Budesonide

It is a potent glucocorticoid used inhaled for asthma, nasally for rhinitis and polyps, orally for inflammatory bowel disease, and applied topically on various skin disorders.

It is excreted in breast milk in clinically insignificant amounts. ^{(Fält 2007)}

Plasma levels in these infants were undetectable. ^{(Fält 2007)}

Its low oral bioavailability protects the infant from intestinal absorption.

Furthermore, long-term administration of inhaled budesonide to young children with severe asthma does not affect pituitary-adrenal function or final growth. ^{(Berger 2005, Irani 2002, Volovitz 1993)}

Several medical societies and expert authors consider topical, systemic or inhaled steroid medication to be compatible with breastfeeding. ^{(Hale, LactMed, Middleton 2020, McConnell 2016, Damas 2015, Briggs 2015, Schaefer 2015, Schulze 2014, Amir 2011, Mottet 2007, Powrie 2006, National Asthma 2004, Ellsworth 1994)}

 

TOPICAL USE:

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. 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. ^{(De Stefano 1983)}

Creams, gels or similar products that contain paraffin or mineral oil should not be used on the nipple to avoid absorption by the infant.^{(Concin 2008, Noti 2003)}