Last update Jan. 29, 2022
Very Low Risk
Mixture of 5 parts of Sulfamethoxazole and 1 part of Trimethoprim. Oral administration in two daily doses.
TRIMETHOPRIM (TMP) is excreted in breast milk in clinically non-significant amount (Borderon 1975, Miller 1974 y 1973, Arnauld 1972). No problems have been observed in infants whose mothers were treated (Ito 1993). Medication which is used in infants from the second month of age.
SULFAMETHOXAZOLE (SMX) is excreted in non-significant levels into breast milk (Miller 1974 y 1973). No adverse effects have been shown in breastfed infants (Ito 1993). Caution with those neonates suffering of hyperbilirrubinemia or Glucose-6-phosphate dehydrogenase (G6PD) deficiency is required. Avoid use in affected patients Check-up for infant jaundice.
Although rare, the possibility of transient gastroenteritis due to alteration of the intestinal flora in infants whose mothers take antibacterial should be taken into account.(Ito 1993)
Expert authors consider the use of TMP-SMX to be compatible during breastfeeding. (Hale, LactMed, Schaefer2015, Mitrano 2009, Kaiser 2007, Chin 2001)
The American Academy of Pediatric states that TMP-SMX is usually compatible with breastfeeding medication. (AAP 2001)
WHO List of Essential Medicines from 2002 has classified TMP as compatible with breastfeeding and SMX as compatible with breastfeeding for older, healthy full- term infants. Avoid if possible if the infant is premature or less than 1 month old. Monitor the infant for side- effects (haemolysis and jaundice). Avoid in infant with G6PD deficiency. (OMS-UNICEF 2002)
We do not have alternatives for Trimethoprim-Sulfamethoxazole (TMP-SMX; TMP-SMZ) since it is relatively safe.
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
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM