I often use tetracycline as an example of a drug which is safe during
breastfeeding even though it is contraindicated for children.  The reasons
are:

1. it comes out in the milk in only tiny amounts, like most drugs.
2. it has always been taught that you should not take tetracycline with
milk, because it binds to calcium and does not get absorbed.

So, even the small amount the baby might get in the milk is not absorbed.

But, you might say, some of the newer tetracyclines are not that strongly
bound to calcium.  Well, if they are not bound to calcium they can't do
anything to the teeth or bones.

I have never heard of amoxycillin causing green milk.  Something else
probably did it.

Jack Newman, MD, FRCPC

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