Question

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

Silver Sulfadiazine lactation summary

Silver Sulfadiazine usage has low risk in breastfeeding
  • DrLact safety Score for Silver Sulfadiazine is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of Silver Sulfadiazine may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that Silver Sulfadiazine may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of Silver Sulfadiazine low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using Silver Sulfadiazine We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Silver Sulfadiazine usage in lactation

Since the last update we have not found published data on its excretion in breast milk. 10% of sulfadiazine and 1% of silver pass into the systemic circulation by absorption through skin damaged by burns or ulcers (AEMPS 2014). The most common side effect is leucopenia (Fuller 2009). It may cause haemolysis in patients with glucose-6-phosphate dehydrogenase deficiency and kernicterus in the neonatal period (Fuller 2009). High plasma levels of silver (Moiemen 2011, Lewis 2010), even more than 100 times higher than normal (Wan 1991) have been measured in patients treated for burns or ulcers with a body surface area exceeding 20% with potential clinical toxicity ( Mintz 2008, Browning 2008, Lansdown 2004, Tsipouras 1995, Coombs 1992). Furthermore, it has been widely used for topical umbilical cord care (Glosan 2013, Ahmadpour 2006) with no reported side effects and its use is permitted after two months of life (Bristol 2012). During breastfeeding it may be advisable not to use it on skin areas greater than 20% and for short periods. Do not apply on the chest to prevent the infant from ingesting it; if necessary, apply after breastfeeding and clean well with water before the next feed. If used during breastfeeding, it is advisable not to apply over a wide area (greater than 20%) or for prolonged periods to avoid systemic absorption. To be avoided in neonatal period and if there is glucose-6-phosphate dehydrogenase deficiency. List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).

Alternate Drugs for Antibiotics and chemotherapeutics for dermatological, topical use. ATC D06

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