Oral methylprednisolone for patient with Crohn's disease

[kpasque]

Hello,

I am an OB giving prenatal counseling to a hospitalized patient. She is 36 weeks with a Crohn's flare and will likely deliver in the next few days. Her GI physicians have increased her medrol from 20 mg to 48 mg daily. We discussed, based on information in this forum, the possibility of discarding milk 4 hours after her dose and breastfeeding the rest of the time. However, now we're looking at a higher dose of steroid and likely a late preterm infant. Would it be reasonable for her to breastfeed from 4-24 hours after her daily dose?
Many thanks.

[Sandra]

kpasque,

The half life of methylprednisolone is 2.8 hours, so at 5.6 hours 75% of medication is eliminated. Baby receives 0.46-3.15% of moms dose. We recommend not to exceed 80mg a day of this particular steroid, if high dose pulse therapy is needed (e.g. 1000mg a day x 3 days) we recommend pumping and dumping for 8-12 hours after each dose, and for 2gm doses we recommend pumping and dumping for 12-24 hours. 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