Hi! I have been NO MAIL for an extended period of time and am joining
in again to tap your collective experience.

My question concerns a 4 month old exclusively breast fed term infant who
was started on prednisone by a pediatric dermatologist for a 1 cm
cavernous hemangioma threatening to obstruct the right nostril.  The
dose has been 15 mg od po from 30 Oct 1998, to be continued for a
further 1 month, then decreased to 10 mg, then 5 mg, and finally 2.5
mg at one month intervals.

Prior to commencing the prednisone the baby's weight had increased
from just above the 50th %ile at 7 weeks (4.90 kg,11/9/98) to the
95th %ile at 3 months.(6.63 kg, 21/10/98), and now is some 300 gm
above the 95th  %ile at 4 months (7.92 kg, 25/11/98).  Birth weight
at 38+ weeks gestation was 3380 gm (55th %ile).  Length continues to
follow the 50th %ile, and head circumference the 90th (length 61.5
cm, HC 42.3 cm 25/11/98).

The baby is thriving delightfully, but we are concerned that weight
gain may become excessive with the appetite stimulatory effects of
the prednisone.  Has anyone had any experience with an infant on
prednisone?  Is there a place for attempting to limit the baby's milk
intake,  eg, by spacing or limiting feeds, responding to feeding cues
with alternate activities, pacifier (standard pacifiers can not be
used because the flange  presses on the hemangioma)?

Please copy responses to this e-mail address <[log in to unmask]> as
well as to the list.  Thanks.

Suzanne McBride, RDH, BA, IBCLC
Community Breastfeeding Support Program