Corticosteroids can be used during breastfeeding. Use the lowest dose and duration possible. 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.


Recommended oral or parenteral (injected) corticosteroids of choice during breastfeeding include beclometasone, budesonide, hydrocortisone, methylprednisolone and prednisolone. This is regardless of whether they are given orally or parenterally (although not all medicines are available as both forms).

Try to minimise infant exposure by using the lowest effective dose for the shortest effective duration.

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 side-effects may occur in the infant. Where such use is unavoidable, monitor the infant’s adrenal function.

Consideration also needs to be given to monitoring the infant at lower doses if the clinical situation is more complex, for example, if the infant is premature or unwell, or there is exposure to additional medicines via breast milk with similar side-effects.

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

Choice considerations

Corticosteroids are used for a wide range of indications. Therefore, choice should primarily be directed at adequately treating the condition first, with safety in breastfeeding a secondary consideration.

Where possible, choose topical or inhaled routes of administration. This will give lower systemic concentrations, which should lead to lower concentrations in breast milk.

Using topical and inhaled corticosteroids during breastfeeding contains further information.

Effect on breastfeeding

There have been limited reports of corticosteroids reducing milk production, when used orally, injected into joints or intramuscularly. For this reason if poor milk production is suspected, infants should be monitored for adequate weight gain.

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.

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