Is (Corticosteroids) compatible with breastfeeding? Do we have alternatives for (Corticosteroids)?

(Corticosteroids)

July 21, 2017 (Very Low Risk)

Corticosteroids are commonly found in breast milk at an average concentration of 6-33 micrograms / liter.

When used topically, in inhalation, intra-articular or enema: Its low absorption through the skin, nasal or bronchial mucosa, joint or colon, makes it unlikely a excretion into breast milk in significant amount. It has been published a case of decreased milk production after intra-articular injection of corticosteroids.

Should you be treated for eczema or dermatitis of the nipple, choose the least potent corticosteroid, make sure to apply it just after the meal to make sure it has been absorbed before the next meal, if necessary remove excess of cream with a gauze and do not used it for more than a week. Mineralocorticoid toxicity has occurred in an infant after continuous application of a corticosteroid in the nipple.
Avoid application creams, gels and other paraffin-containing products on the nipple, to avoid ingestion by the infant.

The American Academy Pediatrics states that systemic corticoid treatment is compatible with breastfeeding, recommending the use of prednisone or prednisolone because it is barely excreted in the breast milk.
WHO List of Essential Medicines 2002: classifies it as compatible with breastfeeding.

For a more detailed information, please check the specific profile of each steroid separately.


See below the information of these related groups:

Alternatives

We do not have alternatives for (Corticosteroids) since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • (Corticoids)

References

  1. Nguyen GC, Seow CH, Maxwell C, Huang V, Leung Y, Jones J, Leontiadis GI, Tse F, Mahadevan U, van der Woude CJ; IBD in Pregnancy Consensus Group. The Toronto Consensus Statements for the Management of Inflammatory Bowel Disease in Pregnancy. Gastroenterology. 2016Abstract Full text (link to original source) Full text (in our servers)
  2. Huang VW, Habal FM. From conception to delivery: managing the pregnant inflammatory bowel disease patient. World J Gastroenterol. 2014Abstract Full text (link to original source) Full text (in our servers)
  3. Nielsen OH, Maxwell C, Hendel J. IBD medications during pregnancy and lactation. Nat Rev Gastroenterol Hepatol. 2014Abstract
  4. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
  5. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013Abstract
  6. Houtchens MK, Kolb CM. Multiple sclerosis and pregnancy: therapeutic considerations. J Neurol. 2013Abstract
  7. Cree BA. Update on reproductive safety of current and emerging disease-modifying therapies for multiple sclerosis. Mult Scler. 2013Abstract Full text (link to original source) Full text (in our servers)
  8. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  9. Weber JC, Kuhnert C. Traitements de fond des affections inflammatoires systémiques au cours de l’allaitement. [Breastfeeding and drug management in connective tissue and rheumatic diseases]. Rev Med Interne. 2008Abstract
  10. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008Abstract
  11. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  12. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003Abstract
  13. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  14. De Stefano P, Bongo IG, Borgna-Pignatti C, Severi F. Factitious hypertension with mineralocorticoid excess in an infant. Helv Paediatr Acta. 1983Abstract