Is Vancomycin 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 Vancomycin. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Limited information indicates that intravenous vancomycin produces low levels in milk and because vancomycin is poorly absorbed orally, it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants. No special precautions are required.
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 single colostrum vancomycin level of 12.7 mg/L was found 4 hours after the end of the infusion of vancomycin 1 gram intravenously given every 12 hours in one woman. Her colostrum was obtained after delivery at a gestational age of about 35 to 38 weeks.[1] Assuming that the colostrum level is a peak level, an exclusively breastfed infant would receive a maximum of 1.9 mg/kg daily by mouth in breastmilk. The amount in mature milk might be lower. This dose is only about 4.8% of the oral vancomycin dose of 40 mg/kg daily used to treat Clostridioides difficile infection of the bowel in infants.
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 Vancomycin 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 “Vancomycin” (LM394). 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.