It is well known that the risk of an MS flair increases dramatically in the post-partum period. As a consequence, women with MS who have recently given birth are faced with the difficult question of should they continue breast feeding while taking steroids (methylprednisolone is a glucocorticoid, a type of steroid) or should they stop breast feeding. There has been little scientific guidance on this subject in the past leaving women in the difficult position of deciding on their own as to the best course of action. In the Multiple Sclerosis Journal, Cavit Boz and colleagues published a study that examined the levels of methylprednisolone in breast milk before intravenous methylprednisolone and 1, 2, 4, 8, and 12 hours after intravenous methylprednisolone.
The study concludes: “The level of methylprednisolone transfer into breast milk is very low. The RID for methylprednisolone was lower than the generally accepted value. As methylprednisolone therapy is of short duration, infant exposure would be very low should a mother choose to breastfeed 1 hour after infusion. Waiting 2–4 hours after infusion will limit infant exposure still further.”
While additional studies are clearly needed, this study should provide some comfort to women choosing to breast feed while on IV glucocorticoids.
Reference: Safety of IV pulse methylprednisolone therapy during breastfeeding in patients with multiple sclerosis
Cavit Boz, Murat Terzi, Serap Zengin Karahan, Sedat Sen, Yasemin Sarac, and Murat Emrah Mavis
Multiple Sclerosis Journal
Vol 24, Issue 9, pp. 1205 - 1211