Is meropenem safe in breastfeeding? A pharmacological review for mothers

October 14, 2025 •

2 min read

Case studies have shown that the amount of meropenem transferred into breast milk is very low, representing a minute fraction of the weight-adjusted maternal dose. For mothers needing treatment for serious infections, evaluating the safety of meropenem in breastfeeding is crucial to make an informed decision with their healthcare provider.

Quick Summary

Meropenem is generally considered compatible with breastfeeding due to low drug levels in milk and poor infant oral absorption. The benefits of treating a severe maternal infection typically outweigh the minimal theoretical risks to the breastfed infant.

Key Points

Minimal Milk Transfer: Meropenem enters breast milk in very low concentrations, with documented infant exposure representing less than 1% of the maternal dose.
Poor Infant Absorption: As a beta-lactam antibiotic, meropenem has poor oral bioavailability, meaning most of the drug that an infant ingests via milk is not absorbed into their bloodstream.
Low Risk of Side Effects: Clinical evidence suggests a low risk of adverse effects in breastfed infants, with case studies showing no observed gastrointestinal or dermatological issues.
Treatment Benefits Outweigh Risks: For serious maternal infections requiring meropenem, the benefits of effective treatment are generally considered to outweigh the minimal, theoretical risks to the infant.
No Interruption Necessary: In most cases, breastfeeding does not need to be interrupted during meropenem therapy, and special infant monitoring is not typically required.
Use for Severe Infections: Meropenem is a powerful, broad-spectrum antibiotic reserved for serious infections, reinforcing that its use should be clinically indicated and supervised by a doctor.

Understanding meropenem: A carbapenem antibiotic

Meropenem is a broad-spectrum, beta-lactam antibiotic from the carbapenem class, used to treat a variety of severe bacterial infections, including meningitis, intra-abdominal infections, and pneumonia. It is administered intravenously and works by blocking the bacteria's ability to build a cell wall.

Meropenem transfer into breast milk

Clinical evidence indicates that meropenem transfers into breast milk in very small amounts. Studies, including one detailed in the Drugs and Lactation Database (LactMed) of the NIH, show:

Low concentration: Minimal meropenem concentration in breast milk.
Minimal infant exposure: Estimated infant daily exposure from breast milk is a tiny percentage of the maternal dose.
Low oral bioavailability: Meropenem is poorly absorbed by the infant's gastrointestinal tract.
Short half-life: Limits accumulation in the body.

Potential side effects in breastfed infants

Adverse effects in breastfed infants are uncommon due to the low milk levels and poor oral absorption. While theoretical risks exist with beta-lactam antibiotics, such as gut flora disruption, observed issues like gastrointestinal problems or rash have not been reported in case studies involving meropenem. There is also a small theoretical risk of allergic sensitization or candidiasis, although these have not been consistently linked to meropenem exposure via breast milk.

Clinical recommendations for breastfeeding mothers

When meropenem is needed for serious maternal infections, medical experts generally agree that the benefits of treatment outweigh the minimal risks to the infant. Breastfeeding typically doesn't need to stop, and special infant monitoring is usually unnecessary. Consultation with a healthcare provider is essential for individualized guidance. More information can be found on the Drugs and Lactation Database (LactMed) from the National Institutes of Health.

Meropenem versus other breastfeeding-compatible antibiotics

The choice of antibiotic for a breastfeeding mother involves balancing the infection's severity with the medication's safety profile. Meropenem is used for specific, severe infections, while other options may be suitable for less severe cases.


Feature	Meropenem	Amoxicillin (Penicillin)	Cefuroxime (Cephalosporin)
Drug Class	Carbapenem	Penicillin	Cephalosporin
Severity of Infection	Typically severe or resistant	Mild to moderate	Mild to moderate
Breast Milk Levels	Very low	Very low	Very low
Oral Absorption in Infant	Poor	Poor to moderate	Poor
Half-Life	~1 hour	~1 hour	~1.2 hours
Risk to Infant	Very low; theoretical risk of gut flora disruption	Minimal	Minimal
Allergy Risk	Cross-sensitivity with other beta-lactams is possible	Minimal risk of sensitization, though possible	Minimal

Important considerations and conclusion

Is meropenem safe in breastfeeding? Evidence indicates that meropenem is safe, primarily due to minimal transfer into milk and poor infant oral absorption. While theoretical risks like minor gut flora disruption exist, adverse effects in infants are rare. For serious maternal infections, effective treatment with meropenem is crucial. Healthcare providers are the best resource for weighing these factors. Continuing to breastfeed during meropenem therapy is generally considered safe and beneficial. Always follow a doctor's guidance and report any infant health concerns.

Frequently Asked Questions

Yes, meropenem does pass into breast milk, but in very low amounts. Case studies have shown that the concentration is minimal, resulting in a very low estimated infant exposure.

No, it is generally not necessary to pump and dump while taking meropenem. Due to the minimal amount of the drug transferred to milk and its poor oral absorption by the infant, most healthcare providers will recommend continuing to breastfeed.

Side effects in breastfed infants are rare. Theoretical concerns include mild gastrointestinal issues like diarrhea or thrush due to the disruption of gut flora. However, case reports have not observed such effects.

Standard clinical guidance does not typically recommend special monitoring for the infant. However, as with any medication, mothers should watch for any unusual changes in the infant's behavior or feeding and report them to a healthcare provider.

No, meropenem is a potent antibiotic reserved for serious infections. It should only be used when clinically indicated for severe or resistant bacterial infections, and a healthcare provider should assess the situation.

Meropenem is considered a safe option, similar to other commonly used antibiotics like penicillins and cephalosporins, which also pass into breast milk in low quantities and have a good safety profile during lactation. The choice depends on the specific infection being treated.

No, breastfeeding should not be stopped. The decision should be made by a healthcare provider who has weighed the benefits of treating the mother against the minimal risks to the infant. The ability to continue breastfeeding is one of the factors considered.