Last update June 10, 2022
Very Low Risk
Aminoglycoside antibacterial with bactericidal action against aerobic gram-negative germs and some strains of staphylococci. It is poorly absorbed from the gastrointestinal tract. Indicated in serious infections, usually with another antibiotic. Administered intravenously or intramuscularly in one or two daily doses. It is also used topically, cutaneously, ophthalmologically or otologically.
It is excreted in breastmilk in insignificant amount. (Celiloglu 1994, Boda 1990, Ito 1970)
Plasma levels of infants of mothers treated with gentamicin were undetectable (Ito 1970) or very low (Celiloglu 1994), lower than the recommended trough level in the monitoring of gentamicin treatment.
No problems have been observed in infants of mothers treated with gentamicin, except for a case of bloody stools in a newborn whose mother was given clindamycin and gentamicin (Mann 1980) and a two-month-old infant who presented transient urticaria after the mother took amoxicillin-clavulanic and gentamicin to treat mastitis. (Cherif 2009)
Gentamicin, like all other aminoglycosides, has very low oral bioavailability (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. (Nelson 1972)
It is important to take into account the possibility of gastroenteritis due to altered intestinal flora. (Arbex 2010).
TOPICAL USE: The small dose and the low plasma absorption of topical nasal, ophthalmological, otological and dermatological preparations prevent its transfer to breastmilk in significant amounts.(Niebyl 1992)
Expert authors consider the use of this medication during breastfeeding to be safe (Hale 2019, Briggs 2015, Rowe 2013, Schaefer 2007, Nahum 2006, Mahadevan 2006). American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001). List of WHO essential medicines: compatible with breastfeeding. (WHO / UNICEF 2002)
We do not have alternatives for Gentamicin Sulfate since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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