Safety in Lactation: Tetracyclines

Laura Kearney, Regional Principal Medicines Information Pharmacist, Midlands and East Medicines Advice Service (Midlands site) & UK Drugs in Lactation Advisory ServicePublished

If other antibiotics are not appropriate, tetracycline is the preferred drug from this group.
Short term use (less than 3 weeks duration) is acceptable for most tetracyclines. Long term use (e.g. in acne) is not advisable.
Concerns regarding bone deposition of tetracyclines and possible staining of infant’s dental enamel have not been confirmed, and are unlikely during short term use. Absorption by the infant is also inhibited by calcium in the breast milk.
Monitor infant for gastro-intestinal disturbances and oral candida infection, especially if used in high doses, although these effects are unlikely to occur, There is also a theoretical risk of hypersensitivity.
Choice of drug and alternatives may be directed by local antimicrobial policy.