Last update July 22, 2022
Very Low Risk
It is a broad-spectrum azole antifungal. It is used to treat fungal infections (candidiasis, dermatophytosis, pityriasis versicolor) of the vagina, oropharynx, intestine, and skin. Topical application.
Since the last update we have not found published data on its excretion in breastmilk.
Excretion into breast milk is highly unlikely due to an almost nil systemic absorption through the skin, vaginal mucosa and even the intestine, with non-significant plasma levels (< 1 mcg/ mL) observed. (Chen 2010, Eichenfield 2007, Cardot 2004, Mactal 2001, Dhondt 1992, Daneshmend 1986)
Miconazole has not been found to be more effective than pure lanolin for treatment of sore or cracked nipples. (Dennis 2012)
In case of use on the nipple, let it be done after the feed and wipe it out any excess of cream before the next feed. A 17-day-old female infant with thrush was almost asphyxiated by miconazole oral gel that had been applied to the nipples of her mother's breasts. The infant recovered after her mother had removed the gel from her mouth. (de Vries 2004)
Creams, gels or similar products that contain paraffin or mineral oil should not be used on the nipple to avoid absorption by the infant. (Concin 2008, Noti 2003)
Several medical societies and expert authors consider the use of this medication to be safe or very probably safe during breastfeeding (Hale, Briggs 2015, Schaefer 2015, Amir 2011, Chen 2010, Leachman 2006) . List of Essential Medicines by WHO 2002: compatible with breastfeeding. (WHO 2002)
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 Academy of Breastfeeding Medicine - 2015 of United States of America
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