Is Nivemycin Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Nivemycin? Is Nivemycin safe for nursing mother and child? Does Nivemycin extracts into breast milk? Does Nivemycin has any long term or short term side effects on infants? Can Nivemycin influence milk supply or can Nivemycin decrease milk supply in lactating mothers?

Aminoglycoside antibiotic which is used in creams, eye drops, and otologic preparations for topical use, and, also orally used for intestinal disinfection. At latest update, relevant published data on excretion in the breast milk were not found. Like other aminoglycoside antibiotics, Nivemycin is not absorbed by the gut. Absorption from other sources like skin, nose, ear and eye mucosa by means of topically used preparations (creams, drops, etc.) is very poor which causes excretion into breast milk in significant amount, unlikely. Do not apply creams, gels and other products that would contain paraffin (mineral oil) to avoid absorption by the infant since it is a hydrocarbon-derived substance. In case of use of Nivemycin on the nipple, let it be done after the feed and wipe it out any excess of cream before the next feed. Be aware of false negative results of microbial cultures done from samples of febrile infants whose mothers are treated with antibiotics. Also, due to imbalance of intestinal flora a diarrheal disease can occur in the breastfed infant. List of Essential Medicines by WHO 2002: compatible with breastfeeding.

Although no information exists on the excretion of Nivemycin into milk, other aminoglycoside antibiotics are poorly excreted into breastmilk. Newborn infants apparently absorb small amounts of aminoglycosides, but serum levels are far below those attained when treating newborn infections and systemic effects of Nivemycin are unlikely. Older infants would be expected to absorb even less Nivemycin. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (e.g., thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis. Oral, topical, ophthalmic or otic Nivemycin should result in very low levels in breastmilk and present negligible risk to the infant,[1][2] although topical application to the nipple may increase the risk of diarrhea in the infant. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[3]