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I have a question for a nursing mom who is nursing 3x/day. She was recently prescribed minocycline ER 65mg daily. Given the limited number of feedings and age of the infant, would she be OK to continue nursing? It is for severe acne scarring and so she is hoping to be able to use this if it is OK as topical creams have not worked. Thank you!
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Dear JenL,
Minocycline is a broad-spectrum tetracycline antibiotic with significant side effects in pediatric patients, including dental staining and reduced bone growth. Although most tetracyclines secreted into milk are generally bound to calcium, thus inhibiting their absorption, minocycline is poorly bound and may be better absorbed in a breastfeeding infant than the older tetracyclines. Approximately 4.2% of the maternal dose would possibly transfer to the infant via milk. Most of this would be unabsorbed orally by the infant. The half-life is long at 15 to 20 hours. Due to the risk of dental staining, and epiphyseal problems with tetracyclines in infants and children, prolonged use ( more than 3 weeks) of tetracyclines should be avoided. Since this child is older and getting limited amounts of breastmilk, the risk to the particular child would be minimal, but there is still a small risk of dental staining and bone issues if used longer than 3 weeks.
Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center
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