Can you take cefoxitin while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Substantial information indicates that cefoxitin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. Combined use of cefoxitin and cefuroxime can alter the milk flora and infant fecal flora. Occasionally, diarrhea or thrush have been reported with cephalosporins, but these effects have not been adequately evaluated. Cefoxitin is acceptable in nursing mothers.
Quoted from Cefoxitin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised September 19, 2022.
How much cefoxitin gets into breastmilk
Maternal Levels. After a 1 gram dose of cefoxitin in one woman, the cefoxitin level in milk 2 hours after the dose was 5.6 mg/L.
Four postpartum women received 1 gram of cefoxitin three times a day. Only 8 of 50 breastmilk samples had measurable cefoxitin levels of 0.8 to 1 mg/L. Other samples had unmeasurable (<0.8 mg/L) cefoxitin levels.
Fifteen nursing others received a single intramuscular dose of cefoxitin 1 gram. Cefoxitin was not detected (<0.5 mg/L) in any milk samples taken up to 24 hours after the dose.
After a single 2 gram intramuscular dose of cefoxitin in 5 women, peak milk levels of 0.31 to 0.65 mg/L occurred 1 to 5 hours after the dose.
Cefoxitin was not measurable in breastmilk at any time up to 6 hours after a single 1 gram intravenous dose of cefoxitin in 2 women.
Eighteen women undergoing cesarean section were given either a single 2 gram dose of cefoxitin or 2 g followed by two 1 gram doses (route unspecified). Cefoxitin was detected (detection limit 0.5 mg/L) in the milk of only one woman at a concentration of 0.9 mg/L 19 hours after the third dose of cefoxitin.
Fifteen women were given a single 1 gram dose of cefoxitin intravenously at about 1 month after delivery. The average milk level 2 hours after the dose was 0.05 mg/L.[
Five women were who had been receiving intravenous cefoxitin 1 gram twice daily for 2 days following cesarean section each donated a milk sample. The highest milk concentration was 1.71 mg/L at 1 hour after the dose in one woman. Drug concentrations in samples taken at 1.5 or 2 hours after the dose in 3 women ranged from 0.71 to 0.94 mg/L. A fifth woman who donated a milk sample at 2.5 hours after the dose had a milk cefoxitin concentration of 0.57 mg/L.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Relevant published information was not found as of the revision date.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take cefoxitin while breastfeeding?
Substantial information indicates that cefoxitin produces low levels in milk that are not expected to cause adverse effects in breastfed infants. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
Does cefoxitin pass into breastmilk?
LactMed's measured drug levels for cefoxitin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking cefoxitin?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on cefoxitin
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.