Safety in Lactation: Corticosteroids

Sarah Fenner, Acting Co-Director, Midlands and East Medicines Advice Service (West Midlands site) & UK Drugs in Lactation Advisory ServicePublished

There is very limited information on the use of corticosteroids during breastfeeding, although they are likely to be present in milk. Avoid prolonged high dose therapy where possible since adrenal suppression and other adverse effects may occur in the infant. Where such use is unavoidable, monitor the infant’s adrenal function. In most cases, maximum doses described as unlikely to cause adverse effects in infant are based on extrapolated anti-inflammatory equivalence to prednisolone, although there is no direct evidence to support this with breastfeeding. Consideration also needs to be given to monitoring the infant at lower doses if the clinical situation is more complex: for example, infant prematurity, exposure to additional medicines with similar side effects.

Short-term use of high dose steroids is normally considered compatible with breastfeeding as the overall exposure will be low.

There have been limited reports of corticosteriods reducing milk production; monitor infants for weight gain.