To Kathleen Doerr:
Medrol is methylprednisolone, and has about the same effect and
pharmacokinetics as prednisolone, and pednisone, although it reportedly has
less mineralocorticoid(water retention) side effects. Its a very popular
steroid, although I don't really think it has many advantages over
prednisone. In general only small levels of corticosteroids are
transferred into human milk. Doses as high as 80 mg/ day transfer steroid
doses to the infant somewhere less than 0.1% of the maternal dose, which is
probably not clinically relevant. Prednisone levels have been reported to
be less than 1.6 ug/ liter of milk, which is miniscule.
A Medrol dosepak is a unique doseage form consisting of 6 tablets
the first day, 5 the next, and then so on until 1 tablet the last day
(6,5,4,3,2,1). At most the dose on the first day would be 24 mg, and then
tapering off to 4 mg the last day. Four mg of medrol is equivalent to 5
mg of prednisone.
There are a number of studies that in general show that only minimal
transfer of corticosteroids to milk occurs in a breastfeeding moms.
In addition, steroids are only hazardous in infants when exposure is
somewhat longer than 7 days. I doubt that short-term exposure to this
steroid would produce any long term sequalae. I have enclosed several
references for your perusal.
Greenberger, PA, et.al. Pharmacokinetics of prednisolone transfer to breast
milk. Clinical Pharmacology and Therapeutics 53:324-328, 1993
Ost L. et.al. Prednisolone excretion in human milk. J. Pediatr.
106:1008, 1985
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T.W. Hale, Ph.D.
Associate Professor of Pediatrics
Texas Tech University School of Medicine
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