All topical and inhaled corticosteroids can be used while breastfeeding; there is no preferred choice. Recommendations apply to full term, healthy infants only.

General considerations

It is important to complete an individual risk assessment for your patient and to apply the principles of prescribing in breastfeeding when looking at the available information and making treatment decisions.


All inhaled and topical corticosteroids can be used during breastfeeding. Topical use includes skin, rectal, intranasal, ophthalmic and use in the ear.

Inhaled or topical corticosteroidsare likely to give very small or negligible systemic concentrations in the mother, leading to negligible concentrations in the breast milk, and therefore pose no significant risk to the breastfed infant.

When using corticosteroids in breastfeeding, try to minimise infant exposure by using the lowest effective dose for the shortest effective duration. Use lower potency corticosteroids if appropriate.

Using oral and parenteral corticosteroids while breastfeeding contains further information about using corticosteroids systemically

Choice considerations

Generally, there is no published evidence to support the use of topical or inhaled, corticosteroids during breastfeeding. However, many have been used historically during breastfeeding for years without any reported issues.

They are often used on a short-term basis which further supports their compatibility during breastfeeding.

There is no preferred corticosteroid and all are considered compatible.

Practical tips

Precautions should be taken to avoid direct contact of the breastfeeding infant with treated areas, such as washing hands thoroughly after application and before touching the infant.

If a topical corticosteroid needs to be applied to the breast itself (especially nipples and areola) a mild or moderate potency preparation is preferred. This should be removed with warm water before breastfeeding, and be reapplied after feeding. Creams are preferred to ointments due to ease of removal.

Specific recommendations

Patient Information

The NHS website provides advice for patients on the use of specific medicines in breastfeeding.

Contact us

Get in touch with the UK Drugs In Lactation Advisory Service (UKDILAS), our specialist breastfeeding medicines advice service if you need support in the following situations:

  • you need further advice
  • the medicine in question is not included here
  • the infant is unwell or premature
  • multiple medicines are being taken

About our recommendations

Recommendations are based on published evidence where available. However, evidence is generally very poor and limited, and can require professional interpretation. Assessments are often based on reviewing case reports which can be conflicting and lack detail.

If there is no published clinical evidence, assessments are based on: pharmacodynamic and pharmacokinetic principles, extrapolation from similar drugs, risk assessment of normal clinical use, expert advice, and unpublished data. Simulated data is now increasingly being used due to the ethical difficulties around gathering good quality evidence in this area.


Full referencing is available on request.