Because of the risk of damage to the cartilage of conjunction, the fluoroquinolones have not been used in children. However it seems that this eventuality is far from being a threat.
It is estimated that the calcium in breast milk may prevent the absorption of levofloxacin that could pass to the baby through breastfeeding, although there are no data from clinical studies that could corroborate this point.
Generally it is considered acceptable the short term treatment with levofloxacin. It is possible minimize the child's exposure by avoiding breastfeeding for six hours following drug administration.
From observational data obtained with the racemic derivative ofloxacin, it follows that the maximum concentration in breast milk is reached within two hours of taking the drug (2.4 mg/L), which is reduced to half after six hours.
An exclusively breastfed infant may receive 0.36 mg/kg per day when the mother received 800 mg daily. Much less than the dose that can be administered directly to the baby.
The levofloxacin topical is unlikely to pose a risk to the infant.
Warning of the manufacturer:
Given the absence of human data, levofloxacin should not be used in lactating women, due to the experimental risk of injury in weight-bearing cartilages with fluoroquinolones.