Pregnancy: Does not appear to be associated with congenital malformations with first trimester exposure. Recommended to avoid at time of delivery as there is a small increased risk of hemolytic anemia of the newborn.
Breastfeeding: Nitrofurantoin is transferred into breastmilk in very low amounts. Nitrofurantoin therapy is contraindicated when given directly to infants < 1 month of age due to the risk of hemolysis. Theoretically, this risk may also be present for infants exposed to nitrofurantoin via breastmilk however, no reports of hemolytic anemia in a breastfeeding neonate exposed to nitrofurantoin have been located. Caution, particularly in preterm infants and infants < 8 days old. An alternative antibiotic should be considered if possible. Breastfeeding should be avoided in infants with G6PD deficiency. Monitor the infant for signs of jaundice and GI intolerances.