Fluconazole and Breastfeeding: Essential Insights

When navigating the terrain of breastfeeding, many mothers ponder the safety of fluconazole, a stalwart medication against yeast and fungal infections. The Drugs and Lactation Database (LactMed) reassures that fluconazole's presence in breast milk is minimal compared to the dosage prescribed to neonates, making it a viable option for nursing mothers.

Consultation with a healthcare provider is paramount before any medication intake during breastfeeding. This professional can balance the benefits and risks of fluconazole use and guide towards a well-informed decision. Following the healthcare provider's advice and adhering to the prescribed medication is key to ensuring safety for both mother and baby.

Fluconazole: Understanding Its Role

As an antifungal agent, fluconazole, commonly known as Diflucan®, is administered orally, through injection, or intravenously. It's primarily used to combat yeast and fungal infections, including vaginal yeast infections and systemic fungal afflictions.

In breastfeeding scenarios, fluconazole is typically deemed safe. Its transmission through breast milk is minimal compared to the direct infant dosage for infection treatment. Breast candidiasis in nursing mothers is often tackled with fluconazole, endorsed by the Academy of Breastfeeding Medicine.

Fluconazole and Breastfeeding: A Closer Look

As a treatment for fungal infections, fluconazole's suitability for nursing mothers hinges on its minimal excretion into breast milk, as evidenced in several studies. However, it is critical to weigh the benefits against any potential risks, especially in infants under six weeks, due to the extended half-life of the drug.

Potential Risks and Side Effects

Although considered safe, fluconazole can cause stomach upset, breast pain, nipple dermatitis, and in rare cases, toxicity when taken in high doses or for prolonged periods. The balance of benefits and risks is essential, and healthcare provider consultation is imperative before starting treatment.

Fluconazole During Pregnancy: A Delicate Balance

In pregnancy, fluconazole, classified as Pregnancy Category C by the FDA, demands cautious use due to limited human data. While untreated fungal infections pose risks, the decision to use fluconazole during pregnancy should be made after careful consideration of the benefits and risks.

Clinical Recommendations and Guidelines

Healthcare providers must navigate the use of fluconazole in breastfeeding with caution. Guidelines from organizations like the CDC, AAP, and FDA offer varying recommendations, emphasizing the importance of individualized treatment decisions and monitoring.

Questions? Email Jack Newman at drjacknewman@sympatico.ca, or Edith Kernerman at breastfeeding@sympatico.ca or consult: Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA) or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding; or The Latch Book and Other Keys to Breastfeeding Success; or L-eat Latch & Transfer Tool, or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.  See our website at www.drjacknewman.com.  To make an appointment email breastfeeding@ccnm.edu and respond to the auto reply or call 416-498-0002.

Handout. Fluconazole, Revised May 2008
Written and Revised by Jack Newman, MD, FRCPC 1995-2005

  This handout may be copied and distributed without further permission,
on the condition that  it is not used in any context that violates
the International WHO Code on The Marketing of Breastmilk Substitutes


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