Here's all you should know about taking antibiotics while pregnant and breastfeeding.
27 August 2013| Last updated on 18 December 2017
It goes without saying that we all want a healthy pregnancy and healthy babies. As soon as we see the blue line, we change our diet, start exercising and clear the medicine cabinet.
Sometimes, however, we get symptoms that send us scurrying off to see the Doctor and depending on who you see, you may walk out with a prescription for antibiotics – the very things that you have been told NOT to take during pregnancy!
Let’s start by taking a look at a short history of medicine...
"Oh Doctor, I have this terrible pain!"
BC 2000 "Here, eat this root."
AD 1000 "That root is heathen. Say this prayer."
AD 1850 "That prayer is superstition. Drink this potion
AD 1940 "That potion is snake oil. Swallow this pill.
AD 1985 That pill is ineffective. Drink this antibiotic
AD 2000 That antibiotic is artificial. Here take this root.
Is it any wonder that we are confused? Our main concern is the possibility of adverse effects that these drugs may have on the fetus.
When might antibiotics be used during pregnancy?
You may have recurrent urinary tract infections that cause burning and pain when you pass urine. Common antibiotics used to treat a UTI are ampicillin, cephalexin and erythromycin. For a more natural approach try:
- Increasing your fluid intake to loosen and flush bacteria clinging to cell walls.
- Medicinal fruits like cranberry and blueberry weaken infectious bacteria and inhibit their ability to attach themselves to the bladder and urethra.
One world's most popular medicinal herbs, echinacea has been used for centuries to treat both viral and bacterial infections. No studies have linked echinacea to preterm birth, miscarriage or birth defects, but you should use it only under the guidance of your health care provider. Consider drinking echinacea tea for one to two weeks until your urinary tract infection has abated.
Antibiotics aren’t an effective treatment because colds and flu are usually caused by viruses.
Fever is a sign that your own immune system is functioning well. So if you have a fever then your body is doing the work of antibiotics. Make sure that you listen by trying the following:
- Rest to support your immune system.
- Drink fluids to keep the mucous membranes that line your nose moist. Dry membranes are much more hospitable to viruses; keeping them moist helps to fight off viral attacks.
- 1000mg of vitamin C each day has been shown to boost immune function.
- Pregnancy increases a woman’s demand for zinc. Pregnant women need around 20 mg daily of zinc.
- Echinacea is the most widely studied and has consistently been shown to strengthen the immune system and fight viral, bacterial and fungal infections.
- Add herbs and spices like garlic, cardamom, cinnamon and cloves to your diet.
- Gargle with salt water for a sore throat or use lozenges made from propolis.
- Certain essential oils, such as tea tree, peppermint and eucalyptus are safe and effective to use with steam inhalations during pregnancy to ease nasal congestion.
- Prophylactic - Just in Case
- Preterm Labour
- Prolonged Rupture of Membranes (more than 18 hours)
- Running a Fever
- Positive GBS screen done at 35- 37 weeks of pregnancy
Effects of antibiotics on breastfeeding
Unfortunately, one of the side effects of the antibiotics that kill the bug that needs killing, is that they kill a few that don’t need killing. This can cause thrush or yeast overgrowth which could impact the comfort and desire to breastfeed and cause thrush in your baby. Common symptoms include:
- Unusually pink or red nipples
- Itching or burning nipples
- A shooting pain deep within the breast
- Pain that continues between nursing
- White patches inside the baby’s mouth. (the inside of his cheeks is a “thrive” zone and an easy to identify location
- Use medications only if absolutely indicated. For antibiotics, this includes treatment of confirmed infection (urinary tract infection, pyelonephritis, appendicitis, cholecystitis, chorioamnionitis), prevention of ascending infection (asymptomatic bacteriuria), and prevention of early-onset neonatal GBS sepsis.
- If possible, avoid initiating therapy during the first trimester. This is the period of fetal structural development and therefore the highest risk for iatrogenic teratogenicity.
- Select a safe medication, This often means an older drug with a proven track record in pregnancy. Certain antibiotics (streptomycin, kanamycin, tetracycline) are best avoided entirely in pregnancy because of their teratogenicity.
- Wherever possible, single-agent therapy is preferred over polypharmacy. Moreover, narrow-spectrum antibiotics are preferred over those with a broad spectrum for the treatment of established infection and intrapartum GBS chemoprophylaxis. The exception is the use of empiric broad-spectrum antibiotics to prolong latency in the setting of pPROM remote from term (discussed above).
- Discourage the use of over-the-counter drugs, These may interfere with the efficacy and/or metabolism of prescription medications.
|MINOR AILMENT||FIRST CHOICE||SECOND CHOICE||DO NOT USE|
|Constipation||Eat more fiber, bulk laxatives that contain ispaghula||On your doctor’s advice: bisacodyl or lactulose|
|Cough||Honey and lemon in hot water. Simple linctus||Medicines that contain codeine, unless advised by your doctor.|
|Diarrhoea||Oral rehydration sachets||Loperamide|
|Haemorrhoids||Soothing creams, ointments or suppositories||Ice pack|
|Hayfever, house dust mite and animal hair allergy||Antihistamine nasal sprays and eye drops. Steroid nasal sprays||On your doctor’s advice: occasional doses of the antihistamines loratadine or chlorphenamine||Other antihistamines|
|Head lice||Wet combing. Dimeticone lotion||If ineffective, head lice treatments containing malathoin in water (aqueous lotion).|
|Indigestion||Antacids (indigestion mixture)||On your doctor’s advice: medicines that reduce acid production, e.g. omeprazole|
|Nasal congestion (stuffy or runny nose)||Steam inhalation (e.g. over a bowl of hot water) or a hot shower||If severe, occasional doses of oxymetazoline or xylometazoline nasal spray||Phenylephrine or pseudoephedine, especially in the 1st trimester|
|Pain (e.g. headache, toothache)||Paracetamol||Ibuprofen may be taken in the 2nd trimester (week 14 to 27) but avoid taking it in the 1st or 3rd trimesters unless advised by your doctor||Medicines that contain codeine (e.g. co-codamol, co-dydramol, dihydrocodeine), unless advised by your doctor|
|Threadworms||Pharmacist cannot supply threadworm medicines to pregnant women without a prescription||On your doctor’s advice: mebendazole, but preferably not in the 1st trimester|
|Vaginal thrush||Pharmacist cannot supply medicines for vaginal thrush to pregnant women without a prescription||On your doctor’s advice: clottrimazole pessaries or cream. Do not use the pessary applicator if you are near term (at the end of your pregnancy).|