Last update: July 2, 2015

Chlorhexidine

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Iodine-free disinfectant which is widely use for skin, mouth, and, obstetric disinfection. It is preferred over iodine-based disinfectants in order to avoid high iodine exposure to the child in the neonatal and breastfeeding period that would pose a higher risk for thyroid dysfunction.

Because of pharmacokinetic data (high molecular weight, high capacity for serum protein-binding and poor oral or gut absorption) significant excretion into breast milk is unlikely.

Used for obstetrical purposes (vaginal or C-section wounds) even during birth or in the puerperal period, has failed to cause harm neither to the newborn nor the breastfed child.

Although use in the nipple may not cause troubles to the breastfed infant (except one reported case in 1989) it is not considered to be a justified practice for prevention of mastitis. Any way, it is preferred to avoid use on the nipple, at least on a long-term basis. If used, wash the nipple thoroughly before nursing.

List of Essential Medicines by WHO 2002: compatible with breastfeeding.

Alternatives

We do not have alternatives for Chlorhexidine since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Chlorhexidine in other languages or writings:

Group

Chlorhexidine belongs to this group or family:

Tradenames

Main tradenames from several countries containing Chlorhexidine in its composition:

Pharmacokinetics

Variable Value Unit
Bioavailability < 5 %
Molecular weight 505 daltons
Protein Binding 87 %
Tmax 0,5 hours
T1/2 4 hours

References

  1. Vieira F, Bachion MM, Mota DD, Munari DB. A systematic review of the interventions for nipple trauma in breastfeeding mothers. J Nurs Scholarsh. 2013 Abstract
  2. Pereira L, Chipato T, Mashu A, Mushangwe V, Rusakaniko S, Bangdiwala SI, Chidede OS, Darmstadt GL, Gwanzura L, Kandawasvika G, Madzime S, Lumbiganon P, Tolosa JE. Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine. Int J Gynaecol Obstet. 2011 Abstract
  3. Hirata K, Kurokawa A. Chlorhexidine gluconate ingestion resulting in fatal respiratory distress syndrome. Vet Hum Toxicol. 2002 Abstract
  4. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  5. Arena Ansotegui J, Emparanza Knörr JI, San Millán Vege MJ, Garrido Chércoles A, Eguileor Gurtubai I. [Iodine overload in newborn infants caused by the use of PVP-iodine for perineal preparation of the mother in vaginal delivery]. An Esp Pediatr. 1989 Abstract
  6. Quinn MW, Bini RM. Bradycardia associated with chlorhexidine spray. Arch Dis Child. 1989 Abstract Full text (link to original source) Full text (in our servers)
  7. Nilsson G, Larsson L, Christensen KK, Christensen P, Dykes AK. Chlorhexidine for prevention of neonatal colonization with group B streptococci. V. Chlorhexidine concentrations in blood following vaginal washing during delivery. Eur J Obstet Gynecol Reprod Biol. 1989 Abstract
  8. Mucklow ES. Accidental feeding of a dilute antiseptic solution (chlorhexidine 0.05% with cetrimide 1%) to five babies. Hum Toxicol. 1988 Abstract
  9. Herd B, Feeney JG. Two aerosol sprays in nipple trauma. Practitioner. 1986 Abstract

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