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Related Experiment Videos

Prednisolone excretion in human milk.

L Ost, G Wettrell, I Björkhem

    The Journal of Pediatrics
    |June 1, 1985
    PubMed
    Summary

    Mothers taking prednisolone can breastfeed safely, as infant exposure is minimal. Timing nursing after doses, especially higher ones, further reduces infant intake of prednisolone and its impact on cortisol levels.

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    Area of Science:

    • Pharmacology
    • Endocrinology
    • Pediatrics

    Background:

    • Prednisolone is a commonly prescribed corticosteroid for various maternal conditions.
    • Concerns exist regarding the transfer of prednisolone into breast milk and potential infant exposure.
    • Understanding prednisolone pharmacokinetics in lactating women is crucial for safe breastfeeding practices.

    Purpose of the Study:

    • To quantify prednisolone transfer into human milk.
    • To assess the potential infant exposure to maternal prednisolone via breastfeeding.
    • To provide evidence-based recommendations for breastfeeding while on prednisolone therapy.

    Main Methods:

    • Studied six lactating women on long-term prednisolone treatment (10-80 mg/day).
    • Measured serum and milk prednisolone and cortisol concentrations using high-performance liquid chromatography.
    • Analyzed milk-to-serum concentration ratios and estimated infant dosage.

    Main Results:

    • Prednisolone milk concentrations were 5-25% of serum concentrations, with parallel time curves.
    • Infant ingestion at 80 mg/day was <0.1% of the maternal dose, <10% of infant's endogenous cortisol.
    • Milk/serum ratio increased with higher maternal serum concentrations.

    Conclusions:

    • Maternal prednisolone dosage via breastfeeding results in minimal infant exposure.
    • Breastfeeding is generally considered safe at maternal doses up to 20 mg/day.
    • For higher doses, timing breastfeeding 4 hours post-maternal dose minimizes infant exposure.

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