- Wet combing or dimeticone may be used to treat head lice in breastfeeding mothers. Malathion may be used as an alternative if a traditional insecticide is required in the case of treatment failure.
- No studies on the passage of any of the parasiticidal agents used to treat head lice into human breast milk following topical application have been located.
- Wet combing has achieved cure rates of up to 57% after 14 days. It is very time consuming, but may be preferred by people wishing to avoid using chemicals.
- Dimeticone has a physical action, coating the lice and disrupting their ability to manage water. There is very little or no absorption of dimeticone through the skin.
- Absorption of malathion through the skin is low, which one study showed was insufficient to have any systemic effect.
- Theoretical considerations would indicate that the amount of malathion passing into milk after topical application would be too low to present a hazard to the breastfeeding infant.
- Other preparations (isopropyl myristate/cyclomethicone or isopropyl myristate/isopropyl alcohol) are not contra-indicated during breastfeeding, but use should be with caution and only after other treatment options have failed.
Acting Co-Director, West Midlands Medicines Information Service & UK Drugs in Lactation Advisory Service