Antibiotics are specialized medicines used to treat infections. Antibiotics are particularly helpful to treat bacterial infections. Due to their fast onset of action, since the twentieth century, there is widespread use of antibiotics to treat infections due to microbes replacing the traditional ways and means of healing in such cases.

With the growing body of research in this regard, it was soon recognized that not all antibiotics are safe for use in pregnant women with infections due to their potential to cause abnormalities in developing fetuses. 

Although some people think it is wise to avoid all antibiotics during the course of pregnancy, it is not the fact. 

Some antibiotics are safe enough not to harm the pregnant woman and the baby she is bearing; others have the potential to cause abnormalities in the fetus which manifest when the child is born with birth abnormalities. With this in mind, doctors treat pregnant women with infections with utmost care weighing the benefits obtained by antibiotic therapy by the risks incurred due to such treatment.

The treating doctor’s task has been simplified much by the US Food and Drug Administration (FDA) guidelines in this regard which classify all drugs including antibiotics into five categories based on the risk they carry for the developing fetus. Drugs and for that matter antibiotic included in the category X are strongly contraindicated for use during pregnancy as there is clear evidence against them in causing birth defects as devastating to the extent of fetuses born with cleft lip or palate and congenital heart defects. Drugs included in the category A are generally considered safe for use during the pregnancy. Those in category B are considered safe to the extent that they failed to produce any harm in pregnant study animals but no data exists for their safety in pregnant women. Category C medicines produced adverse effects in pregnant animals but the lack of evidence in humans coupled with their benefits of usage warrant them to be used after the physicians outweigh their risks against the benefits entailed to the pregnant woman. Similarly, category D drugs have strong evidence of causing fetal malformations in humans but their benefits often warrant their usage. Therefore, the FDA categories make it simpler for physicians to weigh the benefits and risks involved in using an antibiotic in pregnant women. 

Similarly, when a woman is breastfeeding a child, the use of antibiotics needs a careful assessment of the potential risks the antibiotic will have for the feeding baby. 

Since antibiotics consumed by a nursing mother are excreted through her milk, the baby receives a substantial dose while feeding therefore due consideration should be paid to the fact while the selection of antibiotic for a lactating mom. 

Lactating mothers often develop a condition called mastitis, which is an infection of the nipples, for which they may require antibiotic therapy. In such cases, it is safe to use a variety of antibiotics except a special group termed as quinolones to safely combat the infection. There may be some signs in your baby while you get antibiotic treatment. It is better to know them so that you don’t worry if you see them in your baby. These include changes in your baby’s mood and restlessness, changes in his/her stool colour or appearance and diarrhoea. Additionally, you may have diarrhoea yourself coupled with some fungal infections of the Tounge called thrush and these may pass on to the baby as well. There is nothing to worry about and stop the antibiotic treatment, you just need to tell your doctor that you or your baby are suffering having these symptoms and the doctor will tell you measures to get rid of them. 

To conclude, as described above, you must know the role of antibiotics during pregnancy and lactation and must benefit from them if the benefits outweigh the risks. Your doctor is your best guide in this regard and will make the best choice for you depending upon the evidence of knowledge in this regard.

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