Can you take antibiotics while breastfeeding? What you need to know

A photo of a mom breastfeeding a baby, representing the question 'Can you take antibiotics while breastfeeding?'
  • Updated Feb 14, 2025
  • Published

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Created with Natasha Lowe Osho, MD, Obstetrician-Gynecologist, USA

In this article
In a nutshell
  • Most antibiotics are considered safe to take while breastfeeding, however, they should always be taken under medical guidance.
  • Certain antibiotics should be avoided if you have a newborn, premature, or sick baby. Tell your healthcare provider that you’re breastfeeding before you start taking any medication.
  • Some antibiotics can cause mild side effects in your baby; monitor them for signs of fussiness, rash, diarrhea, or breathing difficulties, and reach out to your healthcare provider right away if you have any concerns.

There is no good time to get sick when you’re a parent, but when you’re breastfeeding, getting sick and needing to take medication can feel especially stressful. 

If your healthcare provider suspects a bacterial infection, they may prescribe you antibiotics to help your body fight the infection and prevent you from getting more unwell. While taking prescribed antibiotics is important for your health, it’s normal to wonder how they might affect you, your baby, and your breastfeeding journey. 

In this article, we will guide you through everything you need to know about taking antibiotics while breastfeeding, from which ones are considered safe to which should be avoided, and what signs you should watch out for.

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Are antibiotics safe while breastfeeding?

In general, most antibiotics are considered safe to take while breastfeeding, but there are a few things you should know before starting them. 

According to the Mayo Clinic, almost any drug that is present in the mother’s bloodstream will transfer into the breast milk to some extent. However, most antibiotics are only present in breast milk at very low concentrations and don’t pose a significant risk to your baby. This means it’s usually safe for mothers to continue to breastfeed while taking antibiotics. However, in certain situations, the risks and benefits of taking antibiotics while breastfeeding need closer consideration. 

Here are some general guidelines on what to consider when taking antibiotics while breastfeeding:

  • Baby’s age. Risks from medications in breast milk are higher in premature and newborn babies as their bodies are less able to process and clear the medication. The risk is lowest in babies over 6 months. 
  • Baby’s health. If your baby has a health condition affecting its liver or kidneys, or if they had significant jaundice at birth, then your healthcare provider will likely avoid certain antibiotics or recommend temporarily stopping breastfeeding. 
  • Class of antibiotics. Most antibiotics are considered safe to take while breastfeeding, however, there are a few classes of antibiotics where more caution is advised. 
  • How long and how strong. The American Academy of Pediatrics (AAP) advises that you should take the lowest dose for the shortest time possible when taking any medication while breastfeeding.

👉Find out more: Newborn cues: Decoding your baby’s body language

Good to know
In general, if the antibiotic in question can be prescribed to infants then it’s likely safe for you to take while breastfeeding. But, you should always tell your healthcare provider you’re breastfeeding before starting any new medication and check with your baby’s pediatrician that they don’t have any concerns.

Common antibiotics safe for breastfeeding

Your healthcare provider will judge which antibiotic is safe to take while breastfeeding on a case-by-case basis. That said, many of the most commonly prescribed antibiotics are considered safe for most breastfeeding women to take including:

  • Penicillins (e.g. amoxicillin, flucloxacillin, co-amoxiclav)
  • Cephalosporins (e.g. cephalexin, cefaclor)
  • Macrolides (e.g. clarithromycin, azithromycin, erythromycin)
  • Vancomycin

Antibiotics to avoid while breastfeeding

While most antibiotics are considered safe to take while breastfeeding, there are some that are better avoided where possible. These include:

  • Tetracycline: Small amounts are excreted in breast milk and there is a theoretical concern they can affect bone growth and cause tooth discoloration in babies. However, both the American National Institute of Health (NIH) and the British National Health Service (NHS) agree that short-term use is safe.  
  • Co-trimoxazole or trimethoprim: These should be avoided during the newborn period, in premature, ill, or stressed infants, or with infants diagnosed with G6PD deficiency. This is to prevent the risk of hemolysis (destruction of red blood cells causing anemia) and kernicterus (a severe complication of newborn jaundice).
  • Nitrofurantoin: Should be avoided during the newborn period or with infants with G6PD deficiency to prevent the risk of hemolysis. 
  • Chloramphenicol: Oral or intravenous (through a drip) chloramphenicol should be avoided while breastfeeding as it’s potentially toxic to babies.

If no alternative antibiotic can be used, then talk to your healthcare provider about the best way to manage breastfeeding during this time. They may suggest temporarily stopping breastfeeding while pumping to maintain your supply or suggest breastfeeding at certain times of the day when the medication is at its lowest level in your breast milk.

