Fluorescein and Breastfeeding

Summary of use during lactation

Because absorption from the eye is limited, fluorescein would not be expected to cause any adverse effects in breastfed infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue. After intravenous use in a nursing mother, milk levels and the dose received by the infant are much higher than with ophthalmic use. It is unlikely that these higher levels are problematic for most infants, but exposure to intense light, such as phototherapy, should probably be avoided for a few days after the maternal dose.

Drug levels in milk and infant serum

Maternal Levels. A woman received 5 mL of 10% fluorescein (500 mg) injection shortly after delivering a set of twins. Milk samples were obtained periodically by manual expression for 76 hours after the dose. The highest concentration of 372 mcg/L was obtained in the first sample 6 hours after the dose. By 76 hours after the dose, the milk fluorescein concentration was 170 mcg/L. The half-life of fluorescein in milk was 62 hours.[1] A mother nursing a 3-month-old infant had 2% fluorescein drops applied into each eye. Blood and milk samples were taken 3 times at 30-minute intervals after the dose. Milk levels at these times were 20, 22 and 15 mcg/L, respectively.[2] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

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

Effects on lactation and breastmilk

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

References

1. Maguire AM, Bennett J. Fluorescein elimination in human breast milk. Arch Ophthalmol 1988;106:718-9.3369981 PubMed
2. Mattern J, Mayer PR. Excretion of fluorescein into breast milk. Am J Ophthalmol 1990;109:598-9.2333925 PubMed