Hydrocortisone use while Breastfeeding
Drugs containing Hydrocortisone: Cortisporin Otic, Cortef, Anusol-HC, Solu-Cortef, Proctozone HC, Anucort-HC, Cortisporin Ophthalmic Suspension, Proctosol-HC, Locoid, Westcort, Show all 230 »Proctofoam HC, Analpram-HC, Anusol-HC Suppositories, Hydrocortisone 1% In Absorbase, Cipro HC, Hytone, Vytone, Cortisporin-TC, Cortizone-10, Proctocream-HC, Xerese, Locoid Lipocream, Cortifoam, Cortenema, Proctocort, Procort, AnaMantle HC, Cortisporin Ointment, Anusol HC-1, Novacort, Cortaid, Vosol HC, Pandel, Dermazene, Aquanil HC, Hemorrhoidal HC, Hydrocortisone with Aloe, Pramosone, Hydrocort cream, Coly-Mycin S, Texacort, HC Pramoxine, Zoto-HC Drops, Cortisporin Cream, Epifoam, Analpram E, Colocort, AK-Spore HC Otic Suspension, Zypram, Preparation H Anti-Itch Cream Hydrocortisone 1%, Lipsovir, Earsol-HC, Alcortin A, Oto-End, Lidocort, Rectacreme HC, Triple Antibiotic HC Ophthalmic Ointment, Vagisil Satin Anti-Itch Creme, Trioxin, Ala-Cort, Ketocon+Plus, Scalpicin, Otomar HC, Otirx, Encort, Cortane-B, Pramcort, Aeroseb-HC, Orabase HCA, Lacticare-HC, Nutracort, Dermarest Dricort, Xyralid, Acetasol HC, Peranex HC, RectaGel HC, Alcortin, LidaMantle HC, Uremol HC, Pediaderm HC, Cortizone-10 Anal Itch Cream, Beta HC, Nupercainal HC 1%, Cortaid Maximum Strength, Procto-Pak 1%, Hycort, Genasone/Aloe, Oti-Sone, Pediotic, Hydropram, FIRST Mary's Mouthwash, Mantadil, Coraz, Analpram Advanced, Cortic-ND, Tri-Otic, Cyotic, Aqua Glycolic HC, Keratol HC, Ala-Scalp, Carmol HC, Bioelements Immediate Comfort, UAD Otic, Lodocort Aloe, Cortatrigen, Antibiotic Ear, Cortizone-10 Intensive Healing Formula, Dermasorb HC, NuCort with Aloe, Proctozone-H, Proctosert HC, Hemril-30, Cortizone-10 Plus, Anuzone HC, U-Cort, Cortaid Intensive Therapy, Dermarest Eczema Medicated, Otocort Sterile Suspension, Gynecort Maximum Strength, NuZon, Tucks Hydrocortisone Anti-Itch Ointment, Itch-X Lotion, Cortatrigen Modified, Zone-A, Cortomycin, Neo/PolyB/HC, Cortomycin Suspension, Otobiotic, Dermtex HC, Scalacort DK, HC Pram, Pramosone E, Rectocort HC, Zone-A Forte, Xyralid RC, BP Ana-Lex HC, Enzone, Masporin Otic, Otocort Sterile Solution, Cort-Biotic, Otimar, Drotic, Lidazone HC, Xyralid LP, LidaMantle HC Relief, Senatec HC, AnaMantle HC Forte, Xolegel CorePak, Rectasol-HC, Vio-Tex-HC, Dermasorb AF, Corque, Pedi-Cort V, Hysone, Dek-Quin, Ala-Quin, Iodo-HC, Steroform, 1 Plus 1 F, HC-Derma-Pax, ProctoCare-HC, Instacort, Monistat Soothing Care Itch Relief Cream, Cortalo with Aloe, A-Hydrocort, FIRST Duke's Mouthwash, Hydrocortone, Hydrocortone Phosphate, Cortane-B Lotion, Hydro Ear, Cortomycin Eye Ointment, Neo-Poly-Bac, MyOxin, Cortisporin Ophthalmic Ointment, Neotricin HC, Vasotate HC, Oticot HC, Ocu-Cort, Vanoxide-HC, Bencort, Aero Otic HC, IvDerm, Cortamox, Zolene HC, Exotic-HC, Ophthocort, Pramox-HC, Otozone, Scalacort, MD Hydrocortisone, Hi-Cor, Nogenic HC, Recort Plus, Rederm, Gly-Cort, Dermolate, Corticreme, Delcort, Dermol HC, Sarnol-HC, Scalp-Aid, Cortizone-5, Cortizone for Kids, Neutrogena T-Scalp, Dermarest Plus Anti-Itch, Ivocort, Cort-Dome, Instacort 10, Scalp-Cort, Corticaine, Caldecort, Anuprep-HC, Anumed-HC, Hemril-HC Uniserts, Procto-Kit 2.5%, Procto-Kit 1%, Cort-Dome High Potency, Cetacort, Dermacort, Penecort, Cotacort, Cortaid with Aloe, Acticort 100, Aloe Cort, Anusert HC-1, Anurx-HC, Ala-Scalp HP, Cortane, Anutone-HC, Massengill Medicated Soft Cloth
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.
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.
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).
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.
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.
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. 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. An equivalent dosage regimen of hydrocortisone might have the same effect.
Alternate Drugs to Consider
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
CAS Registry Number
- Corticosteroids, Systemic
- Anti-Inflammatory Agents
LactMed Record Number
Information from the National Library of Medicine's LactMed Database.
Last Revision Date
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