Is Betamethasone safe while breastfeeding?

Effects on the breastfed infant

None reported with any corticosteroid.

Effects on milk supply

A 5.7 mg dose of depot betamethasone injected into the shoulder for bursitis had no effect in the milk supply in one mother.[ 2 ] However, medium to large doses of depot corticosteroids injected into joints have been reported to cause temporary reduction of lactation.[ 2 , 3 ] A double-blind study in the 1970s randomized pregnant women in preterm labor to either 6 mg of short-acting betamethasone phosphate plus 6 mg long-acting betamethasone acetate or a control treatment containing 6 mg cortisone acetate. Later in the trial, the doses were doubled because of an incomplete response. A total of 560 women received betamethasone and 582 received cortisone. No difference was seen in the percentage of women lactating at hospital discharge (32% and 30.5%, respectively); however, these percentages are very low compared to the rates in many hospitals today.[ 4 ] A study of 46 women who delivered an infant before 34 weeks of gestation found that a course of 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.[ 5 ] 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.[ 6 ]

Levels in milk

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.

Alternatives LactMed lists

• Prednisolone
• Prednisone