Since the last update we have not found published data on its excretion in breast milk.
Pharmacokinetic data indicate that excretion into breast milk in significant levels is possible, hence for long term treatments other steroids with lower excretion would be advisable.
Other steroids (Betamethasone) that are administered prior to delivery can produce a delay of Lactogenesis phase II (milk's coming in) and a decrease of milk production within the first post-partum week.
Intra-articular injected large doses of other steroids (Triamcinolone, Methylprednisolone) may transiently affect milk production.
A decrease of prolactin release after administration of dexamethasone has been observed that may decrease milk production mostly in the first post-partum weeks.
Topical use: Because of a low absorption through skin significant excretion into breast milk is unlikely. Additionally, a high protein binding makes excretion even more unlikely.
Whenever a treatment for nipple eczema or dermatitis is required the lowest potency steroid compound should be used. It should be applied right after the feed to make sure it has disappeared before the next nursing occurs. Otherwise, wipe cream out with a clean gauze. Do not continuously use for longer than a week. Reportedly, a case of mineral-steroid toxicity has occurred due to continuous use of cream on the nipple.
Creams, gels or similar products that contain paraffin or mineral oil should not be used on the nipple to avoid absorption by the infant.
Corticoids are frequently prescribed in Pediatrics with no side effects on the infant when indicated for short-term or sporadical use.
On nursing mothers a timely use or not long-term treatment is compatible with breastfeeding along with the assessment of milk production.
WHO Model List of Essential Drugs 2002: Compatible with breastfeeding in single dose. No data is available on long-term use.
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
- Dexamethasone Acetate
- Dexamethasone Isonicotinate
- Dexamethasone Phosphate
- Dexamethasone Sodium Metasulfobenzoate
- Dexamethasone Sodium Phosphate
- Δεξαμεθαζόνη (Greek)
- Дексаметазон (Cyrillic)
- 地塞米松 (Chinese)
- デキサメタゾン (Japanese)
- C22 H29 FO5 (Molecular formula)
- 9α-Fluoro-11β,17α,21-trihydroxy-16α-methylpregna-1,4-diene-3,20-dione (Chemical name)
- A01AC02; C05AA09; D07AB19; H02AB02; R01AD03; S01BA01; S02BA06; S03BA01 (ATC Code/s)
Drug trade names
- Alin™ (Mexico)
- Cresophene™ (Spain)
- Gano Dexacort Plus™
- Otobacid N™
- Paraflex Plus™
- Rino Dexa™
- Una A™
- ДЕКСАМЕТАЗОН ВФЗ
- ДЕКСАМЕТАЗОН КРКА
- ДЕКСАМЕТАЗОНУ НАТРІЮ ФОСФАТ
- ДЕКСАМЕТАЗОНУ ФОСФАТ
- ОФТАН® ДЕКСАМЕТАЗОН
- Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeeding Medicine. 2017 Full text (link to original source) Full text (in our servers)
- Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016Abstract Full text (link to original source) Full text (in our servers)
- Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013Abstract
- McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012Abstract
- Chen LH, Zeind C, Mackell S, LaPointe T, Mutsch M, Wilson ME. Breastfeeding travelers: precautions and recommendations. J Travel Med. 2010Abstract Full text (link to original source) Full text (in our servers)
- Henderson JJ, Newnham JP, Simmer K, Hartmann PE. Effects of antenatal corticosteroids on urinary markers of the initiation of lactation in pregnant women. Breastfeed Med. 2009Abstract
- Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008Abstract Full text (link to original source) Full text (in our servers)
- 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
- 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
- Hubina E, Nagy GM, Tóth BE, Iván G, Görömbey Z, Szabolcs I, Kovács L, Góth MI. Dexamethasone and adrenocorticotropin suppress prolactin secretion in humans. Endocrine. 2002Abstract
- 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)
- De Stefano P, Bongo IG, Borgna-Pignatti C, Severi F. Factitious hypertension with mineralocorticoid excess in an infant. Helv Paediatr Acta. 1983Abstract