Last update July 22, 2022
Very Low Risk
It is a potent glucocorticoid used inhaled for asthma, nasally for rhinitis and polyps, orally for inflammatory bowel disease, and applied topically on various skin disorders.
At latest update no relevant data on this subject were found in connection with breastfeeding.
Its pharmacokinetic characteristics (low systemic absorption, moderately elevated molecular weight, high plasma protein binding and large volume of distribution), make it highly unlikely that significant quantities will pass into breast milk.
Its low oral bioavailability protects the infant from intestinal absorption.
Only long-term treatment with high doses of inhaled corticosteroids can affect pituitary-adrenal function and growth. (Allen 2020)
Another similar inhaled corticosteroid (Budesonide) is excreted in breast milk in negligible amounts.
Several medical societies and expert authors consider topical, systemic or inhaled steroid medication to be safe or probably compatible with breastfeeding (Hale, LactMed, Middleton 2020, Briggs 2015, Schaefer 2015, Amir 2011, National Asthma 2004, Nice 2004, Ellsworth 1994). WHO Model List of Essential Drugs 2002 rates it as compatible with breastfeeding. (WHO 2002)
Whenever a treatment for nipple eczema or dermatitis is required, the lowest potency steroid compound should be used. It should be applied right after the feed to make sure it has disappeared before the next nursing. Otherwise, wipe cream out with a clean gauze. Do not continuously use for longer than a week. Reportedly, a case of mineral-steroid toxicity has occurred due to continuous use of cream on the nipple. (De Stefano 1983)
Creams, gels or similar products that contain paraffin or mineral oil should not be used on the nipple to avoid absorption by the infant.(Concin 2008, Noti 2003)
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2006 of United States of America
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM