Hydrocortisone use while Breastfeeding

Drugs containing Hydrocortisone: Cortisporin Otic, Cortef, Anusol-HC, Solu-Cortef, Proctozone HC, Westcort, Locoid, Anucort-HC, Anusol-HC Suppositories, Hydrocortisone 1% In Absorbase, Show all 227 »Proctosol-HC, Pramosone, Proctofoam HC, Hytone, Cipro HC, Lipsovir, Locoid Lipocream, Cortisporin Ophthalmic Suspension, Cortenema, Epifoam, Hydrocortone, Cortizone-10, Hycort, Proctocort, Hydrocort cream, Analpram-HC, Cortaid, Antibiotic Ear, Procort, Corticaine, Xerese, Acetasol HC, Ketocon+Plus, Cortisporin Ointment, Dermazene, Exotic-HC, AnaMantle HC, Pramox-HC, Vosol HC, Cortifoam, Colocort, Preparation H Anti-Itch Cream Hydrocortisone 1%, Uremol HC, Alcortin A, Aero Otic HC, Lidazone HC, Lidocort, Alcortin, Vytone, Oticot HC, A-Hydrocort, Procto-Kit 1%, Anusol HC-1, Beta HC, Proctocream-HC, Dermacort, Cortizone-10 Plus, HC Pramoxine, Pramosone E, Analpram Advanced, Cortane-B, Otobiotic, Coly-Mycin S, Dermolate, Ivocort, Hemril-30, Corticreme, Ala-Cort, Aeroseb-HC, Texacort, Anumed-HC, Lacticare-HC, Hemorrhoidal HC, Dermarest Eczema Medicated, Enzone, Analpram E, Rectacreme HC, Peranex HC, RectaGel HC, Otirx, Otomar HC, Encort, Vagisil Satin Anti-Itch Creme, Tri-Otic, Cortisporin Cream, Cortaid Intensive Therapy, Scalpicin, Trioxin, Cortomycin Eye Ointment, Otocort Sterile Solution, Senatec HC, Ala-Quin, Bencort, Cortisporin Ophthalmic Ointment, U-Cort, Cortaid Maximum Strength, Lodocort Aloe, Anuzone HC, Massengill Medicated Soft Cloth, Dermtex HC, Proctozone-H, Xolegel CorePak, Proctosert HC, Tucks Hydrocortisone Anti-Itch Ointment, Carmol HC, Pediaderm HC, Keratol HC, Aqua Glycolic HC, Bioelements Immediate Comfort, Ala-Scalp, Cortizone-10 Intensive Healing Formula, Gynecort Maximum Strength, Procto-Pak 1%, NuCort with Aloe, Itch-X Lotion, NuZon, Zone-A, Scalacort DK, Masporin Otic, Dermarest Dricort, Cortatrigen Modified, Pediotic, Otimar, Drotic, Coraz, Zone-A Forte, Rectocort HC, Cortomycin, Hydropram, HC Pram, Zypram, Otocort Sterile Suspension, UAD Otic, BP Ana-Lex HC, Xyralid RC, Xyralid, Xyralid LP, AnaMantle HC Forte, LidaMantle HC Relief, Cortomycin Suspension, Neo/PolyB/HC, Cort-Biotic, Cortatrigen, Oti-Sone, AK-Spore HC Otic Suspension, Novacort, LidaMantle HC, Rectasol-HC, Corque, Pedi-Cort V, 1 Plus 1 F, Vio-Tex-HC, Hysone, Iodo-HC, Steroform, Dek-Quin, Cortisporin-TC, HC-Derma-Pax, Instacort, Nutracort, Monistat Soothing Care Itch Relief Cream, ProctoCare-HC, Cortalo with Aloe, FIRST Duke's Mouthwash, FIRST Mary's Mouthwash, Hydrocortone Phosphate, Cortane-B Lotion, Oto-End, Triple Antibiotic HC Ophthalmic Ointment, MyOxin, Vanoxide-HC, Neo-Poly-Bac, Neotricin HC, Vasotate HC, Earsol-HC, Ocu-Cort, Ophthocort, Mantadil, IvDerm, Cortamox, Hydro Ear, Cortic-ND, Zolene HC, Otozone, Zoto-HC Drops, Cyotic, Scalacort, Hydrocortisone with Aloe, Rederm, Sarnol-HC, Scalp-Aid, Recort Plus, Nogenic HC, Dermol HC, Gly-Cort, Hi-Cor, Cort-Dome, Genasone/Aloe, Dermarest Plus Anti-Itch, Cortizone-5, Cortizone for Kids, Nupercainal HC 1%, Pandel, Instacort 10, Scalp-Cort, Cortizone-10 Anal Itch Cream, Delcort, Caldecort, Hemril-HC Uniserts, Penecort, Cotacort, Anuprep-HC, Procto-Kit 2.5%, MD Hydrocortisone, Cort-Dome High Potency, Cetacort, Orabase HCA, Ala-Scalp HP, Acticort 100, Aloe Cort, Aquanil HC, Cortaid with Aloe, Anusert HC-1, Cortane, Anutone-HC, Anurx-HC, Neutrogena T-Scalp

