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Doxycycline is excreted into breast milk. Oral doxycycline, 200 mg followed after 24 hours by 100 mg, was given to 15 nursing mothers (1). Milk:plasma ratios determined at 3 and 24 hours after the second dose were 0.3 and 0.4, respectively. Mean milk concentrations were 0.77 and 0.38 µg/mL.
Theoretically, dental staining and inhibition of bone growth could occur in breast-fed infants whose mothers were consuming doxycycline. However, this theoretical possibility seems remote, because in infants exposed to a closely related antibiotic, tetracycline, serum levels were undetectable (less than 0.05 µg/mL) (2). The American Academy of Pediatrics considers tetracycline compatible with breast feeding (3). Three potential problems may exist for the nursing infant even though there are no reports in this regard: modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required.
References
Morganti G, Ceccarelli G, Ciaffi EG. Comparative concentrations of a tetracycline antibiotic in serum and maternal milk. Antibiotica 1968;6:216–23.
Posner AC, Prigot A, Konicoff NG. Further observations on the use of tetracycline hydrochloride in prophylaxis and treatment of obstetric infections. Antibiotics Annual 1954–55. New York, NY:Medical Encyclopedia, 1955:594–8.
Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.
