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Iv steroids with older nursling

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  • #1

    Iv steroids with older nursling

    I see the recommendation for high dose iv steroids (1g) is to dump for 12 hours. My dd is 2.5 (actually 2.9, she'll be 3 in 3 months). She still nurses to sleep at night, which will be 7 hours after treatment (which I'm getting as I post this). Is it safe to nurse her tonight?

    As a second question- Im fertile this week and wanted to ttc for a second baby. Should I not try to conceive?
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  • #2
    Solu-Medrol

    Dear Legna,

    Methylprednisolone is usually the steroid given for MS. If that is the IV steroid you are receiving then, the recommendation is waiting 8 to 24 hours after each dose to breastfeed. Because your child is almost 3 years old, the amount of milk consumed is much less than when she was 3 months old so waiting 8 hours would probably be sufficient in your case. The main concern with high dose, long term treatment with steroids is decreased bone growth so have your child's growth monitored periodically.
    There is a small risk of oral clefts (cleft lip/palate) with steroid use in the first trimester so it would probably not be the best time to try to conceive. You can talk with your obstetrician and internist about the best time for conception during your treatment plan. If you have further questions, please call the InfantRisk Center at 806-352-2519, Monday through Friday, 8 to 5 CST.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

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    • #3
      Yes solumedrol is the drug I'm on.

      Just a follow up question to the ttc. My last dose of steroid is Thursday, and I ovulate Sunday. As I'm conceiving via donor (and spent thousands on this cycle) does an ovulation date 3 days after the end of treatment carry the same risk? I'd hate to cancel if I don't need to.

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      • #4
        Dear Legna,

        The fetus does not implant into the uterus until 2 weeks after conception so there would be no umbilical cord for the methylprednisolone to cross over to the fetus. There would be minimal risk of birth defects from methylprednisolone during this time period. Remember, each pregnancy carries the risk of birth defects from 1 to 3 % without taking any medications. That is the average rate of birth defects in the United States. You can talk with your physician to see if he/she has any concerns with the proximity of the large dose of methylprednisolone for your own health as pregnancy changes many systems within the body.

        Sincerely,
        Cindy Pride, MSN, CPNP
        TTUHSC InfantRisk Center

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