Estrogen cream saftey

[Nikita Munro]

Hi I have two different questions to ask please.
I am still nursing my 22 month old baby girl. She is almost two years old but she still nurses quite a lot.

As a result of the breastfeeding I now have low estrogen levels and have developed vaginal atrophy/dryness. It has been recommended to me that I use an estrogen cream made up by the Compounding pharmacy which is called Bi -Est cream (it is 50:50 E2 to E3) meaning that it is balanced between estradiol (E2) and estriol (E3) in a 50:50 ratio. To use vaginally for about 6 weeks. I would like to know if this is safe to use whilst nursing?

Secondly it has been recommended to me that I take Chromium Polynicotinate 200 ug twice daily to assist in stabilising my blood sugar levels. Is this safe to take whilst still nursing?

Thanks

[Sandra]

Nikita Munro,

The estrogen compound cream is rated an L3-limited data-probably compatible. The amount that transfers is thought to bee less than 1% of your dose. The main concern with estrogens is that it might decrease your milk supply. "Vaginal administration of estriol is highly bioavailability and is similar to or greater than oral administration; estriol vaginal delivery may interfere with milk production as well." (Medications and Mothers' Milk database, Dr Thomas Hale PhD). There are rare feminization effects such as gynecomastia reported with the use of estrogens.

Chromium is rated an L3-limited data-probably compatible. It is believed that only 1% of your dose transfers into breast milk. "Because chromium is difficult to measure, levels reported vary widely. One article reports that breastmilk levels are approximately 0.18 ng/mL, which is below the adequate daily intake of 0.2-5.5 µg/day for children 0-12 months of age.[1,2] Most importantly, breastmilk levels are independent of maternal dietary intake and serum levels as chromium is thought to be secreted into breastmilk by a well-controlled pumping mechanism." That said the RDA of chromium is only 45mcg a day. I cannot be sure on the safety of 400mcg a day.

Sandra Lovato R.N.
InfantRisk Center
806-352-2519