Is Dexamethasone safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Dexamethasone. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
No adverse reactions have been reported with any corticosteroid. A retrospective cohort study compared the breastfeeding success among multiparous women with a vaginal delivery who received postpartum epidural analgesia. One group received 0.15% ropivacaine for analgesia and the other group received 0.15% ropivacaine plus 10 mg of dexamethasone. The epidural was continued for 48 hours. There were no significant differences in 1-minute Apgar scores, 5-minute Apgar scores, neonatal jaundice, hypoglycemia, or infection rates nor on neonatal hospital stay duration or neonatal intensive care unit admission rates.[ 1 ]
Effects on milk supply
Dexamethasone can cause a decrease in basal serum prolactin and thyrotropin-releasing hormone stimulated serum prolactin increase in nonnursing women.[ 2 , 3 ] Medium to large doses of corticosteroids given systemically or injected into joints or the breast have been reported to cause temporary reduction of lactation.[ 4 - 8 ] 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.[ 9 ] 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.[ 10 ] An equivalent dosage regimen of dexamethasone might have the same effect. A woman with postpartum depression who was breastfeeding her 8-week-old infant was treated with endovascular embolization for a spinal-dural arteriovenous fistula. Following the procedure, she was treated with intravenous dexamethasone 4 mg every 8 hours for 5 days, followed by oral dexamethasone 12 mg daily in a tapering regimen. After stopping breastfeeding for 3 days after the procedure, she noted a decreased milk supply on restarting breastfeeding, and a complete cessation of milk production 11 days after the procedure. Several measures to increase milk supply, including domperidone, failed. Breastmilk production resumed 36 hours after discontinuing dexamethasone and reached normal production after 8 days. At hospital discharge, she was exclusively n
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
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.