Corticosteroids, including prednisone, are a class of powerful drugs that reduce inflammation and suppress the immune system. They are prescribed for a wide variety of conditions, including rheumatoid arthritis (RA) and lupus, as well as multiple sclerosis, some types of cancer, asthma and skin rashes – including those caused by poison ivy. They can be prescribed short-term – until a rash clears up or until another drug can take effect, for example – or they may be used long-term. Corticosteroids come in skin creams, injections and inhaled forms; however, this study examined only people who took them orally.
Selective serotonin reuptake inhibitors (SSRIs) transfer into breast milk to varying extents. Paroxetine is reported to have the lowest transfer into breast milk (weight-adjusted infant dose 1-3%). Fluoxetine transfers to a greater extent (weight-adjusted infant dose ≤ 14%) and its active metabolite, norfluoxetine, has a long half-life of one to two weeks and may accumulate in a breastfed infant. Data on citalopram (weight-adjusted infant dose approximately 5%) suggest that the relative infant dose of citalopram is intermediate between paroxetine and fluoxetine. Based on these data, paroxetine is the preferred SSRI in breastfeeding women.