Can antibiotics reduce milk supply?

Antibiotics don’t typically alter your breast milk supply, however being ill in general can have a big impact. Having a fever, not being able to eat or drink as much as usual, and being dehydrated can all affect your milk supply and disrupt how much milk your baby is getting. Also, some antibiotics like metronidazole, have been reported to make breast milk taste bitter, which could temporarily put your baby off. 

Here are some tips to help you maintain a healthy milk supply while ill:

  1. Stay hydrated: Drink plenty of fluids to prevent dehydration.
  2. Nurse or pump frequently: Breastfeed or pump frequently to help maintain your supply and prevent engorgement.
  3. Eat a balanced diet: Make sure you’re eating a healthy and nutritious breastfeeding diet that adequately supports your breastfeeding journey. Breastfeeding moms generally need around 340–400 more calories a day than what they consumed before pregnancy. 
  4. Rest as much as possible: We know it can be hard to get decent rest when you’ve got a baby, but now is the time to prioritize yourself. Tiredness can affect your milk supply and rest is crucial in helping you to recover from illness.
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Side effects in babies from antibiotics in breast milk

Rarely, the tiny amount of antibiotic present in your breast milk can cause side effects in your baby. Sometimes these side effects are caused by the antibiotic disrupting their gut flora, but very rarely it can be due to an allergic reaction to the antibiotic. If you notice any of the following signs then reach out to your healthcare provider immediately:

  • Diarrhea
  • Thrush 
  • Generally fussy or more upset
  • Increased sleepiness
  • Vomiting
  • Rash
  • Breathing difficulties
  • Lip swelling

👉Find out more: Signs of ovulation after giving birth: What new moms need to know

What to do if you need antibiotics while breastfeeding

If you’re breastfeeding and need antibiotics then it’s normal to have some concerns about taking them. Here are six steps you can take to keep you and your baby safe:

  1. Tell your healthcare provider you’re breastfeeding. Make sure they’re aware that you’re breastfeeding, how old your baby is, and any other important medical information about your baby that they need to know.
  2. Talk to your baby’s pediatrician. Let your baby’s healthcare provider know what medication you’re starting to make sure they don’t have any concerns.  
  3. Ask about alternatives. Some antibiotics are considered safer than others; ask your healthcare provider if one of these would be suitable for you.
  4. Discuss timing. Sometimes you can time taking your antibiotic around breastfeeding to reduce the amount of antibiotic your baby is exposed to.
  5. Monitor your baby. Watch for any changes in your baby’s behavior like increased fussiness, diarrhea, or a rash.
  6. Reach out for help. If you have any concerns about how you’re feeling or about your baby, reach out to your healthcare provider for help and assurance. 

Questions from the Femia community

  • Can I take antibiotics for a UTI while breastfeeding?

    Yes, many antibiotics prescribed for UTIs, such as cephalexin, are safe for breastfeeding. Always make sure your healthcare provider knows you’re breastfeeding before you start taking any medications, as this may impact which one they prescribe.

  • Should I pump and dump while taking antibiotics?

    In most cases, you do not need to pump and dump, as many antibiotics are considered safe while breastfeeding. In general, if the antibiotic you’re taking can be prescribed to an infant, then it’s ok for you to take it and carry on breastfeeding. But, you should always check with your healthcare provider first.

  • Can antibiotics change the taste of breast milk?

    Some antibiotics, such as metronidazole, can slightly alter the taste of breast milk. This temporary change in breast milk taste is usually not a problem for most babies.

  • What if my baby has an allergic reaction to antibiotics in my milk?

    If your baby shows signs of an allergic reaction (increased fussiness, sleepiness, rash, swelling, or difficulty breathing), stop breastfeeding and seek medical attention immediately.

  • Are probiotics helpful while taking antibiotics during breastfeeding?

    Yes, taking probiotics can help protect your natural gut flora and prevent digestive issues in both mom and baby while on antibiotics. However, you should talk to your baby’s pediatrician before starting to give them any probiotics.

The bottom line

Most antibiotics are considered safe to take while breastfeeding. Although small amounts may pass into breast milk, the levels are typically too low to pose any threat to your baby. However, you should always inform your healthcare provider that you’re breastfeeding; some antibiotics are considered safer than others and knowing this may help guide their choice of antibiotic.

Occasionally, antibiotics may cause mild side effects in your baby, usually due to a temporary disruption of their gut flora. These typically resolve once you’ve completed the antibiotic course although probiotics can help. However, very rarely, they can indicate a more serious reaction. Monitoring your baby for any changes in behavior and reaching out for help if you have any concerns can help ensure both of you stay safe. 

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