Is Lindane safe while breastfeeding?

Effects on the breastfed infant

In a telephone follow-up study, 9 mothers used lindane topically for head lice during breastfeeding. One reported irritability in her breastfed infant.[ 8 ]

Effects on milk supply

Hexachlorocyclohexane appears to have some estrogenic activity which theoretically could suppress lactation.[ 6 ]

Levels in milk

Lindane (gamma-benzenehexachloride; gamma-Hexachlorocyclohexane) is a fat-soluble insecticide that is a persistent environmental contaminant. Residues from its use as a pesticide are found in food and subsequently in breastmilk, particularly the milkfat. Recent data from the United States are lacking, but levels appear to be trending downward in industrialized countries.[ 5 ] Hexachlorocyclohexane appears to have some estrogenic activity.[ 6 ] Maternal Levels. A German woman with a 2-month-old breastfed infant was treated with lindane 0.3% lotion (the product available in the United States contains 1%) for scabies. The lotion was left on for 24 hours, then washed off. The extent of application was not stated, but is usually applied to all skin from the neck down. A baseline lindane concentration in breastmilk was not obtained, but the average value of lindane in mothers' milk in Germany from pesticides in the food chain at the time of the study was 30 mcg/kg of milk fat. Milk from day 4 to 10 contained lindane in the range of 500 to 900 mcg/kg of milk fat. After another repeat application of lindane, lindane was found in aa concentration of 2000 mcg/kg on day 11. Additional measurements on days 18 and 26 were 600 mcg/kg and 400 mcg/kg, respectively.[ 7 ] Infant Levels. Relevant published information was not found as of the revision date.

Alternatives LactMed lists

• Ivermectin
• Permethrin
• Pyrethrins