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Sulfameth/Trimeth while breastfeeding

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  • Sulfameth/Trimeth while breastfeeding

    I’ve been put on the antibiotic sulfameth/trimeth for mastitis. Is it safe? My daughter is just shy of two months old (born 7/25/23 at 37 weeks 4 days). She was borderline jaundice but didn’t need lights/treatment. My OB was unable to see me Friday and sent me to urgent care who prescribed sulfameth. I called our pediatrician to double check safety and they said it was fine and baby would “maybe see 5% of it in breastmilk.” So I took one pill and hadn’t nursed yet when lactation called back saying it’s probably fine but may want to have my OB prescribed something different since it’s “L3” and there are other meds that are “L2.” OB is closed all weekend but I put a call in anyway and still waiting to hear back. I’ve now taken a second pill as it must be taken every 12 hours. So for now we’re feeding her frozen milk I had stashed, but can I nurse her? Especially she’s getting her two month shots Monday I know nursing would help her feel better. Thanks.

  • #2
    Hi SAMom, I know this is too late for you, but I'm hoping we'll help someone else.

    When people say that they "maybe see 5% of it in breastmilk," they are generally referring to a relative infant dose--this means that the baby would be exposed to about 5% of an infant-sized dose if they are fully breastfed. The reason this drug is an L3 rather than L2 is due to some risk for hyperbilirubinemia, babies with G6PD deficiency, and/or problems with folate metabolism. Generally, the risk is for infants in their first few weeks if they have elevated bilirubin levels (which your pediatrician would be monitoring). Overall, "L3" means a medication is probably compatible with breastfeeding. If you have mastitis and have been prescribed antibiotics by your healthcare provider, please take your medication!

    Dr. Krutsch