Dexamethasone use while Breastfeeding

Summary of Use during Lactation

Because no information is available on the use of systemic dexamethasone during breastfeeding, an alternate corticosteroid may be preferred, especially while nursing a newborn or preterm infant. 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 Dexamethasone, Topical.

Drug Levels

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

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

Effects in Breastfed Infants

None reported with any corticosteroid.

Effects on Lactation and Breastmilk

Dexamethasone can cause a decrease in basal serum prolactin and thyrotropin-releasing hormone stimulated serum prolactin increase in nonnursing women.[1,2] Published information on the effects of dexamethasone 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.[3-5]

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 dexamethasone 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 dexamethasone might have the same effect.

Alternate Drugs to Consider

(Systemic) Methylprednisolone, Prednisolone, Prednisone

References

1.

Hubina E, Nagy GM, Toth BE, et al. Dexamethasone and adrenocorticotropin suppress prolactin secretion in humans. Endocrine. 2002;18:215–9. [PubMed: 12450312]

2.

la Marca A, Torricelli M, Morgante G, et al. Effects of dexamethasone and dexamethasone plus naltrexone on pituitary response to GnRH and TRH in normal women. Horm Res. 1999;51:85–90. [PubMed: 10352398]

3.

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

4.

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. [PubMed: 24261425]

5.

Smuin DM, Seidenberg PH, Sirlin EA, et al. Rare adverse events associated with corticosteroid injections: A case series and literature review. Curr Sports Med Rep. 2016;15:171–6. [PubMed: 27172081]

6.

Henderson JJ, Hartmann PE, Newnham JP, et al. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008;121:e92–100. [PubMed: 18166549]

7.

Henderson JJ, Newnham JP, Simmer K, et al. Effects of antenatal corticosteroids on urinary markers of the initiation of lactation in pregnant women. Breastfeed Med. 2009;4:201–6. [PubMed: 19772378]

Substance Name

Dexamethasone

CAS Registry Number

50-02-2

Drug Class

Breast Feeding

Lactation

Corticosteroids, Systemic

Glucocorticoids

Anti-Inflammatory Agents