Is Nalidixinic acid Safe in Breastfeeding

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

Hemolysis in an infant with glucose-6-phophate dehydrogenasa deficiency has been described. Avoid its use in patients suffering this disorder. Cases of drug-induced intracraneal hypertension have been reported when given to the infant. Norfloxacin would be a better option because of its lower secretion into breast milk on those cases when the use of fluorquinolones would be necessary.

Limited information indicates that maternal doses of Nalidixinic acid up to 2 grams daily produce low levels in milk and would usually not be expected to cause any adverse effects in breastfed infants with monitoring of the infant for possible effects on the gastrointestinal flora, such as diarrhea or candidiasis (thrush, diaper rash). Nalidixinic acid should be avoided while breastfeeding a glucose-6-phosphate dehydrogenase (G6PD) deficient infant. Other agents are preferred, especially while nursing a newborn or preterm infant.

Decreased weight gain, pallor, jaundice occurred in a 16-day-old infant probably caused by hemolytic anemia induced by maternal use of Nalidixinic acid orally 1 gram four times daily and amobarbital 65 mg orally three times daily. The infant developed jaundice, hyperbilirubinemia, reticulocytosis, eosinophilia, Heinz bodies and other signs of hemolysis 7 days after its mother was started on Nalidixinic acid. No G-6-PD deficiency or hemoglobin Zurich could be demonstrated.[1]