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Date: | Sat, 28 Mar 2009 11:34:25 -0400 |
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Below is the abstract of a case report of a breastfed infant made quite ill from
1% steroid ointment on mother's bruised nipples...It is just one case from 26
years ago. Also, I beleive the current APNO dose is ten times LESS strength
than the dose in this case report and it may not be the exact same type of
steroid preparation. Not being a licensed prescriber or pharmacist, I am clearly
not an expert to interpret appropriate or safe doses which makes me wary of
putting pharmaceuticals on mom's nipples...I know many women have reported
great relief using APNO ("Saved the breastfeeding")but I too worry about the
interpretation of "use sparingly" in a culture where for many "more is better"
and buying things makes it better....
The March peepers are singing these past two nights and the crocuses are in
bloom here along the south coast of New England!!
Cindi Zembo, RN IBCLC
De Stefano P. Bongo IG. Borgna-Pignatti C. Severi F. Factitious
hypertension with mineralocorticoid excess in an infant. [Case Reports. Journal
Article] Helvetica Paediatrica Acta. 38(2):185-9, 1983 May.
UI: 6874387
Authors Full Name
De Stefano, P. Bongo, I G. Borgna-Pignatti, C. Severi, F.
A 2-month-old breast-fed baby is described, who, admitted for a prolongation
of the QT interval on ECG, was found to be severely hypokalemic, alkalotic
and hypertensive (blood pressure 200/100 mm Hg). Marked generalized
hypotonia was present, and length was less than 3% for age. The results of
endocrinological evaluation showed profound suppression of the pituitary-
adrenal function and of the renin-aldosterone mechanism. CT scan,
cavography and pyelography were normal. A pharmacological cause for the
symptoms was sought and found: the mother had been using for the care of
bruised nipples a cream containing 1% 9-alpha-fluoroprednisolone-21-acetate.
Blood pressure remained elevated for 6 months, but became normal after one
year, and growth has resumed normally. The possible differential diagnoses are
considered, and the risks presented by topical steroids are emphasized.
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