Is Kanamycin Safe in Breastfeeding

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

Aminoglycosides are poorly absorbed by the intestine. Large doses may affect intestinal flora. Be aware of the possibility of false negative results of bacterial cultures when the mother is on antibiotics. American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding.

If kanamycin is required by the mother, it is not a reason to discontinue breastfeeding. Kanamycin is poorly excreted into breastmilk. Newborn infants apparently absorb small amounts of other aminoglycosides, but serum levels with typical three times daily dosages are far below those attained when treating newborn infections and systemic effects of kanamycin are unlikely. Older infants would be expected to absorb even less kanamycin. Because there is little variability in the milk kanamycin levels during multiple daily dose regimens, timing breastfeeding with respect to the dose is of little or no benefit in reducing infant exposure. Data are not available with single daily dose regimens. 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.

Kanamycin was used as part of a six-drug regimen to treat a pregnant woman with multidrug-resistant tuberculosis during the first trimester of pregnancy and postpartum. The infant was breastfed (extent and duration not stated). At age 1.8 years, the child had failure to thrive, possibly due to tuberculosis contracted after birth, but was otherwise developing normally.[4]