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Prednisolone and breastfeeding

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  • Prednisolone and breastfeeding

    I am having a flare up and have been put on 40mg of prednisolone for a week, then 30 for a week and so forth tapering down in 10mgs per week to 5mg for 2 weeks. I'm breast feeding my 15week old daughter. I am happy to take my dose at 6pm after her last feed. If she wakes in the night ill give her a bottle. I would then breast feed on waking at 6/7 am so ill have a 13 hour gap between meds and feeds. Will this be ok? Is this classes as long term? It'll be about 6 weeks. I'm really worried about causing her issues

    Many thanks

  • #2
    Dear Clizzywizzy,

    The amount of prednisolone that enters breastmilk is low. You are on a low dose for a short period of time. Dr. Hale recommends to wait 4 hours from your dose before breastfeeding. The half-life (the time it takes for half of the drug to be eliminated from your system) is short at 2 to 3 hours so if you want all of the medication out of your system before breastfeeding again, waiting overnight should be adequate. The main risk with steroids given in high doses for long periods of time is decreased growth. Your pediatrician can monitor your infant's growth more closely if you have concerns.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

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    • #3
      Thanks!! Does the prednisolone remain in the milk though? As in do I need to pump and dump the first feed and allow a fresh full up? Or does the prednisolone half life apply to "contaminated" milk too? Hope that makes sense

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      • #4
        Dear Clizzywizzy,

        No, you do not have to pump & discard. After four hours, half to 75 percent (1 to 2 half-lives) of the medication would be eliminated from your breastmilk.

        Sincerely,
        Cindy Pride, MSN, CPNP
        TTUHSC InfantRisk Center

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        • #5
          Hello All,

          I am currently on Prednisone 7 mg (started on 10 mg and have been tapering down 1 mg each week). I am soon to be started on Plaquenil and will be taking both for 2 or so months until I can taper off Pred and the Plaq will be working. I take the Pred in the AM per my rheumatologist and I have tried pump and dumping, waiting 4 hours to feed, and just nursing as normal. When I called the Infant Risk hotline, I was told that since it's a low dose I can just nurse as normal. But, on this thread I read that waiting 4 hours is advisable. I am nervous about exposing my baby to too much medication. Can you please advise what to do? And if I'm out of the house and need to nurse within the 4 hour period after taking it, will she be OK? Lastly, is there any contraindication to taking Pred and Plaq at the same time while nursing?

          Thanks so much.

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