Is Clindamycin Safe in Breastfeeding

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

Lincosamide antibacterial. Excreted in non-significant level into breast milk. Except for few cases of enterocolitis due to disturbance of intestinal flora no other harm effects have been shown in breastfed infants. All cases spontaneously cured after discontinuation of medication. One reported case (1980) of pseudomembrane colitis in an infant whose mother was on clindamicin and gentamicin. Be aware of the possibility of false negative results of febrile infant bacterial cultures when the mother is on antibiotics and diarrheal disease due to intestinal flora imbalance. The American Academy of Pediatrics rates it as compatible with breastfeeding.

Clindamycin has the potential to cause adverse effects on the breastfed infant's gastrointestinal flora. If oral or intravenous clindamycin is required by a nursing mother, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis. Vaginal application is unlikely to cause infant side effects, although about 30% of a vaginal dose is absorbed. Infant side effects are unlikely with topical administration for acne; however, topical application to the breast may increase the risk of diarrhea if it is ingested by the infant. Only water-miscible cream, foam, gel or liquid products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[1]

Bloody stools in a 5-day-old breastfed infant were possibly caused by concurrent maternal clindamycin 600 mg intravenously every 6 hours and gentamicin 80 mg intravenously every 8 hours. The infant's stools were reported to have normal flora and the stools became guaiac negative 24 hours after discontinuation of breastfeeding. On day 6 of age, the infant resumed breastfeeding after discontinuation of maternal antibiotics with no further difficulties.[7]