Prednisolone

[Barbara]

Following embryo replacement this morning (FET) I have been prescribed 20 mg of prednisolone daily as part of my quad therapy treatment. I am using oestrogen patches, cyclogest pessaries, daily clexane injections and prednisolone. My concern is about the prednisolone, as research shows that it passes into breast milk. My son is two and a month and still enjoys feeding. Can you give me any reassurance that I am safe to continue feeding him and that I am not doing him any harm using these drugs. Many thanks.

[Sandra]

Barbara,

Prednisone is rated an L2-limited data-probably compatible. The amount transferred into breast milk is 1.8-5.3% of your dose. It has a short half-life of 2-3 hours, so take right after breastfeeding where you have a longer break period. There is little harm in taking steroids unless they are used at high doses (greater than 40mg) for prolonged periods of time (longer than 3-4 weeks). Monitor the infants growth. If higher doses greater than 40mg are needed than wait 4-6 hours to breastfeed. Your infant is older and is not getting as much milk as a new born per their body weight.

Oestrogen patches (estrogen)and cyclogest pessaries (progesterone) are rated L3-limited data-probably compatible. The main concern with estrogen and progesterone is it could reduce your milk supply, and there are rare cases of gynecomastia.

Clexane (enoxaparin) is rated an L2-limited data-probably compatible. [COLOR=#333333][FONT=lucida grande]Because it is a peptide fragment of heparin, its molecular weight is large (2000-8000 daltons). The size alone would largely preclude its entry into human milk at levels clinically relevant. Due to minimal oral bioavailability, any present in milk would not be orally absorbed by the infant. Monitor the infant for rare-bruising on the skin, petechia, blood in urine, vomit or stool.[/FONT][/COLOR]


I hope this helps.

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