Summary of Use during Lactation

Although no information exists on the excretion of neomycin into milk, other aminoglycoside antibiotics are poorly excreted into breastmilk. Newborn infants apparently absorb small amounts of aminoglycosides, but serum levels are far below those attained when treating newborn infections and systemic effects of neomycin are unlikely. Older infants would be expected to absorb even less neomycin. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (e.g., thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis.

Oral, topical, ophthalmic or otic neomycin should result in very low levels in breastmilk and present negligible risk to the infant,[1,2] although topical application to the nipple may increase the risk of diarrhea in the infant. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[3]

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

Alternate Drugs to Consider

(Injection) Gentamicin, Kanamycin, Tobramycin; (Topical) Bacitracin, Clindamycin, Mupirocin, Polymyxin B

References

1.

Niebyl JR. Use of antibiotic of ear, nose, and throat disorders in pregnancy and lactation. Am J Otolaryngol 1992;13:187-92 [PubMed: 1503194]

2.

Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin 2006;24:167-97 [PubMed: 16677965]

3.

Noti A, Grob K, Biedermann M, et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol 2003;38:317-25 [PubMed: 14623482]

Substance Name

Neomycin

CAS Registry Number

1404-04-2

Drug Class

Breast Feeding

Lactation

Milk, Human

Anti-Infective Agents

Antibacterial Agents

Aminoglycosides

Dermatologic Agents