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Drug Info Maternal Matters

Is prednisone breastfeeding safe?

Research shows that nursing is generally safe while taking this medication, but there are some exceptions
Christine Bryant headshot
By | May 9, 2025 Medically reviewed by Leslie Greenberg, MD
medication next to a baby bottle - prednisone and breastfeeding

Key takeaways

  • Research shows small amounts of prednisone may be excreted into breast milk, but the levels are typically low and unlikely to harm an infant.

  • Low doses of prednisone—usually 20 milligrams or less per day—may not require a mother to wait before breastfeeding. High doses may require waiting up to 4 hours.

  • The highest levels of prednisone in breastmilk are one to two hours after ingestion.

In this article:

Prednisone is a prescription corticosteroid medication taken to reduce inflammation. Patients take prednisone to treat many different conditions, including asthma, allergic reactions, certain types of arthritis, autoimmune diseases, and inflammatory bowel disease. 

Because these conditions can impact people of all ages, women may wonder if taking prednisone while breastfeeding is safe. Luckily, research shows that it is generally safe for the baby. 

Can you take prednisone while breastfeeding?

Moms are often careful about what they eat and drink while breastfeeding, knowing that anything they consume, from food to medication, can pass through breast milk and affect their newborn baby.

“When it comes to breastfeeding, prednisone is generally considered safe in low to moderate doses,” explains Kimberly Langdon, MD, an OB-GYN based in Ohio. “Research, including guidance from LactMed and the American Academy of Pediatrics, supports that small amounts of prednisone are excreted into breast milk, but the levels are typically low and unlikely to harm the infant.” 

“Some potential benefits of prednisone in new mothers include rapid relief from postpartum autoimmune flares, like lupus or rheumatoid arthritis, which can improve maternal well-being and ability to care for the baby,” Dr. Langdon says. While prescribing prednisone during breastfeeding isn’t uncommon, physicians weigh the risks and benefits carefully. “It’s not strictly reserved as a last resort, but safer alternatives or topical steroids might be considered for mild conditions,” Dr. Langdon says.

“In pain management, we often use it short-term to help relieve inflammation that’s causing pain flares or nerve irritation,” adds Sean Ormond, MD, of Atlas Pain Specialists.

Several studies over the past few decades, including ones published in The Journal of Clinical Pharmacology and Transplantation, have shown that the amount of prednisone found in breast milk is very low. No adverse effects have been reported in infants who are breastfed by mothers who are taking prednisone.

Prednisone vs. prednisolone while breastfeeding

Prednisone and prednisolone are both synthetic glucocorticoids used to treat inflammatory and autoimmune disorders. Prednisolone is the active metabolite of prednisone. In other words, prednisone becomes prednisolone in the body, Dr. Ormond says.

Prednisolone may be preferred in patients who have impaired liver function since it does not require liver metabolism. Prednisone must be converted into prednisolone in the liver. 

When looking at the potential side effects of prednisolone versus prednisone, no adverse effects have been reported in breastfed infants when the mother uses any type of corticosteroid, according to the National Institutes of Health Drugs and Lactation Database.

“When we compare, we mostly look at how much of the drug enters the bloodstream and then the milk,” Dr. Ormond says. Prednisone has a long track record and is a reliable choice for most situations.” However, it’s always important to reach out to your provider with any questions.

“If you’re facing the need to take prednisone while breastfeeding, know that you’re not alone and there are safe ways to balance both your health and your baby’s well-being,” Dr. Ormond says.

How long should I wait to breastfeed after taking prednisone?

Out of an abundance of caution, it’s commonly recommended to wait four hours after a dose to breastfeed. However waiting is not necessary if you’re taking doses less than 40 mg per day. 

