Can you take clindamycin 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.
Clindamycin has the potential to cause adverse effects on the breastfed infant's gastrointestinal flora. If a nursing mother requires oral or intravenous clindamycin, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis.
Vaginal application is unlikely to cause infant side effects, although about 30% of a vaginal dose is absorbed. Infant side effects are unlikely with topical administration for acne; however, topical application to the breast may increase the risk of diarrhea if the infant ingests it. Only water-miscible cream, foam, gel or liquid products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.
Quoted from Clindamycin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised February 15, 2025.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of clindamycin. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Amoxicillin and Clavulanic Acid
- Doxycycline
- Erythromycin
- Minocycline
- Trimethoprim-Sulfamethoxazole
- Vancomycin
- Metronidazole
- Azelaic Acid
- Benzoyl Peroxide
- Tretinoin
- Bacitracin
- Mupirocin
How much clindamycin gets into breastmilk
Maternal Levels. Two women were given clindamycin 150 mg orally. Breastmilk levels of clindamycin averaged 1.3 mg/L 4 hours after the dose.
Two women were treated with clindamycin 600 mg intravenously every 6 hours followed by 300 mg orally every 6 hours (time postpartum not stated). Peak milk levels after the intravenous dose were 2.65 mg/L at 3.5 hours after the dose in one and 3.1 mg/L at 30 minutes after the dose in the other. During the oral regimen, peak milk levels were 1.3 mg/L at 3.5 hours after the dose in the first woman and 1.8 mg/L at 2 hours after the dose in the other.
Five women were given oral clindamycin 150 mg three times daily during the first 2 weeks postpartum. Milk levels were measured after at least 1 week of therapy and averaged 1.2 mg/L (range <0.5 mg/L to 3.1 mg/L) 6 hours after the dose.
After a single oral dose of 150 mg of clindamycin in 2 women, milk levels averaged from 0.3 to 1.2 mg/L between 1 and 6 hours after the dose. The peak occurred at 2 hours after the dose in one woman and 4 hours after the dose in the other.
After a single dose of 600 mg of clindamycin intravenously to 15 women who were 1 month postpartum, milk clindamycin levels averaged 1.03 mg/L at 2 hours after the dose.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Bloody stools in a 5-day-old breastfed infant were possibly caused by concurrent maternal clindamycin 600 mg intravenously every 6 hours and gentamicin 80 mg intravenously every 8 hours. The infant's stools were reported to have normal flora and the stools became guaiac negative 24 hours after discontinuation of breastfeeding. On day 6 of age, the infant resumed breastfeeding after discontinuation of maternal antibiotics with no further difficulties.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take clindamycin while breastfeeding?
Clindamycin has the potential to cause adverse effects on the breastfed infant's gastrointestinal flora. 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.
What can I take instead of clindamycin while breastfeeding?
LactMed lists Amoxicillin and Clavulanic Acid, Doxycycline, Erythromycin, Minocycline, Trimethoprim-Sulfamethoxazole, Vancomycin, Metronidazole, Azelaic Acid, Benzoyl Peroxide, Tretinoin, Bacitracin, Mupirocin as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does clindamycin pass into breastmilk?
LactMed's measured drug levels for clindamycin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking clindamycin?
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 clindamycin
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.