Last update: Aug. 22, 2019

Neomycin

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Aminoglycoside antibiotic used topically in creams, eye drops, ear drops and orally as an intestinal disinfectant.

Since the last update we have not found any published data on its excretion in breast milk.

The small dose and the low plasma absorption of most topical nasal, ophthalmological, otological and dermatological preparations make the transfer to breastmilk in significant amounts unlikely (Leachman 2006, Niebyl 1992).

Neomycin, like all other aminoglycosides, has very low oral bioavailability (Briggs 2017, Chin 2001, Fulton 1992), which impedes transfer from breastmilk to infant plasma, except in premature infants and the immediate neonatal period when there may be greater intestinal permeability.

It is advisable to avoid the application to the nipple of creams, gels and other topical products containing paraffin (mineral oil) so that the infant does not absorb them (Concin 2008, Noti 2003)

In case of use of Neomycin on the nipple, let it be done after the feed and wipe it out any excess of cream before the next feed.

It is important to take into account possible false negative cultures in febrile infants whose mothers take antibiotics, as well as the possibility of gastroenteritis due to altered intestinal flora (Arbex 2010, Ito 1993).

List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).

Alternatives

We do not have alternatives for Neomycin since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Neomycin in other languages or writings:

Tradenames

Main tradenames from several countries containing Neomycin in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. < 3 %
Molecular weight 615 daltons
Protein Binding < 30 %
VD 0,36 l/Kg
pKa 12,3 -
Tmax 1 - 4 (oral) hours
T1/2 2 - 3 hours

References

  1. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. 11th edition (acces on line) 2017
  2. AEMPS. Oftalmowell. Ficha técnica. 2013 Full text (in our servers)
  3. Arbex MA, Varella Mde C, Siqueira HR, Mello FA. Antituberculosis drugs: drug interactions, adverse effects, and use in special situations. Part 2: second line drugs. J Bras Pneumol. 2010 Abstract Full text (link to original source) Full text (in our servers)
  4. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008 Abstract
  5. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006 Abstract
  6. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006 Abstract
  7. WHO Pharmaceuticals Newsletter. 2005 Full text (link to original source) Full text (in our servers)
  8. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003 Abstract
  9. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  10. Chin KG, McPherson CE 3rd, Hoffman M, Kuchta A, Mactal-Haaf C. Use of anti-infective agents during lactation: Part 2--Aminoglycosides, macrolides, quinolones, sulfonamides, trimethoprim, tetracyclines, chloramphenicol, clindamycin, and metronidazole. J Hum Lact. 2001 Feb;17(1):54-65. Abstract
  11. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract
  12. Niebyl JR. Use of antibiotics for ear, nose, and throat disorders in pregnancy and lactation. Am J Otolaryngol. 1992 Jul-Aug;13(4):187-92. Review. No abstract available. Abstract

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