Prednisone Side Effects And Warnings

Learn Facts and Information About Prednisone, Both Side Effects and Benefits

Prednisone During Breastfeeding

Taking Prednisone While Breastfeeding

Healthcare providers advise mothers to breastfeed their babies exclusively for at least the first 6 months after birth. One of the main reasons that breastfeeding is recommended is because babies have a weak immune system that cannot adequately tolerate or fight against environmental pathogens that may gain access via formula and food. Although breastfeeding is beneficial to babies, it is a huge responsibility for mothers, and they must also ensure that their body doesn't contain any diseases, toxins, drugs or chemicals which can be secreted in the breast milk and easily gain access to the growing infant's circulation.

Can Lactating Mothers Consume Prednisone?

Research suggests that prednisone is secreted in breast milk and that the rate of secretion varies according to the maternal dosage, maternal metabolism, breastfeeding frequency, frequency of prednisone intake and other similar factors; however, generally, as a rule, the rate of secretion varies between 5% and 25%. So, if you are consuming 40 mg/ day of prednisone, the rate of secretion can be anywhere between 20 to 106 ng/mL, and this will be at its highest level within a few hours of consuming the drug.

There is also some evidence that administration of prednisone during the 28th to 34th week of pregnancy can interfere with the secretion of the prolactin hormone, which in turn can cause a delay in the onset of lactation in some women. However, the long-term effects are negligible in this area, and no changes have been observed in the volume or flow of milk once lactation does begin[3].

What are the Effects of Prednisone Intake While Breastfeeding?

A lot of research and clinical studies have been conducted in the past couple of decades to ascertain the risks and potential complications associated with prednisone therapy in lactating mothers. So far, it has been observed that prednisone therapy is not associated with any short-term or long-term complications in babies, and according to the recommendations of the American Academy of Pediatrics[2], prednisone therapy during pregnancy is safe for the baby; however, the mother can develop side effects that can include:

  • Weight gain
  • Changes in blood sugar concentration and impaired capacity to fight infections
  • Slower healing of wounds
  • Acne and other nodular lesions of the skin
  • High risk of developing hypertension
  • Osteoporosis, osteopenia (weak and demineralized bones that are vulnerable to fractures)
  • Loss of hair
  • Growth of facial hair
  • Abnormalities in menstrual cycles

How to Minimize the Risks Associated with Prednisone Intake in Mothers and Infants?

A number of strategies can be adopted to minimize the rate of secretion of prednisone in maternal milk; for example:

  • Avoiding breastfeeding for at least 4- 6 hours after prednisone intake. This is because the prednisone diffusion in breast milk is bidirectional and fairly rapid.
  • Monitoring the baby for signs of adrenal insufficiency, such as infections, oral thrush or viral illnesses.
  • Increasing your intake of water to ensure optimal excretion of prednisone metabolites from the body.
  • Avoiding other drugs, chemicals and synthetic compounds to minimize the possible risk of interactions and complications.

Additionally, if you are breastfeeding your baby, it is very important to consume supplemental calcium and vitamin D throughout the lactation period to minimize the risk of developing osteoporosis. Moreover, speak to your healthcare provider to ascertain the best dosage frequency and duration of therapy.

Case studies[4][5] report that lactating mothers have consumed more than 60 mg/ day for weeks while breastfeeding their babies, without developing any complications or side effects, but it is generally advisable to avoid drugs and medications as much as possible while breastfeeding your baby.

References:

  1. Janssen, N. M., & Genta, M. S. (2000). The effects of immunosuppressive and anti-inflammatory medications on fertility, pregnancy, and lactation. Archives of internal medicine, 160(5), 610.
  2. Committee on Drugs, American Academy of Pediatrics, The transfer of drugs and other chemicals into human milk. Pediatrics. 1994;93137- 150
  3. Henderson, J. J., Hartmann, P. E., Newnham, J. P., & Simmer, K. (2008). Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics, 121(1), e92-e100.
  4. Gan, D. C. C., Welsh, B., & Webster, M. (2012). Successful treatment of a severe persistent case of pemphigoid gestationis with antepartum and postpartum intravenous immunoglobulin followed by azathioprine. Australasian Journal of Dermatology, 53(1), 66-69.
  5. Westermann L, Hugel R, Meier M et al. Glucocorticosteroid-resistant pemphigoid gestationis: successful treatment with adjuvant immunoadsorption. J Dermatol. 2012;39:168-71

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