Last update: Aug. 22, 2019
Minimal risk for breastfeeding and infant.
Aminoglycoside antibiotic used topically in creams, eye drops, ear drops and orally as an intestinal disinfectant.
Since the last update we have not found any published data on its excretion in breast milk.
The small dose and the low plasma absorption of most topical nasal, ophthalmological, otological and dermatological preparations make the transfer to breastmilk in significant amounts unlikely (Leachman 2006, Niebyl 1992).
Neomycin, like all other aminoglycosides, has very low oral bioavailability (Briggs 2017, Chin 2001, Fulton 1992), which impedes transfer from breastmilk to infant plasma, except in premature infants and the immediate neonatal period when there may be greater intestinal permeability.
It is advisable to avoid the application to the nipple of creams, gels and other topical products containing paraffin (mineral oil) so that the infant does not absorb them (Concin 2008, Noti 2003)
In case of use of Neomycin on the nipple, let it be done after the feed and wipe it out any excess of cream before the next feed.
It is important to take into account possible false negative cultures in febrile infants whose mothers take antibiotics, as well as the possibility of gastroenteritis due to altered intestinal flora (Arbex 2010, Ito 1993).
List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).
We do not have alternatives for Neomycin 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.
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