Is Nitrofurantoin Safe in Breastfeeding

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

Excretion into breast milk is clinically non-significant with no side-effects observed among breastfed infants from treated mothers except rare cases of diarrhea. Do not use while the infant is younger of two weeks of age or suffers of G-6-P dehydrogenase deficiency to avoid likelihood of hemolysis. Be aware of false negative results that may be obtained from febrile infants with bacterial cultures when the mother is on antibiotics. Also, the possibility of developing diarrhea due to bacterial flora imbalance.

Administration of nitrofurantoin directly to infants under 1 month of age and in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency is contraindicated because of potential hemolysis in these infants. However, the time of greatest risk for hemolysis in fullterm newborns without G6PD deficiency might be as short as 8 days after birth.[1] Nitrofurantoin doses in milk are low and it can be used while breastfeeding older infants, but alternate drugs are preferred in mothers of infants under 8 days of age, or infants with G6PD deficiency of any age. Observe infants for possible diarrhea.

In a prospective follow-up study, 6 nursing mothers reported taking nitrofurantoin (dosage and dosage form not specified). Two mothers reported diarrhea in their infants. No rashes or candidiasis were reported among the exposed infants.[6]

In a prospective follow-up study, 1 of 6 nursing mothers who took nitrofurantoin (dosage unspecified) reported a decrease in milk supply.[6] It is not known if there was a causal relationship.