Excreted into breast milk in non-significant amount with no problems reported in breastfed infants whose mothers were treated at a daily dose as high as 8 mg for a long time period. On long term treatments it would be advisable to wait for 2 - 4 hours until the next nurse to minimize the transfer of drug to breast milk. By waiting for 2 a 4 hours after a methylprednisolone megadose or a pulse therapy dose, the transfer into breast milk may be minimized as well. At high doses, intra-articular treatment with other steroid drugs (Triamcinolone) have transiently affected milk production. Steroids administered before delivery may delay initiation of phase II of Lactogenesis ("milk come in") and decrease milk production in the first postpartum week. Decreased production has been seen while taking Dexametasone. Steroid drugs are commonly used for Pediatric treatment with no side effects when infrequently used and for short-time periods. The American Academy of Pediatrics rates it compatible with breastfeeding. WHO Model List of Essential Medicines (2002) rates it compatible with breastfeeding