Breastfeeding in women with rheumatic diseases

Abstract

ObjectiveMany rheumatologists and women with rheumatic disease worry that the disease or treatment will prevent breast feeding. International guidelines establish, however, that most antirheumatic medications are compatible with breast feeding. We sought to identify the frequency and predictors of desire to and actually breast feeding in women with rheumatic diseases.MethodsPregnant women with rheumatic disease were enrolled prospectively. Demographics and breastfeeding intention were collected at study entry, while actual breastfeeding decision was recorded postpartum. Maternal diagnosis, demographics and medication use was collected throughout the study. Predictors of breast feeding and intention were identified using stepwise logistic regression.ResultsA total of 265 pregnancies were included in the study, 88 with SLE, 33 with undifferentiated connective tissue disease, 100 with arthritis and 44 with other rare rheumatic diagnoses. Of these, 79% intended to breastfeed, 84% of women ever breast fed and 65% were still breast feeding at an average of 7.6 weeks postpartum. Medication concern was the most commonly cited reason not to breastfeed though only 5% of women were taking or planning to start a non-lactation compatible medication at their postpartum visit. In multivariate analysis, women with a college degree were more likely and women with SLE were less likely to intend to breastfeed. Actual breast feeding was most strongly predicted by the woman’s intention to breastfeed, but also increased with maternal age, decreased if the baby was born preterm and decreased the further the postpartum appointment occurred from delivery.ConclusionThis study demonstrates that the majority of women with rheumatic disease want to and can breastfeed successfully. Additionally, very few women required a medication that was not compatible with breast feeding to control their rheumatic disease in the postpartum period. Despite this, an important minority of patients did not continue breast feeding due to their personal concerns about the risks of antirheumatic medications to their infant.

Active counselling and well-controlled disease result in a higher percentage of women with rheumatoid arthritis that breast feed: results from the PreCARA study

“…In their study, 222 out of 264 (85%) women initiated breast feeding. Of these women, 172 (65%) still breast fed at the postpartum visit, which was scheduled at an average of 7.6 (SD 4.6) weeks post partum 15. The latter percentage is somewhat difficult to compare to our results due to the large variation in the number of weeks after birth but appears slightly higher.…”

“…Recently, Ikram et al published a paper on breast feeding among women with rheumatic diseases. 15 In their study, 222 out of 264 (85%) women initiated breast feeding. Of these women, 172 (65%) still breast fed at the postpartum visit, which was scheduled at an average of 7.6 (SD 4.6) weeks post partum.…”

“…Literature on breast feeding among patients with rheumatic diseases is scarce. Recently, Ikram et al published a paper on breast feeding among women with rheumatic diseases 15. In their study, 222 out of 264 (85%) women initiated breast feeding.…”

“…Of these women, 172 (65%) still breast fed at the postpartum visit, which was scheduled at an average of 7.6 (SD 4.6) weeks post partum. 15 The latter percentage is somewhat difficult to compare to our results due to the large variation in the number of weeks after birth but appears slightly higher. Our observations are in line with literature on other chronic diseases, such as Crohn’s disease.…”

The Benefits of Breastfeeding Still Outweigh the Risks of COVID-19 Transmission

“…The amount of hydroxylchloroquine excreted from breast milk is low, and its amount in the breast milk was 3.2 ug after an oral regimen of 800 mg for 24 h ( 58 ), and infants receive no more than 0.2mg/kg of hydroxylchloroquine through breastfeeding from mothers who had 200 mg of hydroxychloroquine daily ( 59 ). In addition, 130 breastfed infants whose mothers received hydroxychloroquine treatment appeared to have normal development ( 60 ). Breastfeeding for mothers during hydroxychloroquine treatment are also recommended ( 61 , 62 ).…”