Use of ciprofloxacin during breastfeeding

Question: My patient has a urinary tract infection and is currently breastfeeding her 9-week-old son. I would like to prescribe her ciprofloxacin. Should I be concerned about osteoarticular toxicity in the infant? Answer: Although there are concerns about the possible risk of osteoarticular toxicity with ciprofloxacin, the amounts excreted into breast milk are low and studies report no substantial increase in osteoarticular toxicity even with the systemic use of ciprofloxacin in neonates and children. Therefore, interrupting breastfeeding during ciprofloxacin treatment appears unnecessary.