Bismuth Subsalicylate and Breastfeeding

Summary of use during lactation

Because of the possibility of absorption of salicylate from the breastmilk by the infant, alternate therapies are preferred.[1]

Drug levels in milk and infant serum

Maternal Levels. No published information was found on the use of bismuth subsalicylate during breastfeeding. Infant salicylate intake is estimated to be less than 1% of the maternal dose when both drug and metabolite are considered.[2] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

One case report of metabolic acidosis was caused by salicylate in a 16-day old breastfed infant whose mother was taking aspirin 650 mg every 4 hours for arthritis.[3] However, there was no measurement of salicylate in maternal serum or milk and it is unclear whether the infant had received any salicylate directly.

Effects on lactation and breastmilk

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

Alternative drugs to consider

(Diarrhea) Loperamide; (Heartburn) Antacids, Famotidine, Nizatidine, Omeprazole, Pantoprazole

References

1. Lewis JH, Weingold AB and the Committee of FDA-Related Matters American College of Gastroenterology. The use of gastrointestinal drugs during pregnancy and lactation. Am J Gastroenterol 1985;80:912-23.2864852 PubMed
2. Levy G. Salicylate pharmacokinetics in the human neonate. In: Morselli P, Garattini S, Sereni F, eds. Basic and therapeutic aspects of perinatal pharmacology. New York: Raven Press; 1975:319-30.
3. Clark JH, Wilson WG. A 16-day-old breast-fed infant with metabolic acidosis caused by salicylate. Clin Pediatr (Phila) 1981;20:53-4.7449246 PubMed