no adverse effects observed.[2]
In an observational study of 251 women, 23.8% of nursing mothers received tetracycline during breastfeeding. No gross adverse effect occurred in any of the breastfed infants.[4]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Maternal Levels. In a study using a microbiologic assay, milk tetracycline levels were in an unspecified number of nursing mothers at 9 am after various dosages of tetracycline during the previous days. Whether they had mastitis and the time postpartum were not stated. Milk levels increased to 2.5 mg/L after a daily dose of 1 gram orally for 3 days. Milk levels increased to 2 mg/L after a daily dose of 1.5 grams orally for 2 days. Milk levels increased to 2.5 mg/L after a daily dose of 2 grams orally for 3 days.[1]
Five women were given oral tetracycline 500 mg 4 times a day for 3 days. Milk levels ranged from 0.43 to 2.58 mg/L (times not specified).[2]
After a single dose of 150 mg of tetracycline orally in 2 women, milk levels of tetracycline averaged 0.7 mg at 2 and 6 hours after the dose and had an average peak of 0.8 mg/L 4 hours after the dose.[3]
Infant Levels. Five women were given oral tetracycline 500 mg 4 times a day for 3 days. Their infants were allowed to nurse and tetracycline was undetectable (<50 mcg/L) in the infants’ serum.[2]
Alternatives LactMed lists
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Tetracycline” (LM252). 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.