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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