Can you take vancomycin 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.
Limited information indicates that vancomycin produces low levels in milk and because vancomycin is poorly absorbed orally, it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants. No special precautions are required.
Quoted from Vancomycin — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised June 20, 2022.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of vancomycin. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
- Clindamycin
- Daptomycin
- Doxycycline
- Linezolid
- Trimethoprim-Sulfamethoxazole
How much vancomycin gets into breastmilk
Maternal Levels. A single colostrum vancomycin level of 12.7 mg/L was found 4 hours after the end of the infusion of vancomycin 1 gram intravenously given every 12 hours in one woman. Her colostrum was obtained after delivery at a gestational age of about 35 to 38 weeks. Assuming that the colostrum level is a peak level, an exclusively breastfed infant would receive a maximum of 1.9 mg/kg daily by mouth in breastmilk. The amount in mature milk might be lower. This dose is only about 4.8% of the oral vancomycin dose of 40 mg/kg daily used to treat Clostridioides difficile infection of the bowel in infants.
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 vancomycin while breastfeeding?
What the NIH's Drugs and Lactation Database says about Vancomycin 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 vancomycin while breastfeeding?
LactMed lists Clindamycin, Daptomycin, Doxycycline, Linezolid, Trimethoprim-Sulfamethoxazole 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 vancomycin pass into breastmilk?
LactMed's measured drug levels for vancomycin are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking vancomycin?
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 vancomycin
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.