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Thread: Clindamyicin

  1. #1
    Join Date
    Nov 2009

    Default Clindamyicin

    I'm taking Clindamyicin for a bacterial infection. My midwife says it's fine for breastfeeding, but the second day of taking it, and my DD has had 5 BMs. Normally she only has one a day. They've also been green. Is that diarreha?

    Should I start pumping and dumping? I've got a big freezer stash so it's not a problem, I just hate to lose all that milk. but I don't want her to be sick. Has anyone else had this problem with antibiotics before?

  2. #2
    Join Date
    Jul 2008

    Default Re: Clindamyicin

    This is the info from LactMed. Is there maybe an alternate abx they can put you on?

    CASRN: 18323-44-9

    For other data, click on the Table of Contents

    Drug Levels and Effects:

    Summary of Use during Lactation:
    Clindamycin has the potential to cause adverse effects on the breastfed infant's gastrointestinal flora. If oral or intravenous clindamycin is required by a nursing mother, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis.

    Vaginal application is unlikely to cause infant side effects, although about 30% of a vaginal dose is absorbed. Infant side effects are unlikely with topical administration for acne, however topical application to the nipple may increase the risk of diarrhea in the infant.

    Drug Levels:
    Maternal Levels. Two women were give clindamycin 150 mg orally. Breastmilk levels of clindamycin averaged 1.3 mg/L 4 hours after the dose.[1]

    Two women were treated with clindamycin 600 mg intravenously every 6 hours followed by 300 mg orally every 6 hours. Peak milk levels after the intravenous dose were 2.65 mg/L at 3.5 hours after the dose in one and 3.1 mg/L at 30 minutes after the dose in the other. During the oral regimen, peak milk levels were 1.3 mg/L at 3.5 hours after the dose in the first woman and 1.8 mg/L at 2 hours after the dose in the other.[2]

    Five women were given oral clindamycin 150 mg three times daily during the first 2 weeks postpartum. Milk levels were measured after at least 1 week of therapy and averaged 1.2 mg/L (range <0.5 mg/L to 3.1 mg/L) 6 hours after the dose.[3]

    After a single oral dose of 150 mg of clindamycin in 2 women, milk levels averaged from 0.3 to 1.2 mg/L between 1 and 6 hours after the dose. The peak occurred at 2 hours after the dose in one woman and 4 hours after the dose in the other.[4]

    After a single dose of 600 mg of clindamycin intravenously to 15 women who were 1 month postpartum, milk clindamycin levels averaged 1.03 mg/L 2 hours after the dose.[5]

    In summary, the amounts in milk represent an infant dosage of about 1 to 2.5% of the maternal weight-adjusted dosage.[2][3][5]

    Infant Levels. Relevant published information was not found as of the revision date.

    Effects in Breastfed Infants:
    Bloody stools in a 5-day-old breastfed infant were possibly caused by concurrent maternal clindamycin 600 mg intravenously every 6 hours and gentamicin 80 mg intravenously every 8 hours. The infant's stools were reported to have normal flora and the stools became guaiac negative 24 hours after discontinuation of breastfeeding. On day 6 of age, the infant resumed breastfeeding after discontinuation of maternal antibiotics with no further difficulties.[6]

    Possible Effects on Lactation:
    Relevant published information was not found as of the revision date.

    AAP Category:
    Usually compatible with breastfeeding.[7]

    Alternate Drugs to Consider:
    (Systemic infections) Amoxicillin and Clavulanic Acid, Doxycycline, Erythromycin, (Skin infections) Bacitracin, Mupirocin, (Acne) Azelaic Acid, Benzoyl Peroxide, Erythromycin, Tretinoin
    I'm Hillary
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    Born at 32 weeks-3lbs/10oz
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  3. #3
    Join Date
    Nov 2009

    Default Re: Clindamyicin

    Her father has been bottlefeeding her from the freezer stash. My midwife says the only alternative for my particular problem is a harsher drug that's not at all compatible.

    Baby feeling better today, so I'm loading on probiotics and trying again with breastfeeding to see if she gets sick again. The next recommendation if it comes back is to pump and dump and feed from the freezer. Luckily I've got a milk stash, I just hate to feed her from bottles for the next four days, because I'm trying to get her off a nipple shield anyway, and a week of bottles probably won't help that.

    Thanks for the info.

  4. #4
    Join Date
    May 2006

    Default Re: Clindamyicin

    Because you're trying to get your baby off the shield, I would consider nursing her 1-2 times per day even while you're taking the Clindamycin. That way she only gets a small amount of antibiotic from your milk, but hopefully she won't forget how to nurse or wind up with an unshakable preference for the bottle.

    Hope you're feeling better soon!

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