INFO - Breastfeeding and prednisone

[Guest guest]

eMedicine.com

Last updated 22 Jun 2009

" RA and pregnancy "

Excerpt:

Prednisone can be used safely during breastfeeding because small

amounts (5% of the glucocorticoid dose) are secreted in breast milk.

At doses higher than prednisone 20 mg once or twice daily, breast milk

is recommended to be pumped and discarded 4 hours following the

steroid dose to minimize drug exposure to the infant.

http://emedicine.medscape.com/article/335186-followup

*****************************************************************

s Hopkins Arthritis

" RA Treatment "

Excerpt:

Although safety has not been proven in controlled trials, no evidence

exists for risks to the fetus of low dose prednisone (less than 20mg

daily) or of NSAIDs used in the first two trimesters. If necessary,

joint symptoms are best managed with the lowest possible dose of

prednisone. Potential prednisone complications include worsening of

maternal gestational diabetes, hypertension and intrauterine growth

retardation. NSAIDs should be avoided in the third trimester because

of the potential for premature closure of the ductus arteriosus,

prolonged labor and peripartum hemorrhage. Although both NSAIDs and

prednisone are excreted in the breast milk, both are considered

compatible with breast-feeding by the American Academy of Pediatrics.

http://www.hopkins-arthritis.org/arthritis-info/rheumatoid-arthritis/rheum_treat\

..html

*****************************************************************

Hospital for Special Surgery

Posted 30 Jan 2002

" Pregnancy in autoimmune and musculoskeletal disease "

Excerpt:

A. Paget, MD: What about in the post-partum state, when the

woman is nursing -- and obviously some women nurse for a shorter

period of time and others longer -- relative to transferring

antibodies and protection. What do you usually recommend there as far

as the reinstitution of medicines?

Sammaritano, MD: Well, again, it depends on the patient and on

the medication. Steroids are considered -- again low-dose is optimal

-- safe for women who are breast-feeding. Anti-inflammatories are in

the middle, and we usually recommend ibuprofen and try to time the

breast feeding about four hours after taking the medication to

minimize the amount of ibuprofen in the breast milk. Other medications

are considered relatively safe, for example, heparin in patients who

need to be on that for some weeks post-partum. Interestingly, for

patients who have problems with blood clotting during pregnancy who

don't take warfarin (Coumadin) during the pregnancy, Coumadin is

actually considered okay for women who are breast-feeding because it

really doesn't go into the breast milk to any significant degree. So

you have to decide how great the risk of increased disease activity

is, how great a desire the patient has to breast feed, and then try to

balance things between that.

Generally hydroxychloroquine and gold salts, people don't like to have

their patients breast feeding on those medications, but if the patient

insists sometimes you try to work out a compromise.

http://www.hss.edu/conditions_14428.asp#Pregnancy_Considerations_for_Patients_wi\

th_Autoimmune_Disorders_or_Musculoskeletal_Problems

*****************************************************************

Not an MD