Last update Aug. 28, 2021
Very Low Risk
Lincosamide antibacterial active against many gram-positive bacteria (staphylococci, streptococci, clostridium) and some anaerobes (Bacteroides fragilis) and parasites (plasmodium, toxoplasma).
Oral, intramuscular or intravenous administration in 3 to 4 daily doses. Topical cutaneous and vaginal administration.
It is excreted in breast milk in clinically insignificant amounts (van Wattum 2019, Zhang 1997, Matsuda 1984, Stéen 1982, Smith 1975) and no problems have been recorded in infants whose mothers were taking it, except occasional gastroenterocolitis due to alteration of the intestinal flora which clears a few days after treatment ends.
Clindamycin is used intravenously in the treatment of severe acute mastitis, without side effects in the infant (Maier 2021).
A single case (Mann 1980) of pseudomembranous colitis has been reported in an infant whose mother was taking clindamycin and gentamicin, although the infant was also receiving intravenous antibiotics.
The possibility of transient gastroenteritis due to altered intestinal flora in infants whose mothers take antibiotics should be taken into account (Ito 1993).
DERMATOLOGICAL AND VAGINAL USE:
The small dose and poor plasma absorption of most topical dermatological preparations make it unlikely that a significant amount will pass into breast milk.
Less than 8% of cutaneous clindamycin passes into plasma (van Hoogdalem 1998, Eller 1998, Barza 1982).
Do not apply on the breasts to prevent the infant from ingesting it; if necessary, apply after one feeding and clean well with water before the next.
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)
Less than 10% of vaginal clindamycin in cream form and less than 30% of clindamycin in ovule form passes into plasma (Borin 1999, 1995 y 1990).
Expert authors consider the use of this medication safe or probably safe during breastfeeding (Hale, van Wattum 2019, Saito 2018, Briggs 2015, Schaefer 2015, Butler 2014, Amir 2014 y 2011, Kong 2013, Mitrano 2009, Spencer 2008, Nahum 2006, Chin 2001).
American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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e-lactancia is a resource recommended by Asociación Española de Bancos de Leche Humana of Spain
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