Breastfeeding in Women with a Rheumatic Disease

Introduction

Breastfeeding is a treasured and advantageous experience for both moms and newborns that offers several health benefits. However, women with rheumatic disorders must take special care when it comes to nursing. To ensure the health of both mother and child, rheumatic disorders such as rheumatoid arthritis, systemic lupus erythematosus, and psoriatic arthritis offer challenges that must be properly managed. Healthcare professionals can help women with rheumatic illnesses make proper decisions regarding nursing while successfully treating their condition by addressing these aspects.

What Are the Benefits of Breastfeeding for Women With Rheumatoid Arthritis?

For women with rheumatic disorders, breastfeeding has several advantages that promote their general health and well-being.

Here are a few significant benefits:

• Reduced Disease Activity: For certain women with rheumatic conditions, breastfeeding has been linked to reduced disease activity. This impact could be influenced by hormonal changes related to breastfeeding, such as elevated prolactin and oxytocin levels. Mothers can better manage their illness and enhance their quality of life when the disease is less active.

• Better Bone Health: Inflammatory rheumatic illnesses can raise the risk of osteoporosis and bone loss. Women who breastfeed have been found to have a protective impact on their bone density, which is particularly important for those who have rheumatic disorders since they may be more susceptible to osteoporosis.

• Psychological Health: Breastfeeding has considerable emotional and psychological advantages for women with rheumatic disorders. During nursing, the bonding process and the production of hormones like oxytocin can encourage feelings of relaxation, stress relief, and mood improvement. This can be especially helpful for women coping with the difficulties of having a chronic ailment.

• Weight Loss: Breastfeeding encourages weight loss during the postpartum period, which is crucial for women with rheumatic disorders. Increased disease activity and joint stress can both be caused by being overweight. Breastfeeding aids in illness management and lowers the risk of problems associated with obesity by helping moms lose pregnancy weight.

• Long-Term Health Benefits: Studies indicate that breastfeeding may have long-term preventive benefits against the onset of rheumatic disorders, such as rheumatoid arthritis, later in life. Although the precise processes are unclear, breastfeeding may alter the immune system and protect against autoimmune diseases.

What Are the Challenges of Breastfeeding With Rheumatoid Arthritis?

For women with rheumatoid arthritis (RA), breastfeeding can be particularly difficult due to the nature of the disease and its effects on physical health.

Breastfeeding might be difficult for some mothers with rheumatoid arthritis because of:

• Joint Pain and Stiffness: Rheumatoid arthritis is characterized by joint pain and inflammation. In particular, breastfeeding can increase joint discomfort and stiffness in the wrists, hands, and shoulders due to the physical demands of holding the infant and maintaining correct placement. Breastfeeding may become unpleasant and difficult as a result.

• Fatigue and Energy Levels: Rheumatoid arthritis frequently causes fatigue, which can be exacerbated by the responsibilities of caring for a newborn, such as repeated nursing sessions.

• Concerns About Drugs: Many rheumatoid arthritis sufferers, especially women, must take medications to control their illness. There may be questions about these drugs' safety when nursing. Some rheumatoid arthritis drugs may pose dangers to newborns if given to them through breast milk. Women should speak with their healthcare practitioners to determine the compatibility and safety of their drugs during nursing.

• Disease Flares: Women with rheumatoid arthritis experience an increased risk of illness flares during postpartum. Disease activity may be influenced by hormonal changes, physical stress, and sleep deprivation brought on by caring for a baby. It takes close monitoring and collaboration between the mother, her rheumatologist, and other medical professionals to manage illness flares while the mother is nursing.

Are Arthritis Medications Safe During Breastfeeding?

Generally, safe drugs during pregnancy are often also compatible with nursing. However, this might change based on the medication, the child's age, and how frequently they breastfeed.

For the majority of nursing mothers:

• Breastfeeding is thought to be safe with hydroxychloroquine, colchicine, sulfasalazine, rituximab, and tumor necrosis factor (TNF) inhibitors, including etanercept (Enbrel), and adalimumab (Humira); however,, sulfasalazine is not recommended.

• Prednisone or another glucocorticoid (corticosteroid) dose under 20 milligrams is safe, but the infant has to be watched closely. If one takes a greater dose, wait four hours before nursing (or pump and discard the milk).

• It is not recommended to breastfeed while using methotrexate, mycophenolate mofetil, cyclophosphamide, leflunomide, or thalidomide because they can accumulate in the baby's tissues and cause significant damage.

• Small-molecule medications like tofacitinib (Xeljanz), apremilast (Otezla), and baricitinib (Olumiant) are likely to secrete in breast milk, but there is not enough evidence to support it. JAK inhibitors like baricitinib and tofacitinib have received increased warnings from the Food and Drug Administration regarding their general safety, especially for adults.

Ask the doctor about any essential precautions mothers should take for arthritis and medication necessary or compatible with nursing. Do not use any medication without prior consent from the doctor.

How to Manage Breastfeeding in Women with a Rheumatic Disease?

For the comfort and well-being of both the mother and the child, managing to breastfeed while living with rheumatoid arthritis (RA) calls for meticulous preparation and self-care techniques. The following advice can help mothers handle nursing while having RA:

Improve Joint Health

• Use Reassuring Postures for Breastfeeding: Select postures that provide the least amount of stress possible on damaged joints, such as those supported by pillows or cushions.

• Use Helpful Devices: To reduce joint stress and improve comfort, use products like breastfeeding cushions, ergonomic chairs, or adjustable nursing bras.

• Apply Warm Compresses or Cold Packs to swollen joints before or during nursing to lessen discomfort and swelling.

Prioritizing Self-Care:

• Better Sleep: Getting enough sleep is essential for treating RA and coping with breastfeeding demands. Take frequent pauses, sleep when the baby does, and ask friends, relatives, or partners for help with domestic duties.

• Exercise and Moderate Stretching: To increase joint mobility and decrease stiffness, engage in mild exercises and stretching. Speak with a physical or occupational therapist for the best workouts for your unique requirements.

• Pain Management: Create a pain management strategy with the help of your doctor, which may include prescription drugs, physical therapy, or complementary treatments like heat therapy or transcutaneous electrical nerve stimulation (TENS).

Obtain Assistance:

• Hire a Lactation Consultant: A lactation consultant can offer advice on appropriate latching methods, ideal nursing positions, and methods to deal with any particular difficulties you might experience because of RA.

• Joining a Support Group: Contact other rheumatic disease-affected nursing mothers to exchange experiences, advice, and emotional support. Online forums or neighborhood support groups may be excellent sources of information.

• Flexibility and Adaptation: Consider options such as pumping breast milk and bottle-feeding, utilizing a supplemental nursing system, or combining breastfeeding with formula if breastfeeding is too difficult. This enables one to offer the advantages of breast milk while considering mothers' requirements and restrictions.

Conclusion

Breastfeeding may be a rewarding experience for women with rheumatic disorders, but it demands careful attention and specialized management. Collaboration between the patient, medical professionals, and support systems is essential to navigating difficulties and making wise decisions. Women with rheumatic disorders can care for their newborns while efficiently managing their health by addressing drug safety, disease monitoring, and offering suitable support.