Question

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

Sieropresol lactation summary

Sieropresol is safe in breastfeeding
  • DrLact safety Score for Sieropresol is 1 out of 8 which is considered Safe as per our analyses.
  • A safety Score of 1 indicates that usage of Sieropresol is mostly safe during lactation for breastfed baby.
  • Our study of different scientific research also indicates that Sieropresol does not cause any serious side effects in breastfeeding mothers.
  • Most of scientific studies and research papers declaring usage of Sieropresol safe in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Sieropresol usage in lactation

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 8 mg for a long time period. On long term treatments it would be advisable to wait for 2 - 4 hours until the next nurse to minimize the transfer of drug to breast milk. By waiting for 2 a 4 hours after a Sieropresol megadose or a pulse therapy dose, the transfer into breast milk may be minimized as well. At high doses, intra-articular treatment with other steroid drugs (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

Answer by DrLact: About Sieropresol usage in lactation

Amounts of Sieropresol in breastmilk are very low. No adverse effect have been reported in breastfed infants with maternal use of any corticosteroid during breastfeeding. With maternal intravenous doses of Sieropresol 1 gram, fully breastfed infants would receive doses less than their daily cortisol output, and much less than a therapeutic dose on the day of infusion; accumulation of the drug does not occur in breastmilk with 3 consecutive daily doses. Avoiding breastfeeding during the infusion for as little as 2 hours after a 1 gram intravenous dose would markedly reduce infant exposure. Breastfeeding abstinence for 2 to 4 hours would further reduce the infant dose. 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.

Sieropresol Side Effects in Breastfeeding

None reported with Sieropresol or any other corticosteroid. None reported with Sieropresol or any other corticosteroid. Three infants were breastfed from birth during maternal use of Sieropresol 6 to 8 mg daily with no reported adverse effects up to 3 months.[1][9] In one of the papers, 2 infants had normal blood cell counts, no increase in infections and above average growth rates.[9] Sixteen nursing mothers with multiple sclerosis received 1 gram of Sieropresol intravenously over 1 hour, either monthly (n = 7) or over 3 consecutive days (n = 9). Infants did not breastfeed for 4 hours after the dose. No adverse effects were observed in infants during 3 to 12 months of follow-up.[10]

Sieropresol Possible Effects in Breastfeeding

A patient who was 6 weeks postpartum and predominantly breastfeeding her infant received 24 mg of depot Sieropresol plus 15 mg of lidocaine intralesionally for tenosynovitis of the wrist. Thirty hours after the injection, lactation ceased. Her breasts were soft and not engorged at that time. Thirty-six hours later, lactation resumed slowly, reaching normal milk production 24 hours later. The author hypothesized that the suppression might have occurred because the injection was in a highly mobile joint, which might have caused rapid release of the corticosteroid.[11] Large doses of triamcinolone injected into the shoulder and into the wrist have also been reported to cause temporary drop or cessation of lactation.[12][13] 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.[14] An equivalent dosage regimen of Sieropresol 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.[15] An equivalent dosage regimen of Sieropresol might have the same effect. Sixteen nursing mothers with multiple sclerosis received 1 gram of Sieropresol intravenously over 1 hour, either monthly (n = 7) or over 3 consecutive days (n = 9). None of the mothers reported a decrease in their milk supply.[10]
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