I'm looking for information about the likely effect of long-term 
infant co-trimoxazole prophylaxis on the infant gut.  I've just done 
a LACTNET search on co-trimoxazole (Brand names Septrin, Septra, 
Bactrim) but haven't found quite what I need.    The drug would be 
administered from 6 weeks until 3 months after breastfeeding was 
stopped - ie possibly for up to two years.

In your opinion, would this medication be likely to cause loose 
stools/diarrhoea, damage to the intestinal mucosa, changes in 
intestinal flora, increase the risk of oral or gastrointestinal 
thrush and/or increase the risk of nipple thrush in the mother, or 
affect lactose absorption (and if so, how?).  Could we expect that 
co-trimoxazole would not have any impact on newborn jaundice if it is 
not initiated until after 6 weeks?   Have you worked with breastfed 
babies who have received co-trimoxazole?   Did you notice any 
increased risk of allergy/eczema, loose(r) stools, or anything 
else?  Do you know of any research which documents the effects of 
antibiotic use on the infant gut?

Many thanks if you can help with any of these questions, or if you 
have any other thoughts/any info at all about the effect of this drug 
on the breastfed baby.

Pamela Morrison IBCLC
WABA Breastfeeding and HIV Task Force Co-coordinator
Email: [log in to unmask]

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