Is Neosporin the best alternative to Neomycin and Polymyxin B Sulfates and Dexamethasone Ointment for a breastfeeding mother?

Question

I had an upper bleph yesterday to correct inherited droopy upper lids. Everything seems fine, but I read the package insert for the antibiotic ointment and it says that corticosteroids appear in human milk and could interfere with growth, so I am choosing not to apply this ointment to my stitches as recommended by my surgeon. Instead, I am using neosporin. Are there any other alternatives or recommendations? I don't want the wound to get infected, but the antibiotics are off the table.

Erik Miles, MD, FACS · Answer

Numerous studies have shown that the antibiotic components in antibiotic ointments do not confer any clinical benefits when applied to a clean surgical wound. These antibiotic ointments can even irritate the skin in some cases.  Many practitioners no longer use them. Numerous studies support using only petroleum jelly as wound dressing.  Check with your particular surgeon.

Kenneth D. Steinsapir, MD · Answer

Generally it is best to defer cosmetic eyelid surgery while pregnant or breastfeeding.  Of course your surgeon has to ask to discover this information.  Was your surgeon aware that you were breastfeeding before the surgery?  For example, many of the drugs used for surgery can appear in the breast milk, no just the corticosteroids.  I recommend calling your surgeon immediately for guidance on this.  The safest course would be to used a bland ophthalmic ointment like refresh pm or lacrilube.

R. Laurence Berkowitz, MD · Answer

Avoid the antibiotic unless it is necessary to treat an established infection.  Neomycin is particularly irritating to many people. You probably don't absorb enough to be an issue with lactation, but why use this if it is not absolutely necessary.

Sheldon S. Kabaker, MD FACS (retired) · Answer

The lubricant aspect of ointment application is useful for post operative comfort. There shoukd be no need for medication to be in the ointment unless infection or excessive inflammation is present.

Is Neosporin the best alternative to Neomycin and Polymyxin B Sulfates and Dexamethasone Ointment for a breastfeeding mother?

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