Can you take permethrin 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.
Because less than 2% is absorbed after topical application, rapid metabolism to inactive metabolites and safe application directly on infants’ skin, topical permethrin products are acceptable in nursing mothers.[1–5] Extensive exposure, such as from agricultural use or malaria control might have long-term health concerns because residues can be found in breastmilk. Only water-miscible cream, 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 Permethrin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised June 15, 2025.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of permethrin. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Ivermectin
- Pyrethrins
How much permethrin gets into breastmilk
Maternal Levels. Permethrin was measured in 53 breastmilk samples from 29 mothers collected 1998 to 1999 in Basel Switzerland. Permethrin was detected in 25 milk samples, even in mothers from households that reported no permethrin use. The average permethrin concentration was 74 mcg/kg of fat (range undetectable [<60 mcg/kg] to 152 mcg/kg fat).
Permethrin was found in the breastmilk of nursing mothers in 3 South African towns. Average levels in breastmilk ranged from 8.3 to 48.4 mcg/L in the 3 towns. The source was thought to be from a dusting powder widely available and used in gardening. The dosage and route of exposure (i.e., topical, inhalation, oral) could not be determined. All milk levels were below the allowable daily limit for permethrin.
Samples of mature milk were collected in 2002 from 22 mothers in Mozambique where pyrethrins were used for mosquito control in the thatching of homes from 1993 to 2000 and continued to be used in bed netting after this period. The average permethrin concentration in the milk samples was 79 mcg/kg of lipid; the median concentration was 55 mcg/kg of lipid (range 10 to 230 mcg/kg of lipid). The milk permethrin levels in all mothers were below the allowable daily limit for permethrin.
Breastmilk samples from mothers in Brazil, Colombia and Spain were analyzed for pyrethroids. Permethrin was detected in all samples, regardless of reported household usage. Samples from rural Brazil (n = 9) contained a mean permethrin concentration of 3.57 ng/gram of lipid. Samples from Sao Paulo (n = 8) contained a mean permethrin concentration of 0.36 ng/gram of lipid. Samples from Santiago de Cali, Colombia (n = 27) contained a mean permethrin concentration of 0.91 ng/gram of lipid. Samples from Barcelona, Spain (n = 6) contained a mean permethrin concentration of 2.2 ng/gram of lipid. Other pyrethroids were also detected, but estimated daily intakes by breastfed infants were all below acceptable daily intake limits.
Breastmilk samples from 79 women from a lactation study at the University of California Davis had their breastmilk tested for the presence of trans-permethrin on day 42 postpartum. The mean concentration found was 7.8 mcg/L (range 0.43 to 150.3 mcg/L).
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
In a telephone follow-up study, 5 mothers who used permethrin during breastfeeding reported no adverse reactions in their breastfed infants.
Effects on milk supply
Relevant published information was not found as of the revision date.
Frequently asked questions
Can you take permethrin while breastfeeding?
What the NIH's Drugs and Lactation Database says about Permethrin while breastfeeding — quoted in full. 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 permethrin while breastfeeding?
LactMed lists Ivermectin, Pyrethrins 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 permethrin pass into breastmilk?
LactMed's measured drug levels for permethrin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking permethrin?
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 permethrin
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.