Oral Hydrocortisone and breastfeeding

[Tap]

I am 35 weeks pregnant and have been taking oral hydrocortisone (now at 40 mg/day- early pregnancy was 15 mg/day- pre-pregnancy I was on Prednisone) for treatment of congenital adrenal hyperplasia (I will require a stress dose during delivery- typically a triple dose).
I very much want to breastfeed immediately after delivery and then continuing on. Some time after delivery, I anticipate the dose will be stepped down to early/pre-pregnancy dose, but this will take time. Is it safe for the baby to be breastfed immediately after delivery while I am on hydrocortisone. Then after delivery from a breastfeeding perspective, is there a better alternative to which I should consider being switched (prednisone or dexamethasone, etc.)? Are there any areas for concern I should be aware of for the baby (linear bone growth, increased susceptibility to infection, etc.)
Thank you for your guidance, as I have received conflicting advice from my medical professionals.

[admin]

Tap:

The dose of prednisone or dexamethasone used typically to control adrenal hyperplasia is generally quite low, prednisone (2.5 mg /day) or dexamethasone (0.25 mg/day). Neither of these would cause a problem at all for a breastfed infant, as steroids are generally excluded from the milk compartment.

The only thing you have to "think" about would be linear growth rate in the infant. I really doubt these low doses would have any long-term effect on the infant.

Tom Hale Ph.D.

[NewDewMama]

I do not think that you can transfer side effects from prednsione. You just have to worry about yourself. Stay away from using prednisone for the long term because the side effects can do big damage to your body.

[narvo]

The only thing you have to "think" about would be linear growth rate in the infant. I really doubt these low doses would have any long-term effect on the infant.