Impetigo during breastfeeding
Topical fusidic acid, hydrogen peroxide or mupirocin can all be used during breastfeeding.
- is limited or no published evidence of use of these topical medicines during breastfeeding
- there is limited systemic absorption and therefore negligible levels are expected in breast milk
If systematic antibiotics are required then flucloxacillin is safe in breastfeeding (2):
- if penicillin allergic then all macrolide antibiotics can be used during breastfeeding with precautionary infant monitoring (3)
Clinical considerations
- care should be taken to avoid direct contact between the infant and impetigo lesion(s) and treated area.
- if lesions are on the breast or close to the nipple, it may not be possible to feed from that breast, although this would need thorough assessment
- infant feeding support should also be sought in order to effectively maintain milk supply.
- hands should be washed after applying topical preparations and before touching the infant.
Reference:
- NHS Specialist Pharmacy Service (March 21st 2024). Treating impetigo topically during breastfeeding
- NHS Specialist Pharmacy Service (February 16th 2024). Using penicillin antibiotics during breastfeeding
- NHS Specialist Pharmacy Service (March 21st 2024). Using macrolide antibiotics during breastfeeding