From the Guidelines
Yes, you can generally breastfeed while taking corticosteroids for knee issues, but it's crucial to consult with your healthcare provider about your specific medication and dosage. According to the most recent and highest quality study, corticosteroids like prednisone are considered compatible with breastfeeding, especially when the dosage is less than 20 mg daily 1. The amount of corticosteroids that passes into breast milk is typically small and considered safe for the baby. However, if the dosage is 20 mg or more, it is recommended to delay breastfeeding or discard breast milk for 4 hours after taking the medication 1. Some key points to consider include:
- Common corticosteroids like prednisone, methylprednisolone, and dexamethasone do pass into breast milk in small amounts, but these quantities are typically considered compatible with breastfeeding.
- Short-term use or local injections into the knee joint pose even less concern as systemic absorption is limited.
- If possible, you can time your medication intake right after a feeding session to minimize the amount in milk during the next feeding.
- Watch for any unusual symptoms in your baby such as irritability, poor feeding, or growth issues, though these are rare.
- Untreated pain or inflammation can negatively impact your breastfeeding experience, so managing your knee condition appropriately is important for both you and your baby. It's essential to follow the guidance of your healthcare provider and monitor your baby's health while breastfeeding on corticosteroids.
From the Research
Breastfeeding and Steroids for Knee Issues
- Breastfeeding mothers can be affected by steroid injections for knee issues, as shown in a study where a 26-year-old female experienced temporary suppression of lactation after a local corticosteroid injection for tenosynovitis 2.
- The dose and site of the steroid injection can contribute to the suppression of lactation, with high doses and injections in areas of high physical activity (like the knee) potentially leading to greater systemic absorption of steroids 2.
- Mothers can take precautions like expressing and storing enough breast milk to cover the period of potential lactation suppression prior to receiving steroid injections 2.
- The use of medications, including steroids, during breastfeeding should be approached with a positive attitude, and healthcare professionals should assess the latest evidence and consider the risk-benefit ratio before advising mothers to interrupt breastfeeding 3.
- There is limited data on the effects of steroid injections on breastfeeding, but available studies suggest that mothers can continue breastfeeding while taking steroids for knee issues, with proper precautions and monitoring 2, 3.
Knee Issues and Breastfeeding
- Long-term breastfeeding (more than 25 months) has been associated with an increased prevalence of joint pain and degenerative arthritis in Korean women aged 50 years and older 4.
- Intra-articular corticosteroid injections are commonly used to treat degenerative arthritis of the knee, and their efficacy and safety profile have been debated 5, 6.
- A systematic review and meta-analysis of randomized controlled trials found that intra-articular corticosteroid injections can reduce pain and improve function in the short term (≤6 weeks), but their effectiveness decreases in the long term (≥24 weeks) compared to other interventions 6.