Is Dexamethasone Safe in Breastfeeding

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

Pharmacokinetic data indicate that excretion into breast milk in significant levels is possible, hence for long term treatments other steroids with lower excretion would be advisable. Other steroids (Betamethasone) that are administered prior to delivery can produce a delay of Lactogenesis phase II (milk's coming in) and a decrease of milk production within the first post-partum week. Intra-articular injected large doses of other steroids (Triamcinolone, Methylprednisolone) may transiently affect milk production. A decrease of prolactin release after administration of dexamethasone has been observed that may decrease milk production mostly in the first post-partum weeks. Topical use: Because of a low absorption through skin significant excretion into breast milk is unlikely. Additionally, a high protein binding makes excretion even more unlikely. Whenever a treatment for nipple eczema or dermatitis is required the lowest potency steroid compound should be used. It should be applied right after the feed to make sure it has disappeared before the next nursing occurs. Otherwise, wipe cream out with a clean gauze. Do not continuously use for longer than a week. Reportedly, a case of mineral-steroid toxicity has occurred due to continuous use of cream on the nipple. Creams, gels or similar products that contain paraffin or mineral oil should not be used on the nipple to avoid absorption by the infant. Corticoids are frequently prescribed in Pediatrics with no side effects on the infant when indicated for short-term or sporadical use. On nursing mothers a timely use or not long-term treatment is compatible with breastfeeding along with the assessment of milk production. WHO Model List of Essential Drugs 2002: Compatible with breastfeeding in single dose. No data is available on long-term use.

Because no information is available on the use of systemic dexamethasone during breastfeeding, an alternate corticosteroid may be preferred, especially while nursing a newborn or preterm infant. Local 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.

None reported with any corticosteroid.

Dexamethasone can cause a decrease in basal serum prolactin and thyrotropin-releasing hormone stimulated serum prolactin increase in nonnursing women.[1][2] Published information on the effects of dexamethasone 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.[3][4][5] 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.[6] An equivalent dosage regimen of dexamethasone 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.[7] An equivalent dosage regimen of dexamethasone might have the same effect.