Hydrocortisone 0.5% / Hydroquinone 8% / Tretinoin 0.025% Emulsion while Breastfeeding

Can I continue breastfeeding if I am using Hydrocortisone 0.5% / Hydroquinone 8% / Tretinoin 0.025% Emulsion? How long does it stays in breast milk?

Hydrocortisone while Breastfeeding

CAS Number: 50-23-7

Cortisol is a normal component of breast milk. Although unlikely to achieve harmful levels for the infant, it is preferred the use of an alternative (Methylprednisolone, Prednisolone, Prednisone). Intra-articular administration of depot prednisone derivatives may be a cause of transient decrease of milk production. Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Hydroquinone while Breastfeeding

CAS Number: 123-31-9

Benzene derivative which is topically used with creams and solutions (2-4%) as a bleaching agent for several skin disorders associated to hyper-pigmentation. In industry it is used as photographic developer. TLV or threshold limit value which means maximum exposure limit for workers is 2 mg / m3 (Flickinger 1976). At latest update relevant published data were not found on excretion into breast milk. It is well absorbed through the skin, both when used as a therapeutic agent (Bucks 1998, Wester 1998, Westerhof 2005, Andersen 2010, Bozzo 2011) or industrial use (Barber 1995, McGregor 2007), however, a significant excretion into breastmilk is not likely for their lack of fat solubility. There is controversy and doubt about a possible mutagenic and carcinogenic effect (Kooyers 2004, FDA 2006, Levitt 2007, Andersen 2010), so it does not seem wise a chronic or continued use while breastfeeding. Do not apply it on the breast to prevent ingestion by the infant; otherwise, do it just after a meal and clean the nipple thoroughly with water before the next feed.Do not apply it over large areas or on long-term treatments to avoid an excessive systemic absorption.

Tretinoin while Breastfeeding

Retinoid, an acid form of vitamin A. At latest update no published data on excretion into breast milk were found.It is a normal component of breastmilk. Because of the small dose used and poor absorption into plasma of most topical dermatological preparations, excretion into breastmilk in significant amount appears to be unlikely. Do not apply on the breast, otherwise, wash it off thoroughly before next feed. Systemic use (overall as an antineoplastic drug) while breastfeeding is absolutely contraindicated.

Hydrocortisone while Breastfeeding

CAS Number: 50-23-7

Hydrocortisone (cortisol) is a normal component of breastmilk that passes from the mother's bloodstream into milk and might have a role in intestinal maturation, the intestinal microbiome, growth, body composition or neurodevelopment, but adequate studies are lacking.[1] Concentrations follow a diurnal rhythm, with the highest concentrations in the morning at about 7:00 am and the lowest concentrations in the late afternoon and evening.[2][3] Cortisol in milk may protect against later infant obesity, especially in girls.[4] Hydrocortisone has not been studied in breastmilk after exogenous administration in pharmacologic amounts. Hydrocortisone in breastmilk is stable at room temperature and during repeated freeze-thaw cycles.[5] Although it is unlikely that dangerous amounts of hydrocortisone would reach the infant, a better studied alternate corticosteroid might be preferred. Maternal use of hydrocortisone as an enema would not be expected to cause any adverse effects in breastfed infants. Local maternal injections, such as for tendinitis, would not be expected to cause any adverse effects in breastfed infants, but might occasionally cause temporary loss of milk supply. See also Hydrocortisone, Topical. Hydrocortisone concentrations in breastmilk are not affected by storage for 36 hours at room temperature, during multiple freeze-thaw cycles, nor Holder pasteurization (62.5 degrees C for 30 minutes).[5][6]

Hydroquinone while Breastfeeding

CAS Number: 123-31-9

Topical hydroquinone has not been studied during breastfeeding. Hydroquinone is not contraindicated during breastfeeding and if hydroquinone is required by the mother, it is not a reason to discontinue breastfeeding. However, some experts feel that long-term use of hydroquinone is difficult to justify in a nursing mother.[1] If hydroquinone is used, ensure that the infant's skin does not come into direct contact with the areas of maternal skin that have been treated and the infant does not ingest the product from the mother's skin.

Tretinoin while Breastfeeding

CAS Number: 302-79-4

Tretinoin has not been studied during breastfeeding. Breastfeeding should probably be avoided after oral use. Because it is poorly absorbed after topical application, it is considered a low risk to the nursing infant.[1][2][3] Ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[4]

What if I already have used Hydrocortisone 0.5% / Hydroquinone 8% / Tretinoin 0.025% Emulsion?

My doctor has prescribed me Hydrocortisone 0.5% / Hydroquinone 8% / Tretinoin 0.025% Emulsion, what should I do?

If I am using Hydrocortisone 0.5% / Hydroquinone 8% / Tretinoin 0.025% Emulsion, will my baby need extra monitoring?

Who can I talk to if I have questions about usage of Hydrocortisone 0.5% / Hydroquinone 8% / Tretinoin 0.025% Emulsion in breastfeeding?