Flagyl (Metronidazole) is safe to take while breastfeeding.  Hale (2000) rates it at L2 "safer"--it has been studied in lactating women and the theoretical infant dose is about 2.3 mg/kg.  Flagyl is the treatment of choice for infants and children with giardiasis and is quite safe to give infants and children directly in therapeutic doses.  It is certainly safe to give a 6 month old child directly; the minimal amount transferred in the breastmilk is of no concern.

Please encourage the mom to get treated with the Flagyl and keep right on breastfeeding!

Linda L. Shaw MD FAAP
Pediatrics and adolescent medicine
Altoona PA USA

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