Can you take cortisone while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Cortisone is a normal component of breastmilk that passes from the mother's bloodstream into milk and might have a role in intestinal maturation, the intestinal microbiome, growth, body composition or neurodevelopment, but adequate studies are lacking. Concentrations follow a diurnal rhythm, with the highest concentrations in the morning at about 7:00 am and the lowest concentrations in the late afternoon and evening. Cortisone has not been studied in breastmilk after exogenous administration in pharmacologic amounts. Although it is unlikely that dangerous amounts of cortisone would reach the infant, a better studied alternate drug might be preferred. Medium to large doses of corticosteroids given systemically or injected into joints or the breast have been reported to cause temporary reduction of lactation.
Quoted from Cortisone — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised April 15, 2024.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of cortisone. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much cortisone gets into breastmilk
Maternal Levels. A study of 23 mothers found that cortisone was the predominant corticosteroid in breastmilk with an average concentration of 3.4 mcg/L over 24 hours. Concentrations were highest in the morning between 4:00 am and 10:00 am and lowest in the evening between 4:00 pm to 10:00 pm.
Cortisone was measured in the breastmilk of 22 women who delivered preterm infants between 28 and 32 weeks of gestation. The average cortisone concentration in breastmilk was 4.48 mcg/L with considerable variation. Mothers who gave birth before 30 weeks of gestation had an average cortisone concentration of 4.26 mcg/L and those who delivered after 30 weeks had an average concentration of 4.70 mcg/L.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
None reported with any corticosteroid.
Effects on milk supply
Published information on the effects of cortisone on serum prolactin or on lactation in nursing mothers was not found as of the revision date. Medium to large doses of corticosteroids given systemically or injected into joints or the breast have been reported to cause temporary reduction of lactation.
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. An equivalent dosage regimen of cortisone 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. An equivalent dosage regimen of cortisone might have the same effect.
Frequently asked questions
Can you take cortisone while breastfeeding?
What the NIH's Drugs and Lactation Database says about Cortisone while breastfeeding — quoted in full. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
What can I take instead of cortisone while breastfeeding?
LactMed lists Methylprednisolone, Prednisolone, Prednisone as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does cortisone pass into breastmilk?
LactMed's measured drug levels for cortisone are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking cortisone?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on cortisone
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.