Nystatin and Breastfeeding

Summary of use during lactation

Although no information exists on the milk excretion of nystatin, it is virtually unabsorbed orally, therefore most reviewers and clinicians consider it acceptable for use in nursing mothers, including topical application to the nipples.[1-3] Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[4] Any excess cream should be removed from the nipples before nursing. Nystatin is less effective than other topical agents for the treatment of thrush.[5,6]

Drug levels in milk and infant serum

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

Alternative drugs to consider

(Systemic) Amphotericin B, Fluconazole; (Topical) Clotrimazole, Miconazole

References

1. Mactal-HaafC HoffmanM KuchtaA Use of anti-infective agents during lactation, Part 3: Antivirals, antifungals, and urinary antiseptics. J Hum Lact 2001 17 160 6 11847833 PubMed
2. IlettKF KristensenJH Drug use and breastfeeding. Expert Opin Drug Saf 2005 4 745 68 16011452 PubMed
3. BrentNB Thrush in the breastfeeding dyad: Results of a survey on diagnosis and treatment. Clin Pediatr (Phila) 2001 40 503 6 11583049 PubMed
4. NotiA GrobK BiedermannM Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol 2003 38 317 25 14623482 PubMed
5. HugginsKE BillonSF Twenty cases of persistent sore nipples: Collaboration between lactation consultant and dermatologist. J Hum Lact 1993 9 155 60 8260031 PubMed
6. HoppeJE HahnH Randomized comparison of two nystatin oral gels with miconazole oral gel for treatment of oral thrush in infants. Antimycotics Study Group. Infection 1996 24 136 9 8740106 PubMed