Ciprofloxacin: This is one antibiotic that is considered to be definitely toxic. It should be avoided if breast-feeding. If it is necessary to use it, then breast-feeding needs to be suspended during its use and for at least 48 hours after the last dose, to allow the drug to be eliminated from the mother's system.
Anti-TB medication: If the mother is on anti-tuberculosis medication, including Isoniazid, Rifampicin and Ethambutol, she should continue, as these are known to be safe for the baby. There is therefore no justification to prohibit breast-feeding in such a case.
Sulphonamides: these could be prescribed on their own or as part of a combination. (such as with Septrin®). These are regarded as safe unless the baby is premature or jaundiced, in which case they are best avoided.
Aciclovir is an antiviral preparation used for such conditions as fever blisters" (cold sores) and genital herpes. Is it safe?
Even though some aciclovir will be found in breast-milk, it is regarded to be safe for the baby, so where necessary treatment should continue, together with breast-feeding. Other related drugs which carry a similar advice include Famciclovir (Famvir®) and Valaciclovir (Valtrex®).
Antimalarials with breast-feeding
If living or travelling to tropical countries where malaria is endemic, is Chloroquine safe to use?
Yes. So is Proguanil (Malarone®), another common antimalarial.
What about Mefloquine?
There is really no information as to its potential effects on the baby. However, on the basis of side-effects associated with it in adults, the advice is to avoid if breast-feeding. Mefloquine is available under the brand name Lariam®.
Antacids and ulcer drugs use when breastfeeding
Antacids are used for peptic ulcers or even heartburn. Are they safe?
Most of them are safe but a breast-feeding woman should ensure she reads the manufacturers' recommendation, since new ones are continually coming out and this opinion is by no means universal.
What about drugs such as Zantac®?
Zantac® - the generic name of which is Ranitidine is the most widely used drug in the world for peptic ulcers. It is one of a group of drugs known as H2-receptor antagonists. Others include Cimetidine (Dyspamet®, Tagamet®), Nizatidine (Axid®) and Famotidine (Pepcid®) . Even though they appear in breast milk in significant amounts, these are known to be safe and breast-feeding should continue.
What about Omeprazole (Losec®)?
This is also a popular drug used for eliminating Helicobacter pylori, peptic ulcers, or simple heartburn. It belongs to a group of drugs called ‘Proton Pump Inhibitors’. It is known to be safe.