Prednisone>6 years, Hydroxychloroquine>5 years

[Kattie]

I was diagnosed with systemic lupus erythematosus (SLE) 6 years ago. And I am now pregnant for 7 months.
I have been taking Prednisone for more than 6 years and Hydroxychloroquine for more than 5 years.
One year ago, I began to take the dose with 10mg Prednisone and 200mg Hydroxychloroquine per day.
Can I breastfeeding my baby when she is born?

[Sandra]

Kattie, thanks for posting,

Prednisone is given an L2-safer rating. The amount transferred into breast milk is 1.8-5.3% of your dose. The infants are usually exposed to more of medications in utero than through breast milk. The main concern with steroids is if they are used at high doses for prolonged periods of time then it could effect the infants growth and development. Your 10mg a day dose is considered a low dose. We recommend it is probably ok to breastfeed at this dose as long as the infant is reaching their growth and developmental milestones.

Hydroxychloroquine is given an L2-safer rating also. The amount transferred in breast milk is 2.9% of your dose. Due to its huge volume of distribution, milk levels are generally quite low, and therefore this drug maybe considered compatible with breastfeeding as long as the infant is not symptomatic. Monitor the infant for irritability, insomnia, vomiting, diarrhea, and weight gain. With prolonged exposure monitor vision.

I hope this helps. if you have any other questions please call the InfantRisk Center at 806-352-2519. Thanks,

Sandra Lovato R.N.
InfantRisk Center

[Kattie]

Thank you for you quick reply. One more thing, about 8 months ago, my doctor asked me to take one more medicine-Rocaltrol. 0.25ug per day. Is this drug also ok for breastfeeding? Thanks in advance.

[Sandra]

Kattie,

Rocaltrol is a vitamin D analog. A normal adult dose is 0.25-0.5 ?g/day initially. While plasma levels of vitamin D are normally quite low in human milk (<20 IU/L), at least one study now suggests that supplementing a mother with extraordinarily high levels of vitamin D2 can elevate milk levels, and subsequently could lead to hypercalcemia in a breastfed infant.

I hope this helps. If you have any other Questions please call the InfantRisk Center at 806-352-2519. Thanks,

Sandra Lovato R.N.
InfantRisk Center

[rj21212]

Yes, you can breastfeeding your child/