Question

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

Miconazole lactation summary

Miconazole is safe in breastfeeding
  • DrLact safety Score for Miconazole is 1 out of 8 which is considered Safe as per our analyses.
  • A safety Score of 1 indicates that usage of Miconazole is mostly safe during lactation for breastfed baby.
  • Our study of different scientific research also indicates that Miconazole does not cause any serious side effects in breastfeeding mothers.
  • Most of scientific studies and research papers declaring usage of Miconazole safe in breastfeeding are based on normal dosage and may not hold true for higher 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 Miconazole usage in lactation

Excretion into breast milk is highly unlikely due to an almost nil systemic absorption through the skin, vaginal mucosa and even the intestine, with non-significant plasma levels (< 1 mcg/ mL) observed. In case of use on the nipple, let it be done after the feed and wipe it out any excess of cream before the next feed. 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. Miconazole has not been found to be more effective than pure lanolin for treatment of sore or cracked nipples. List of Essential Medicines by WHO 2002: compatible with breastfeeding.

Answer by DrLact: About Miconazole usage in lactation

Because miconazole has poor oral bioavailability, it is unlikely to adversely affect the breastfed infant, including topical application to the nipples. However, miconazole ointment appears to have no advantage over lanolin for treating sore nipples during breastfeeding[1] and a survey of members of the Academy of Breastfeeding Medicine found topical miconazole is rarely prescribed to nursing mothers to treat thrush.[2] Any excess cream or ointment should be removed from the nipples before nursing. 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]

Miconazole Possible Effects in Breastfeeding

In a randomized, double-bind trial, lanolin was compared to an all-purpose nipple ointment containing mupirocin 1%, betamethasone 0.05%, and miconazole 2% for painful nipples while nursing in the first 2 weeks postpartum. The two treatments were equally effective in reducing nipple pain, nipple healing time, breastfeeding duration, breastfeeding exclusivity rate, mastitis and nipple symptoms, side effects or maternal satisfaction with treatment.[1]
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. We do not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.