Is Chloramphenicol safe while breastfeeding?

Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Chloramphenicol. This is a summary of that source — not our own verdict.

Effects on the breastfed infant

One study reported 50 breastfed infants whose mothers were give oral chloramphenicol beginning 2 to 12 days postpartum in dosages of 1 (n = 20), 2 (n = 20)or 3 grams (n = 10) daily. All of the infants refused to suck, and 50 to 60% fell asleep during nursing. Vomiting occurred after feeding in 10%, 25%, and 90% of infants with daily maternal dosages of 1, 2 and 3 grams, respectively. All infants had excessive intestinal gas and abdominal distention, with severe problems in 0.5%, 20% and 100% of infants with daily maternal dosages of 1, 2 and 3 grams, respectively.[ 4 ]

Effects on milk supply

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

Levels in milk

Maternal Levels. Milk concentrations reported vary somewhat apparently due to the use of older assay techniques in early studies.[ 1 - 3 ] Peak milk levels in 10 breastfeeding women were 1.7 to 2.8 mg/L during therapy with 250 mg orally 4 times daily and 3.6 to 6.1 mg/L during therapy with 500 mg orally 4 times daily.[ 1 ] Four women were given a single dose of chloramphenicol 500 mg orally. The average peak milk concentration of 3.24 mg/L (range 2.5 to 4.5 mg/L) occurred 2 hours after the dose. By 8 hours after the dose, the milk concentration averaged 0.31 mg/L. In 5 other women given chloramphenicol 500 mg 3 times daily by mouth at 7-hour intervals for 2 days, breastmilk chloramphenicol levels were 1.72 and 0.66 mg/L at 24 and 48 hours after the first dose. The average half-life in milk was 1.77 hours.[ 2 ] After a single oral dose of 500 mg of chloramphenicol in 2 women, the drug was first measurable in milk in a concentration of 3.3 mg/L 2 hours after the dose. At 4 and 6 hours after the dose, milk concentrations averaged 4.1 mg/L at both times.[ 3 ] Infant Levels. Relevant published information was not found as of the revision date.

Source: NIH LactMed (National Library of Medicine).

Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.