▁and ▁several ▁reports ▁of ▁irre vers ible ▁bil ater al ▁con gen ital ▁de af ness ▁in ▁children ▁have ▁been ▁seen . ▁In tr am us cular ▁injection ▁of ▁gent am ic in ▁in ▁moth ers ▁can ▁cause ▁mus cle ▁weak ness ▁in ▁the ▁new born . ▁ ▁The ▁safety ▁and ▁effic acy ▁for ▁gent am ic in ▁in ▁n urs ing ▁moth ers ▁has ▁not ▁been ▁established . ▁Det ect able ▁gent am ic in ▁levels ▁are ▁found ▁in ▁human ▁breast ▁milk ▁and ▁in ▁n urs ing ▁b ab ies . ▁ ▁E lder ly ▁ ▁In ▁the ▁elder ly , ▁ren al ▁function ▁should ▁be ▁ass essed ▁before ▁beginning ▁ther apy ▁as ▁well ▁as ▁during ▁treatment ▁due ▁to ▁a ▁decl ine ▁in ▁gl omer ular ▁fil tr ation ▁rate . ▁Gent am ic in ▁levels ▁in ▁the ▁body ▁can ▁remain ▁higher ▁for ▁a ▁longer ▁period ▁of ▁time ▁in ▁this ▁population . ▁Gent am ic in ▁should ▁be ▁used ▁c aut iously ▁in ▁persons ▁with ▁ren al , ▁aud itory , ▁vest ib ular , ▁or ▁neur om us cular ▁d ys function . ▁ ▁Children ▁▁ ▁Gent am ic in ▁may ▁not ▁be ▁appropriate ▁to ▁use ▁in ▁children , ▁including ▁b ab ies . ▁Studies ▁have ▁shown ▁higher ▁ser um ▁levels ▁and ▁a ▁longer ▁half - life ▁in ▁this ▁population . ▁Kid ney ▁function ▁should ▁be ▁checked ▁period ically ▁during ▁ther apy . ▁Long - term ▁effects ▁of ▁treatment ▁can ▁include ▁hearing ▁loss ▁and ▁balance ▁problems . ▁Hyp ocal cem ia