The breast feeding mother with moderate to severe asthma can quite safely use beta-adrenoceptor agonists via the inhaled route; systemic absorption is minimal. Less is known about the oral route: terbutaline and salbutamol seem safe.
Similarly, inhaled corticosteroids pose no threat to the infant but prolonged doses of oral prednisolone greater than 40mg per day after an acute attack are postulated to be more dangerous. The best policy is rapid and graded reduction in dose or cessation of breast feeding.
Modified-release theophyllines are believed to be safe but other preparations have been linked with case reports of infant irritability.
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