To assess breastfeeding in patients with systemic lupus erythematosus (SLE), a cross-sectional study of patients with SLE compared to a non-SLE sample was performed. Patients who had pregnancies subsequent to their diagnosis of SLE and who were followed up in the hospital were interviewed. The group of non-SLE mothers consisted of patients who had no known rheumatic disease at the time of their pregnancy, and who were approached at the hospital paediatrics service waiting room. Thirty-six pregnancies in 31 patients with SLE and the same number of non-SLE mothers were studied. The number of SLE patients who did not initiate breastfeeding was higher than that of non-SLE mothers (19.4 vs 5.6%, respectively; p 0.07). The average duration of breastfeeding in SLE patients was 6 months (SD 6 months) versus 12 months (SD 8 months) in non-SLE mothers (log rank p: 0.003). Fifty-three percent of the non-SLE mothers indicated no particular reason for weaning, and considered that they had nursed their children a suitable amount of time. Conversely, SLE patients often set weaning in motion on the grounds that they had been placed on medication (41%). However, when the treatment was analysed, in 6 out of 12 cases, it consisted of low doses of either corticosteroids or hydroxychloroquine. Patients with SLE showed reduced rates of initiating breastfeeding. They also showed reduced duration of breastfeeding, and the reason for cessation was frequently cited to be therapies which were actually of low risk. Breastfeeding duration could be optimised by improving the level of information provided to patients.

The aim of this study was to ascertain the frequency of use, search intent (SI), level of accessibility, and degree of reliability of sources of information (SOIs) in rheumatology. Methods:A survey among adult outpatients with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and spondyloarthritis was conducted. They were asked if they had procured information from 12 selected SOIs during the past year. Search intent was defined as the source they would like to consult. Accessibility and reliability were assessed through 0-to-10 scales (minimum and maximum, respectively).Results: Four hundred two patients were surveyed. They had consulted a median of 3 SOIs (interquartile range, 2-6) but described a higher SI: median of 5 SOIs (interquartile range 3-8); p = 0.001.The most consulted SOIs were the physician (83%), other patients (45%), and Facebook (36%). The main differences between SI and the searches actually performed were observed in community lectures by health care professionals (49%), scientific societies (48%), and associations of patients (27%); p < 0.001. These 3 sources showed low level of accessibility. Facebook, press, radio, and YouTube were the least reliable sources.Conclusions: Patients consulted a median of 3 SOIs but reported a significantly higher SI. Although patients demand more information, the request is leveled at SOIs with difficult accessibility but high reliability.

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BackgroundBreastfeeding is the optimal source of nourishment for newborns and infants during their first year of life.Both short and long benefits accrue to mothers who breastfeed (1,2). The clinical condition of patients with systemic lupus erythematosus (SLE) may have an impact on breastfeeding onset and duration.ObjectivesAssess breastfeeding in patients with SLE.MethodsRetrospective case-control study. Patients who had got pregnant after being diagnosed with SLE (4 or more SLICC ACR/EULAR criteria) and whose pregnancies had been followed up in the hospital were interviewed. The control group consisted of patients approached in the waiting-room of the paediatrics service. The data collected included epidemiological information, main features of their pregnancies and newborns, breastfeeding duration, and reasons for weaning. This study was approved by the Bioethics Committee of the Ramos Mejia Hospital, and both patients and controls signed the informed consent form.ResultsThirty-six pregnancies in 31 patients with SLE and the same number of controls were studied. The following features were similar in both groups: current age, age at the time of delivery, level of education, average number of children, number of patients that breastfed for the first time, and preterm birth rates.Patients with SLE had planned their pregnancies ahead less frequently than controls (16.7% vs 44.4%, p 0.02), they had experienced a greater number of complications during the pregnancies (33.6% vs 5.6%; p 0.007), and their newborns showed a higher trend to minor complications (25% vs 11.1%; p 0.2).Twenty-five percent of the patients with SLE presented some kind of complication during puerperium, mainly related to disease activity, versus none in the controls (p 0.001). Also, a higher number of patients with SLE did not even initiate breastfeeding (19.4% vs 5.6% in the controls; p 0.07). Breastfeeding average duration in patients with SLE was 6 months (SD 6 months) versus 12 months (SD 8 months) in the controls (Log Rank p: 0.003).Fifty-two percent of the controls mentioned that there had been no reason for weaning and considered that they had nursed their children a suitable amount of time. Conversely, patients with SLE frequently set weaning in motion on the grounds that they had been placed on medication (42%). However, when the medication was analysed, in 6 of 11 cases (55%), it consisted of low doses of corticoids or Hydroxychloroquine.ConclusionsIn this retrospective case-control study it was observed that patients with SLE show a lower trend to initiate breastfeeding, and they sustain it for less time than controls (6 months vs 12 months respectively). Although the most common reason for weaning is the administration of medication, breastfeeding duration could be optimised by improving the level of information provided to patients.ReferencesAmerican Academy of Pediatrics. Section on breastfeeding: policy statement: breastfeeding and the use of human milk. Pediatrics 2012; 129: e827–41.World Health Organization. Breastfeeding heal...