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I've hurt my back pretty badly....long story short I'm reluctantly trying 60mg Prednisone daily (orally). My daughter is 1 yo and we've recently weaned to two breastfeeding sessions/day...in the morning when she wakes and before bed. Is the prednisone safe or should I pump and dump? Thanks so much
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Dear awilhelm1,
Small amounts of prednisone-prednisolone are transferred to the breast milk, although it is probably safe in breastfeeding. There is concern of growth impairment in breastfed infants with high-dose prolonged steroid therapy. In small doses, most steroids are certainly not contraindicated in nursing mothers. Following administration, wait at least 4 hours if possible prior to feeding infant to reduce exposure. With high doses (>40 mg/day), particularly for long periods, steroids could potentially produce problems in infant growth and development, although we have absolutely no data in this area, or which doses would pose problems. Brief applications of high dose steroids are probably not contraindicated as the overall exposure is low. With prolonged high dose therapy, the infant should be closely monitored for growth and development. Since your child is older and only breastfeeding twice daily, the risk to your child is minimal. It takes 10 to 15 hours for the medication to be eliminated from your system so if your child sleeps all night, you can breastfeed then take your dose at bedtime then resume breastfeeding the next morning to reduce risk. Because your child is older and is getting small amounts of milk, the risk is low.
Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center
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