For higher doses, ask a healthcare provider about timing of nursing. The highest levels of prednisone occur one to two hours after ingestion, so Jessica Madden, MD, a pediatrician, neonatologist, and medical director at Aeroflow Breastpumps, suggests waiting two hours to breastfeed or breast pump after each dose if possible. “Prednisone is typically totally gone from the body and breastmilk about 12 hours after ingestion,” Dr. Madden adds. 

Prednisone, sometimes prescribed under the brand names Deltasone or Rayos, is available as an oral tablet in 2.5 mg, 5 mg, 10 mg, 20 mg, or 50 mg doses. It is also available as an oral solution.

Side effects of prednisone while breastfeeding

While there have been no adverse effects reported in infants who are breastfeeding from mothers who have been prescribed prednisone, side effects in mothers may still occur.

Prednisone side effects in mothers may include:

  • Acne
  • General discomfort and fatigue
  • Headache
  • Increased appetite
  • Insomnia
  • Nausea
  • Trouble sleeping
  • Moodiness
  • Weight gain
  • Decreased milk supply (with high doses)

Some potential rare, but serious side effects include:

  • Allergic reactions
  • Cushing syndrome
  • High blood sugar
  • Increase in blood pressure
  • Infection
  • Low adrenal gland function
  • Mood and behavior changes
  • Stomach bleeding
  • Swelling of the ankles, hands, and feet

Despite the potential side effects for a mother, it is fairly common for healthcare providers to prescribe prednisone to breastfeeding mothers when it is needed to treat a medical condition.

To mitigate risks, breastfeeding mothers should work closely with their healthcare provider to monitor systems, use the lowest effective dose, and possibly time breastfeeding to reduce infant exposure, Dr. Langdon says. “It’s also helpful to maintain regular pediatric check-ups to ensure the baby is thriving.” 

How to take prednisone while breastfeeding

With any medication, it’s important to take proper safety precautions. When using prednisone while breastfeeding, Dr. Ormond advises that breastfeeding parents:

  • Use the lowest dose that is effective.
  • Time your dose to avoid breastfeeding when levels are highest if you’re taking a high dose.
  • Communicate with your baby’s healthcare provider or pediatrician that you’re taking prednisone.
  • Stay on top of your health—that includes hydration, sleep, mood, and nutrition. 
  • Report any side effects you experience to your healthcare provider, especially mood changes.

“If you notice these, talk to your provider,” Dr. Ormond says. “We can help adjust your dose or add in support like diet changes, supplements like calcium and vitamin D, or even taper the medication. It’s really important to stay in touch with your doctor so we can tailor your treatment to keep you feeling well and your baby safe.”

Prednisone can be prescribed as a tapered dose in which patients gradually decrease the amount they take. “If you are on a prednisone taper, please do not stop the medication cold turkey without talking to your provider first,” Dr. Madden emphasizes.

Alternative steroids for nursing mothers

Of the steroids available, prednisone has a long track record of safety while breastfeeding, Dr. Madden says. Depending on what condition is being treated, there are additional steroid options that may be prescribed in place of prednisone, she explains:

  • Methylprednisolone: Methylprednisolone is very similar to prednisone and also considered safe while breastfeeding.
  • Hydrocortisone: Hydrocortisone is another option, often used in lower-potency treatments or topical applications. Topical steroids are considered safe when used properly and applied to small areas of the skin.
  • Budesonide: This is commonly used for asthma or digestive issues.
  • Fluticasone: One good alternative to prednisone for asthma patients is to use an inhaled steroid such as fluticasone.

“Prednisone is the preferred oral steroid over others like dexamethasone,” says Dr. Madden.

The bottom line

Backed by medical research, healthcare experts agree that taking prednisone while breastfeeding is generally safe. Ultimately, a mother’s health is critical to her ability to care for her baby. In many cases, treating conditions like asthma and autoimmune conditions with medications like prednisone is an important part of that care. 

While prednisone is considered safe during breastfeeding, it’s always important to take proper precautions. These precautions include using the lowest effective dose, timing doses strategically, and staying in close communication with your healthcare provider.