“Doctor, is it safe for my baby if I am on ringworm treatment while breastfeeding?”. Many mothers face this dilemma when they are suffering from ringworm infections while feeding or nursing their baby. It is common knowledge that whatever the mother eats or drinks passes into the breast milk and can negatively affect the baby. Hence, it is always a good idea to consult a doctor regarding medications to take and stay away from when breastfeeding. The same is true regarding ringworm treatment while breastfeeding. Many classes of antifungal medicines that are used for treating ringworm infections in the mother have not been adequately tested for any effect they might have on a newborn through the breast milk.
In this guide, we will study more about the interrelation between ringworm treatment while breastfeeding.
Ringworm treatment while nursing: Is it safe?
The answer to whether a particular class of antifungal ringworm treatment while breastfeeding is safe is to first accurately identify the dermatophyte fungi causing the ringworm. The unfortunate fact regarding ringworm infection is that they are extremely difficult to get rid of. Also, in nearly 90% women, the infection recurs within a few days of treatment. The fungi causing the ringworm belong to two categories namely, Trichophyton and Microsporum. Both these microbes are relatively harmless but they are also highly contagious. So, if an individual gets infected, s/he is highly likely to pass it on to their family members.
When a breastfeeding mother on ringworm treatment nurses her child, she is highly likely to pass the infection to the newborn as well as her other children. The lesions and rashes of ringworm are usually very itchy. If a patient scratches these rashes, the spores could get trapped under the nails. These are then dispersed in the patient’s surroundings where they are highly likely to affect a newborn baby who is generally always attached to its mother.
Class of antifungal medications used for treating ringworm
Dermatophyte infections generally respond very well to Imidazole antifungal medicines. These include Clotrimazole, Econazole, Ketoconazole and Tioconazole. The Fluconazole antifungal (Brand names Diflucan® and Canesten Once®) is also used for treating Candida on the breast as well as yeast and fungal infections on other parts of the body. Tests performed on this class of medicine have shown the following results as far as its presence in breast milk is concerned:
- A single oral dose of 150mg produced milk fluconazole levels of 1.5mg per liter after 3 hours of taking it orally.
- 1997 test conducted on a woman’s breast milk (who had candida on the breast area and was treated with 100-200mg Fluconazole 20 days post partum) showed peak milk level of 4.1 mg per liter.
- Liver function tests performed on baby and mother showed no significant adverse reaction to fluconazole.
All these tests showed that breast milk levels of Fluconazole ringworm treatment was too insignificant and thus this class of oral antifungal was deemed safe for use on a breastfeeding woman.
Ketoconazole (brand names Nizoral®) is generally excreted in breast milk. It is known to produce some symptoms such as gastro-intestinal effects, nausea and vomiting. Oral use of Ketoconazole is to be strictly avoided while breast feeding.
Terbinafine (brand name Lamisil®) is used for treating ringworm infections of the nails, toenails and other dermatophyte infections on different bodyparts. Oral terbinafine can cause gastrointestinal effects such as nausea and vomiting as well as mild abdominal discomfort. Bio-availability of oral Terbinafine is 40% but topical absorption is very low. This means that woman on ringworm treatment while breastfeeding is less likely to pass this medicine to the child. That being said; very few studies have been conducted on this drug and its effect on breastfeeding. So, most doctors recommend delaying oral treatment with terbinafine due to lack of sufficient information.
Most topical antifungal medications used for ringworm when breastfeeding are generally safe as they are not absorbed by the skin. However, Ringworm can be present on various parts of the body. In women, ringworm may be present on the arms, legs, folds of the thighs, elbow creases and even under or on the breasts. A nursing mother with fungal infection of the breast or nipple area is highly likely to infect her newborn child. It is also very difficult to treat fungus or candida/yeast infections in this region since one cannot apply medication while breastfeeding baby. The only time one can use topical antifungal cream or lotion is between feeds and it is best to wipe off medication before the baby nurses. Most oral drugs have low bioavailability and can be used for treating ringworm while nursing. Your doctor is the best judge in this matter. If possible, it is best to delay oral ringworm treatment while breastfeeding until the baby is a little older. Also, there are many natural products like Echinacea, tea tree oil etc that can be used safely to treat most fungal infections topically. These are less invasive and also safer for baby when used right. Nursing mothers should also pay special attention to their diet to prevent such infections. This includes taking a vitamin and mineral supplement to boost the immune system.