Is Hydrocortisone Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Hydrocortisone? Is Hydrocortisone safe for nursing mother and child? Does Hydrocortisone extracts into breast milk? Does Hydrocortisone has any long term or short term side effects on infants? Can Hydrocortisone influence milk supply or can Hydrocortisone decrease milk supply in lactating mothers?

Cortisol is a normal component of breast milk. Although unlikely to achieve harmful levels for the infant, it is preferred the use of an alternative (Methylprednisolone, Prednisolone, Prednisone). Intra-articular administration of depot prednisone derivatives may be a cause of transient decrease of milk production. Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Hydrocortisone (cortisol) is a normal component of breastmilk that passes from the mother's bloodstream into milk and might have a role in intestinal maturation, the intestinal microbiome, growth, body composition or neurodevelopment, but adequate studies are lacking.[1] Concentrations follow a diurnal rhythm, with the highest concentrations in the morning at about 7:00 am and the lowest concentrations in the late afternoon and evening.[2][3] Cortisol in milk may protect against later infant obesity, especially in girls.[4] Hydrocortisone has not been studied in breastmilk after exogenous administration in pharmacologic amounts. Hydrocortisone in breastmilk is stable at room temperature and during repeated freeze-thaw cycles.[5] Although it is unlikely that dangerous amounts of hydrocortisone would reach the infant, a better studied alternate corticosteroid might be preferred. Maternal use of hydrocortisone as an enema would not be expected to cause any adverse effects in breastfed infants. Local maternal injections, such as for tendinitis, would not be expected to cause any adverse effects in breastfed infants, but might occasionally cause temporary loss of milk supply. See also Hydrocortisone, Topical. Hydrocortisone concentrations in breastmilk are not affected by storage for 36 hours at room temperature, during multiple freeze-thaw cycles, nor Holder pasteurization (62.5 degrees C for 30 minutes).[5][6]

None reported with any systemic corticosteroid.

Published information on the effects of hydrocortisone on serum prolactin or on lactation in nursing mothers was not found as of the revision date. However, medium to large doses of depot corticosteroids injected into joints have been reported to cause temporary reduction of lactation.[10][11][12] A study of 46 women who delivered an infant before 34 weeks of gestation found that a course of another corticosteroid (betamethasone, 2 intramuscular injections of 11.4 mg of betamethasone 24 hours apart) given between 3 and 9 days before delivery resulted in delayed lactogenesis II and lower average milk volumes during the 10 days after delivery. Milk volume was not affected if the infant was delivered less than 3 days or more than 10 days after the mother received the corticosteroid.[13] An equivalent dosage regimen of hydrocortisone might have the same effect. A study of 87 pregnant women found that betamethasone given as above during pregnancy caused a premature stimulation of lactose secretion during pregnancy. Although the increase was statistically significant, the clinical importance appears to be minimal.[14] An equivalent dosage regimen of hydrocortisone might have the same effect.