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Medicines and breast-feeding: Continues from previous page

Tetracycline: Even though Tetracyclines appear in low concentration in breast-milk, they tend to be deposited in bone, and they may interfere with the growth of bones. In addition, deposition in tooth buds may lead to permanent discoloration of teeth.

Gentamicin and other aminoglycosides: This group of antibiotics is only used in serious infections in hospital. They are given through the intravenous route. Only low concentrations appear in breast-milk. Moreover, absorption from the gut is poor.

For all these reasons, they are considered safe with breast-feeding. However, they may cause diarrhea in the baby, which is very rarely serious.

Chloramphenicol: Even though it appears in low concentration in breast-milk, it still has a potential of causing bone-marrow suppression in the baby. Moreover, in most cases there are safer alternatives. The general counsel is to avoid if breast-feeding.

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 and breast-feeding

Aciclovir (Zovirax) is used mainly for fever blisters (cold sores) and genital herpes. 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 antiviral drugs which carry a similar advice with breast-feeding include Famciclovir (Famvir®) and Valaciclovir (Valtrex®).

Antimalarial medication and breast-feeding

If you live or are travelling to a tropical country where malaria is endemic, chloroquine is safe to use if breast-feeding. So is Proguanil (Malarone®), another common antimalarial.

Using Mefloquine for prophylaxis while breast-feeding

Mefloquine is used chiefly to protect against acquiring malaria. It is mainly a short term measure for those traveling to areas endemic with the disease.

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 Mefloquine if breast-feeding. Mefloquine, which is a synthetic analogue of the old anti-malarial warhorse quinine, is available under the brand name Lariam®.

Teeth discoloration caused by tetracycline is permanent