Fluticasone Furoate; Fluticasone Propionate

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

At latest update no relevant data on this subject were found in connection with breastfeeding.

Its pharmacokinetic characteristics (low systemic absorption, moderately elevated molecular weight, high plasma protein binding and large volume of distribution), make it highly unlikely that significant quantities will pass into breast milk. ^{(Chambers 2021)}

Its low oral bioavailability protects the infant from intestinal absorption.

Directly administered in childhood, only prolonged treatment with high doses of fluticasone can affect pituitary-adrenal function and growth. ^{(Allen 2020, Todd 2002 & 1996)}

Another similar inhaled corticosteroid (Budesonide) is excreted in breast milk in negligible amounts.

Several medical societies and expert authors consider topical, systemic or inhaled steroid medication to be safe or probably compatible with breastfeeding. ^{(Hale, LactMed, Middleton 2020, Briggs 2015, Schaefer 2015, Amir 2011, 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)}