Last update: May 30, 2020
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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Dexamethasone is a corticosteroid with mainly glucocorticoid activity.
Oral, parenteral, topical cutaneous, intra-articular and ophthalmic administration.
Since the last update we have not found published data on its excretion in breast milk.
Its high volume of distribution makes it difficult to excrete it in breast milk.
Other steroids (Betamethasone) that are administered prior to delivery can produce a delay of Lactogenesis phase II (milk's coming in) and a decrease of milk production within the first postpartum week (Henderson 2008)..
Intra-articular injected large doses of other steroids (Triamcinolone, Methylprednisolone) may transiently affect milk production (Smuin 2016, Babwah 2013, McGuire 2012)..
A decrease of prolactin release after administration of dexamethasone has been observed (Hubina 2002, Risch 1987), that may decrease milk production mostly in the first post-partum weeks.
Corticoids are frequently prescribed in Pediatrics with no side effects on the infant when indicated for short-term or sporadical use.
On nursing mothers a timely use or not long-term treatment is compatible with breastfeeding along with the assessment of milk production.
Expert authors consider the use of this medication to be probably compatible during breastfeeding (Hale 2019, Briggs 2017, Reece 2017, Bordini 2016, Chen 2010).
WHO Model List of Essential Drugs 2002: Compatible with breastfeeding in single dose. No data is available on long-term use (WHO 2002).
Because of a low absorption through skin significant excretion into breast milk is unlikely. Additionally, a high protein binding makes excretion even more unlikely.
Whenever a treatment for nipple eczema or dermatitis is required the lowest potency steroid compound should be used. It should be applied right after the feed to make sure it has disappeared before the next nursing occurs. Otherwise, wipe cream out with a clean gauze. Do not continuously use for longer than a week. Reportedly, a case of mineral-steroid toxicity has occurred due to continuous use of cream on the nipple.
Creams, gels or similar products that contain paraffin or mineral oil should not be used on the nipple to avoid absorption by the infant (De Stefano 1983).
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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