Hydrocortisone Levels and Effects while Breastfeeding

Summary of Use during Lactation

Hydrocortisone (cortisol) is a normal component of breastmilk that passes from the mother's bloodstream into milk. Hydrocortisone has not been studied in breastmilk after exogenous administration in pharmacologic amounts. Although it is unlikely that dangerous amounts of hydrocortisone would reach the infant, a better studied alternate corticosteroid might be preferred. Use of hydrocortisone as an enema would not be expected to cause any adverse effects in breastfed infants. Local injections, such as for tendinitis, would not be expected to cause any adverse effects in breastfed infants, but might occasionally cause temporary loss of milk supply. See also Hydrocortisone, Topical.

Drug Levels

Maternal Levels. An unspecified number of mothers had endogenous breastmilk cortisol (hydrocortisone) levels measured at various random times postpartum. Milk cortisol levels ranged from 7 to 33 mcg/L during the first 10 days postpartum; levels after 40 days postpartum were 6 to 17 mcg/L.[1]

Cortisol was measured in the colostrum and milk of 11 women monthly for up to 12 months postpartum. Levels in late pregnancy averaged 24.5 mcg/L and fell over the first 10 days postpartum to an average of 1.8 mcg/L. Milk cortisol levels between months 2 and 12 averaged 7.2 mcg/L, but varied with time and among individuals (range 0.2 to 32 mcg/L).[2]

Free cortisol was measured in 13 women on days 1, 2, and 3 postpartum (7 spontaneous births) or days 3, 4, and 5 postpartum (6 elective cesarean sections). Milk levels were measured before and after nursing, but the values were not statistically different. In the women with spontaneous deliveries, before and after milk levels averaged 17.2 mcg/L on day 1, 16.8 mcg/L on day 2, and 7.4 mcg/L on day 3 postpartum. In the women with cesarean deliveries, before and after milk levels averaged 26.5 mcg/L on day 3, 15.1 mcg/L on day 4, and 14.1 mcg/L on day 6 postpartum.[3]

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

None reported with any systemic corticosteroid.

Possible Effects on Lactation

Published information on the effects of hydrocortisone on serum prolactin or on lactation in nursing mothers was not found as of the revision date. However, medium to large doses of depot corticosteroids injected into joints have been reported to cause temporary reduction of lactation.[4][5]

A study of 46 women who delivered an infant before 34 weeks of gestation found that a course of another corticosteroid (betamethasone, 2 intramuscular injections of 11.4 mg of betamethasone 24 hours apart) given between 3 and 9 days before delivery resulted in delayed lactogenesis II and lower average milk volumes during the 10 days after delivery. Milk volume was not affected if the infant was delivered less than 3 days or more than 10 days after the mother received the corticosteroid.[6] An equivalent dosage regimen of hydrocortisone might have the same effect.

A study of 87 pregnant women found that betamethasone given as above during pregnancy caused a premature stimulation of lactose secretion during pregnancy. Although the increase was statistically significant, the clinical importance appears to be minimal.[7] An equivalent dosage regimen of hydrocortisone might have the same effect.

Alternate Drugs to Consider

(Systemic) Methylprednisolone, Prednisolone, Prednisone

References

1. Rosner W, Beers PC, Awan T, Khan MS. Identification of corticosteroid-binding globulin in human milk: measurement with a filter disk assay. J Clin Endocrinol Metab. 1976;42:1064-73. PMID: 932172

2. Kulski JK, Hartmann PE. Changes in the concentration of cortisol in milk during different stages of human lactation. Aust J Exp Biol Med Sci. 1981;59 (Pt 6):769-78. PMID: 7340774

3. Patacchiolo FR, Cigliana G, Cilumbriello A et al. Maternal plasma and milk free cortisol during the first 3 days of breast-feeding following spontaneous delivery or elective cesarean section. Gynecol Obstet Investig. 1992;34:159-63. PMID: 1427417

4. McGuire E . Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012;20:32-4. PMID: 22724311

5. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013;19:248-50. PMID: 24261425

6. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis ii in women. Pediatrics. 2008;121:e92-100. PMID: 18166549

7. Henderson JJ, Newnham JP, Simmer K, Hartmann PE. Effects of antenatal corticosteroids on urinary markers of the initiation of lactation in pregnant women. Breastfeed Med. 2009;4:201-6. PMID: 19772378

Hydrocortisone Identification

Substance Name

Hydrocortisone

CAS Registry Number

50-23-7

Drug Class

Administrative Information

LactMed Record Number

138

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2013-12-06

Disclaimer

Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.

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