Is Prednisone Safe in Breastfeeding

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

Excreted into breast milk in non-significant amount with no problems reported in breastfed infants whose mothers were treated at a daily dose as high as 10 mg for a long time period. At a daily dose of 60 mg used for treatment of Herpes or Gestational Pemphigus no harm effects on breastfed infants have been reported. On long term treatments it would be advisable to wait for 3 - 4 hours until the next nurse to minimize the transfer of drug to breast milk. At high doses, intra-articular treatment with other steroid drugs (Methylprednisolone, Triamcinolone) have transiently affected milk production. Steroids administered before delivery may delay initiation of phase II of Lactogenesis ("milk come in") and decrease milk production in the first postpartum week. Decreased production has been seen while taking Dexametasone. Steroid drugs are commonly used for Pediatric treatment with no side effects when infrequently used and for short-time periods. The American Academy of Pediatrics rates it compatible with breastfeeding. WHO Model List of Essential Medicines (2002) rates it compatible with breastfeeding

Amounts of prednisone in breastmilk are very low. No adverse effect have been reported in breastfed infants with maternal use of any corticosteroid during breastfeeding. With high maternal doses, the use of prednisolone instead of prednisone and avoiding breastfeeding for 4 hours after a dose theoretically should decrease the dose received by the infant. However, these maneuvers are not necessary with short-term use. High doses might occasionally cause temporary loss of milk supply.

None reported with prednisone or any other corticosteroid. In a prospective follow-up study, six nursing mothers reported taking prednisone (dosage unspecified) with no adverse infant effects.[5] There are several reports of mothers breastfeeding during long-term use of corticosteroids with no adverse infant effects: prednisone 10 mg daily (2 infants)[6][7] and prednisolone 5 to 7.5 mg daily (14 infants).[8] A woman with Crohn's disease used prednisone 60 mg/day in a tapering schedule immediately postpartum during breastfeeding (extent not stated). She also received sulfasalazine 4 g/day and infliximab 5 mg/kg every 8 weeks during pregnancy and postpartum. At 6 months of age, the infant was asymptomatic with regular weight gain.[9] The National Transplantation Pregnancy Registry reports that as of December 2013, 124 women with transplants have taken prednisone while breastfeeding 169 infants for periods as long as 48 months, with no apparent infant harm.[10]

Published information on the effects of prednisone 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.[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 prednisone 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 prednisone might have the same effect.