Patient's question:
During breastfeeding, I developed a vaginal infection. The hospital prescribed Cefpodoxime Proxetil Tablets, Hot Granules, and Lactobacillus Lactis Capsules. I'm unsure if I can use 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 only focus on whether the drug affects milk production, rarely considering its impact on the infant, or may not even know 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 fragile and tender infant is significant. The following drugs 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 in rare cases, they may cause allergic reactions in the infant. They should be used with caution.
(3) Sulfonamide drugs, such as isoxazole sulfonamide, sulfadiazine, sulfamethoxazole, sulfamethizole, probenecid, trimethoprim, sulfamethizole, dipyrone tablets, and compound sulfamethoxazole, etc. 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 harmful effects, leading to increased free bilirubin in the plasma. They may also cause 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), which has no confirmed adverse effects on the infant. However, since antituberculosis drugs require long-term use, it is best to switch to other medications or discontinue breastfeeding to avoid potential harm to the infant.
(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 still 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, and even cause the 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 the 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 such as atropine sulfate, gentamicin sulfate, and streptomycin sulfate, which have high concentrations in milk and can reduce the infant's hearing. They should be avoided.
(10) Antithyroid drugs such as methimazole, which can inhibit the infant's thyroid function through breast milk. Oral administration of sulfathiazole can lead to thyroid enlargement and agranulocytosis in the infant, so it should be prohibited.
(11) Antiviral drugs such as amantadine, which are often prescribed by doctors to treat colds. Breastfeeding mothers taking this drug may cause vomiting, rashes, and urinary retention in the infant. It should be prohibited.
(12) Breastfeeding mothers with cancer should stop breastfeeding, as anticancer drugs entering the infant's body through milk can cause bone marrow suppression and agranulocytosis.