From the Guidelines
Hydrocortisone 1% is considered safe for use during breastfeeding, as the amount absorbed systemically is minimal when applied topically in small amounts to limited areas of the skin. According to the 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases 1, prednisone or nonfluorinated steroid equivalent <20 mg daily is recommended as compatible with breastfeeding, implying that topical hydrocortisone 1% is also safe due to its low systemic absorption.
Key Considerations
- When applying hydrocortisone 1% cream to the breasts, it's best to wipe the area clean before nursing to prevent direct contact between the medication and the baby.
- For most skin conditions requiring hydrocortisone, a thin layer can be applied to affected areas 1-4 times daily as needed, using the lowest effective amount for the shortest duration necessary.
- Hydrocortisone works by reducing inflammation, redness, and itching by suppressing the local immune response in the skin.
Precautions
- If larger areas of skin need to be treated or the medication is required for extended periods, consultation with a healthcare provider is recommended for personalized guidance, as higher doses or prolonged use might require additional precautions 1.
From the Research
Hydrocortisone 1% and Breastfeeding Safety
There are no direct research papers provided to assist in answering the question of whether hydrocortisone 1% is safe during breastfeeding.
Available Research on Cortisol and Breastfeeding
- The provided studies focus on the relationship between cortisol levels, maternal stress, and breastfeeding rates 2, 3, 4, 5, 6.
- These studies suggest that maternal cortisol levels can affect breastfeeding rates and infant development, but do not provide information on the safety of hydrocortisone 1% during breastfeeding.
- One study found that breastfeeding mothers had positive correlations between maternal cortisol levels and infant cortisol levels 3.
- Another study found that elevated cortisol levels due to postpartum stressors can negatively affect breastfeeding rates 4.
- A study on breastmilk cortisol levels found no significant associations with maternal or infant characteristics, except for a relationship with breastmilk crude protein in the third month of lactation 5.
- A recent study found that milk letdown/secretion in breastfeeding mothers was associated with decreases in maternal cortisol concentration, independent of infant contact 6.
Limitations
- The available research does not directly address the safety of hydrocortisone 1% during breastfeeding.
- More specific studies on the topic are needed to provide a definitive answer.