Last update Dec. 2, 2022

Betamethasone

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

Betamethasone

Corticoid of high anti-inflammatory power (25 times more than hydrocortisone) with main effect glucocorticoid and almost zero mineralocorticoid. Oral, parenteral (iv, im, intra- articular, intra-lesional), topical (dermatological, otic and ophthalmological) and inhalatory administration. Authorized use in children under one year of age.

At the date of the last update, the authors did not find any published data on its excretion in breast milk.

Its pharmacokinetic data make the transition to milk likely in an amount that could be significant, so in prolonged treatments it is advisable to use corticosteroids known for their poor transition to milk.

SYSTEMIC USE: ORAL, IM, IV, INTRA-ARTICULAR, INTRALESIONAL

Administered in prepartum, it can cause delay in lactogenesis II (raising/lowering of milk) and decrease the amount of milk in the first week (Henderson 2008). Other corticosteroids such as dexamethasone may cause a decrease in prolactin, which could decrease milk production especially during the first few weeks (Hubina 2002, Risch 1987). Large intra- articular doses of other corticosteroids (methylprednisolone, triamcinolone) may transiently affect milk production (Babwah 2013, McGuire 2012). Intra-articular injection of betamethasone did not cause a decrease in milk production. (McGuire 2012)

Corticosteroids are commonly used in pediatrics and have no side effects when used alone or in short treatments.

In breastfeeding mothers, the occasional use and not prolonged treatment is compatible with breastfeeding by monitoring milk production.

TOPICAL USE: DERMATOLOGICAL, OTOLOGICAL, OPHTHALMOLOGICAL, INHALED

The small dose and poor plasma absorption of most topical preparations (nasal, ophthalmological, otological, dermatological (Leo 2011) or inhaled) make the transition from significant amount to breast milk very unlikely.

If corticosteroids are required to treat eczema or dermatosis of the nipple, it is advisable to choose a less powerful corticosteroid (Barrett 2013), apply it just after the feeding so that it has been reabsorbed before the next one and, if necessary, remove remains with a gauze and do not use for more than 10 days in a row. (Amir 1993)

Preparations containing betamethasone, mupirocin and miconazole are not superior to lanolin creams in treating pain, cracks and swelling of the nipple. (Dennis 2012)

Mineral-corticoid poisoning has occurred in an infant by continuous application of a corticosteroid to the nipple. (De Stefano 1983)

Creams, gels and other topical products containing paraffin (mineral oil) should not be applied to the nipple so that they are not absorbed by the infant. (Concin 2008, Noti 2003)

List of essential medicines WHO 2002: topical use compatible with breastfeeding. (WHO 2002)

Alternatives

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.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Betamethasone is also known as


Betamethasone in other languages or writings:

Tradenames

Main tradenames from several countries containing Betamethasone in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 393 daltons
Protein Binding 64 %
Tmax 0.2 - 0.5 hours
5.6 - 10.2 hours

References

  1. AEMPS-Galenicum Derma. Cuatrocrem. Ficha técnica. 2017 Full text (in our servers)
  2. AEMPS. Calcipotriol-Betametasona (Daivobet). Ficha técnica. 2014 Full text (in our servers)
  3. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013 Dec;19(4):248-50. Abstract
  4. Barrett ME, Heller MM, Fullerton Stone H, Murase JE. Dermatoses of the breast in lactation. Dermatol Ther. 2013 Abstract
  5. Dennis CL, Schottle N, Hodnett E, McQueen K. An all-purpose nipple ointment versus lanolin in treating painful damaged nipples in breastfeeding women: a randomized controlled trial. Breastfeed Med. 2012 Dec;7(6):473-9. Abstract
  6. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012 Mar;20(1):32-4. Review. Abstract
  7. Leo. Calcipotriol & Betamethasone (Dovobet). Product Monograph. 2011 Full text (in our servers)
  8. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008 Abstract Full text (link to original source) Full text (in our servers)
  9. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008 Abstract
  10. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003 Abstract
  11. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  12. Hubina E, Nagy GM, Tóth BE, Iván G, Görömbey Z, Szabolcs I, Kovács L, Góth MI. Dexamethasone and adrenocorticotropin suppress prolactin secretion in humans. Endocrine. 2002 Abstract
  13. Amir L. Eczema of the nipple and breast: a case report. J Hum Lact. 1993 Abstract
  14. Risch SC, Janowsky DS, Judd LL, Gillin JC, Mott MA, Rausch JL, Huey L. Measurement of ACTH and prolactin in the dexamethasone suppression test. Acta Psychiatr Scand. 1987 Nov;76(5):535-40. Abstract
  15. De Stefano P, Bongo IG, Borgna-Pignatti C, Severi F. Factitious hypertension with mineralocorticoid excess in an infant. Helv Paediatr Acta. 1983 Abstract

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