Below is a collection of Information I have gathered from Blog posts, person comments and Medical articles from online. While there seems to be no definitive Yes or No answer, as with many things to do with ITP, I did think this offered a great platform to begin your own research and make up your own mind about what is right for you and your baby.
Yes. Small amounts of prednisone and prednisolone enter breast milk. Prednisone is very similar to the body’s naturally occurring hormones, which are necessary for milk production and the health of infants. Since people produce these hormones naturally, it is not expected that the amount of prednisone or prednisolone in the breast milk would cause harmful effects in the nursing infant or the mother’s milk production.
The amount of prednisone or prednisolone in breast milk is highest approximately one hour after taking the medicine. To limit the amount in the breast milk, you can wait four hours after taking prednisone or prednisolone before breastfeeding your baby. Keeping your dose as low as possible will also help to limit the amount of medicine in your breast milk.
The American Academy of Pediatrics classifies prednisone and prednisolone as usually compatible with breastfeeding. A Circle of Mums
Small amounts of most corticosteroids are secreted into breastmilk. Following a 10 mg oral dose of prednisone, peak milk levels of prednisolone and prednisone were 1.6 Âµg/L and 2.67 Âµg/L, respectively. In a group of 10 women who received 10-80 mg/d prednisolone, the milk levels were only 5-25% of the maternal serum levels.
In one patient who received 80 mg/day prednisolone, the Cmax at 1 hour was 317 Âµg/L. The AUC average milk concentration in this mother was 156 Âµg/L over 6 hours. This is significantly less than 2% of the weight-normalized maternal dose. Because this last estimate was only determined over 6 hours and this dose was administered once each 24 hours, the total daily estimate would be much less than the 2% estimate.In small doses, most steroids are certainly not contraindicated in nursing mothers. Whenever possible use low-dose alternatives such as aerosols or inhalers. Following administration, wait at least 4 hours if possible prior to feeding infant to reduce exposure. With high doses (>40 mg/day), particularly for long periods, steroids could potentially produce problems in infant growth and development, although we have absolutely no data in this area, or which doses would pose problems. Brief applications of high dose steroids are probably not contraindicated as the overall exposure is low. With prolonged high dose therapy, the infant should be closely monitored for growth and development. The Infant Risk Centre
Posted on this website is a list of drugs that have been approved by the AAP for consumption during lactation. Prednisolone is on the list as being approved, but there is no further information. I could not find Immuran on the list, but it does say that the list is very general.
In general my anxiety has heightened from the prednisone and I am just so worried about my baby even more so than before. I’m breastfeeding to benefit him not to hinder him in anyway. I am so sad breastfeeding has been so wonderful so far and now with this flare it is turning into a nightmare I don’t want to give up because of fear of something that may not even be an issue. I would feel even worse then.
I’m thinking if he puts me on a higher dose that could potentially be a problem I could pump and dump (formula feed) for several hours after taking the meds then breastfeed at night and in the morning before I take my dose.
Like with everything to do with ITP, there is no simple straight forward answer. Everything you do while being treated for ITP and especially when you are pregnant will depend of what your Doctors and Haematologists recommend at the time. It makes sense to look for as much information as possible online – but please remember that everyone is different.