Breast feeding and antibiotics.

At all times the necessity of prescribing to breast feeding mothers should be questioned. The advantages and disadvantages should be carefully assessed for both mother and baby. Whenever possible the long-acting form of the drug should be avoided. The use of drugs with short half lives minimises the risk of accumulation, e.g. Cefotaxime 1.1 hours, Ceftriaxone 7.25 hours. Aim to avoid breast feeding when milk drug concentrations are at their peak. In general, this occurs 1-2 hours following oral medication. As a general principle, advising the administration of medication immediately following a breast feed is the safest option for the baby but this is not true for all drugs. Where information is available, choose the drug which appears in the least concentration in breast milk. All infants should be monitored for uncharacteristic symptoms and signs. If it is essential that a drug with known potential serious toxicity to the infant has to be prescribed to the mother, then breast feeding should be discontinued. As the infant's metabolic and excretory capacities rapidly improve during the first months of life, the risk of toxicity to the infant will decrease with increasing age of the infant.