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Chronadase Pre C/S

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  • Chronadase Pre C/S

    Chronadase is used for some elective c/sections, intramuscularly 11.4mg is given at 24 hourly intervals to increase lung maturation in the baby post birth. Do you have any literature on a sudden change to the breasts within 12 hours of having the injections? Two patients have presented with acute tenderness and fullness. Both of these patients have had delayed lactation despite not having any issues previously. I cannot find any literature.

  • #2

    I think you mean Celestone Chronodose injection, which contains the corticosteroid Betamethasone. This is commonly used just before delivery in mothers with premature infants. It is well known to increase lung maturation prior to delivery which is really important. The possibility that corticosteroids could suppress milk production is not new, but there's virtually no evidence to support this contention, particularly in 'humans'.

    One study by McGuire suggests loss of milk supply in a mother but this was done in a mother who was 14 months postpartum and only feeding 3-7 times per day. The other study by the Hartmann group in sheep suggested that betamethasone could suppress milk production but only if it was administered approximately 20 days PRIOR to delivery.

    Thus while these studies are interesting, they don't really answer this question in a human mother immediately before delivery. The use of this product is so common, and so important in premature infants, that I'm not sure we can be assured that betamethasone actually suppresses milk production, or we would have heard a lot more about it. I tend to believe that it could in some individuals, but it is very unlikely.

    Because betamethasone is so important on lung maturation in premature infants, I hope we don't jump to conclusions and condemn this important drug, prematurely and without good evidence.

    Tom Hale Ph.D.


    Breastfeed Rev. 2012 Mar;20(1):32-4.

    Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection.
    McGuire E1.
    Author information
    Endogenous corticosteroids are involved in breast development, initiation and maintenance of milk production. Animal studies have shown that exogenous corticosteroids diminish milk production and milk ejection. A high dose depot injection of triamcinolone resulted in dramatic reduction in milk production in an established lactation. Domperidone and frequent expression restored milk production. Lower dose depot injection of betamethasone into the shoulder joint did not noticeably reduce milk production.

    PMID: 22724311 [PubMed - indexed for MEDLINE]

    Reproduction. 2008 Nov;136(5):649-55. doi: 10.1530/REP-08-0134. Epub 2008 Jul 28.

    Disrupted secretory activation of the mammary gland after antenatal glucocorticoid treatment in sheep.
    Henderson JJ1, Hartmann PE, Moss TJ, Doherty DA, Newnham JP.
    Author information
    Antenatal glucocorticoids are administered to women at risk of preterm delivery to prevent neonatal respiratory morbidity. The effects of exogenous glucocorticoids on the development of lactation are unknown. This study investigated the effects of a single dose of antenatal glucocorticoids on secretory activation in sheep before and after parturition. Pregnant ewes (N=36) were randomised to receive either medroxyprogesterone acetate (MPA) at 118 days of pregnancy and betamethasone at 125 days (BETA group), MPA at 118 days and saline at 125 days (MPA group) or saline at 118 and 125 days (SALINE group). The concentration of lactose, progesterone, cortisol and prolactin in maternal plasma was measured during pregnancy. After term parturition, the concentration of lactose in milk and maternal plasma was measured daily for 5 days. Lambs were weighed at birth and at 5 days of age; milk volume was measured on day 5. The concentration of lactose in maternal plasma increased significantly after betamethasone administration, corresponding to a fall in plasma progesterone. No changes in lactose were observed in MPA or SALINE ewes. Transient decreases in cortisol and increases in prolactin were observed in the BETA group, but not in either the MPA or SALINE group. After parturition, BETA ewes experienced reduced milk yield and lamb weight gain, and delayed increases in milk lactose levels compared with MPA and saline controls. This study demonstrated that, in sheep, antenatal glucocorticoid administration disrupted secretory activation, causing precocious mammary secretion before parturition and compromising postpartum milk production and lamb growth.
    PMID: 18663017 [PubMed - indexed for MEDLINE] Free full text