Is Betamethasone Safe in Breastfeeding

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

Because pharmacokinetic data suggest excretion into breast milk in significant levels long lasting treatments should use other steroidal drugs known to be excreted in low amounts. When administered before delivery it may induce delay in phase II of Lactogenesis (coming-in) and a decrease of milk production within the first week post-partum. Large intra-articular doses may transitory decrease milk production. WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Betamethasone has not been well studied during breastfeeding after systemic or topical use. Systemic betamethasone is best avoided in favor of one of the shorter-acting and better studied alternatives because of its potency and low protein binding which would favor its passage into milk. Use of betamethasone 3 to 9 days prior to delivery of a preterm infant might decrease postpartum milk production in some women. Local injections, such as for tendinitis, would not be expected to cause any adverse effects in breastfed infants,[1] but might occasionally cause temporary loss of milk supply.

None reported with any corticosteroid.

A 5.7 mg dose of depot betamethasone injected into the shoulder for bursitis had no effect in the milk supply in one mother.[2] However, medium to large doses of depot corticosteroids injected into joints have been reported to cause temporary reduction of lactation.[2][3]A study of 46 women who delivered an infant before 34 weeks of gestation found that a course of 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.[4]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.[5]