Patient's question:
During breastfeeding, I developed a vaginal infection. The hospital prescribed Cefpodoxime proxetil tablets, Hoten Qing granules, and Lactobacillus vivus capsules. I'm unsure if I can take them while breastfeeding, if it will affect my milk supply, or if it will harm the baby. Thank you!Doctor's answer:
When breastfeeding women take medication, they often focus solely on whether the drug affects milk production, rarely considering its impact on the infant, or may not even be aware of which drugs are harmful to the baby. In fact, many drugs can enter the infant's body through the mother's milk, thereby affecting the baby. Although some drugs have low concentrations in milk, their harm to the vulnerable infant is significant. The following medications should be avoided or prohibited for breastfeeding women:(1) Chinese herbal medicines such as roasted malt, pepper, and Epsom salt, as well as Western drugs like levodopa, ergometrine, estrogen, vitamin B6, atropine derivatives, and diuretics. These drugs can induce lactation suppression in the mother, so they should not be taken lightly during breastfeeding.
(2) Penicillin-class antibiotics, including penicillin, penicillin II, penicillin III, and ampicillin. These drugs rarely enter milk but may occasionally cause allergic reactions in the infant. They should be used with caution.
(3) Sulfonamide drugs, such as isoxazole, sulfadiazine, sulfamethoxazole, sulfamethizole, probenecid, trimethoprim, sulfamethizole, dapsone tablets, and compound sulfamethoxazole. Sulfonamide drugs are weakly acidic and do not easily enter milk, showing no obvious adverse effects on the infant. However, due to the underdeveloped drug metabolism enzyme system and poor liver detoxification function in infants, even small amounts of these drugs absorbed into the infant's body can cause harm, leading to increased free bilirubin in the plasma or hemolytic anemia in infants lacking glucose-6-phosphate dehydrogenase. Therefore, these drugs should not be used long-term or in large doses during breastfeeding, especially long-acting sulfonamide preparations, which should be restricted.
(4) Isoniazid (Rimifon). Although no definite adverse effects on the infant have been confirmed, due to the long-term use of antituberculosis drugs, it is best to switch to other medications or discontinue breastfeeding to avoid potential harm.
(5) Metronidazole, a broad-spectrum antibiotic commonly used to treat trichomoniasis and anaerobic infections. Although the harm to breastfeeding infants has not been definitively confirmed, it is recommended to avoid its use.
(6) Chloramphenicol. Infants, especially newborns, have underdeveloped liver detoxification functions. If chloramphenicol is absorbed through milk, it can easily cause infant toxicity, suppress bone marrow function, lead to leukopenia, or even fatal gray baby syndrome. It should be prohibited.
(7) Tetracycline and doxycycline. Both are lipophilic drugs that easily enter milk. Tetracycline, in particular, can damage the infant's teeth, impair enamel development, cause permanent yellowing of teeth, and lead to jaundice in infants. Therefore, they should be prohibited.
(8) Aminopyrine and drugs containing aminopyrine, such as painkillers, Salicin tablets, and Antipyrin, which quickly enter milk and should be avoided.
(9) Drugs with high concentrations in milk, such as atropine sulfate, gentamicin sulfate, and streptomycin sulfate, can lower the infant's hearing ability and should be avoided.
(10) Antithyroid drugs such as methimazole can inhibit the infant's thyroid function through breast milk. Oral administration of sulfathiazole can cause thyroid enlargement and agranulocytosis in the infant, so it should be prohibited.
(11) Antiviral drugs such as amantadine, often prescribed by doctors to treat colds. Breastfeeding mothers taking this drug may cause vomiting, rashes, and urinary retention in the infant, so it should be prohibited.
(12) Breastfeeding women with cancer should stop breastfeeding, as anticancer drugs entering the infant's body through milk can suppress the bone marrow and cause agranulocytosis.