Ivermectin is a medication primarily prescribed to treat parasitic infections in humans. For a new mother, the decision to take any medication while nursing involves weighing the benefit of the treatment against the potential risk to the baby. Understanding the safety profile and the extent to which this drug transfers into breast milk is important.
What Ivermectin Is Used For
The United States Food and Drug Administration (FDA) has approved Ivermectin tablets for treating two specific infections caused by parasitic worms: intestinal strongyloidiasis and onchocerciasis, commonly known as river blindness.
Beyond the oral tablet form, Ivermectin is also available in topical formulations for human use. These forms are approved for treating external parasitic infestations and skin conditions, such as Ivermectin lotion for head lice and the cream for the inflammatory lesions of rosacea.
Ivermectin Transfer Into Breast Milk
Ivermectin is highly protein-bound in the mother’s bloodstream (approximately 93%) and has a relatively long elimination half-life, meaning it stays in the system for an extended period.
Studies suggest Ivermectin is poorly excreted into human milk after oral administration. After a single maternal dose, the average peak concentration found in breast milk was low (around 15 micrograms per liter), and the drug was detectable for up to 72 hours.
The estimated amount of Ivermectin an exclusively breastfed infant would receive is small. The calculated Relative Infant Dose (RID) is low, typically ranging from 0.55% to 0.98% of the weight-adjusted maternal dose. This value suggests minimal systemic exposure for the infant.
Current Medical Recommendations for Use During Lactation
Authoritative sources agree that Ivermectin transfer into breast milk is minimal. The World Health Organization (WHO) indicates the estimated infant dose is below the threshold for safe breastfeeding. The manufacturer’s recommendation, however, is conservative, suggesting treatment only when the benefit to the mother outweighs the possible risk to the infant.
Clinical guidance suggests Ivermectin is compatible with breastfeeding, especially for infants older than one week. This recommendation addresses theoretical concerns for newborns, whose systems are less mature for processing drugs. Topical applications result in lower systemic absorption and are often considered a treatment of choice for conditions like scabies during lactation.
Healthcare providers consider the specific infection and the infant’s age when making a recommendation. Adverse effects are not expected in most breastfed infants receiving oral Ivermectin. The decision requires careful assessment of the mother’s need against the theoretical risks to the baby.
Monitoring the Infant and Dosing Considerations
To minimize infant exposure, mothers should time the dose immediately after a feeding. This ensures the longest interval before the next nursing session, allowing the drug concentration in the mother’s blood and milk to drop before the next feed.
Mothers should monitor the infant for any signs of an adverse reaction. While most infants show no effects, watch for unusual symptoms such as increased drowsiness, lethargy, vomiting, lack of appetite, skin rashes, or gastrointestinal distress. Report any concerning symptoms promptly to a healthcare provider.
If a topical formulation is prescribed, avoid applying the product to the breast area to prevent direct ingestion. If advised to temporarily interrupt breastfeeding due to a high-dose regimen or infant vulnerability, the mother can maintain her milk supply by pumping during the treatment period.