Breastfeeding initiation, duration, and reasons for weaning in patients with systemic lupus erythematosus

Abstract

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.

Breastfeeding in women affected by systemic lupus erythematosus: Rate, duration and associated factors

“…The factors most positively associated with breastfeeding were low postpartum disease activity, full term delivery, and plan to breastfeed early in pregnancy; moreover, 67% of SLE patients declared intention of breastfeeding. 18 In the other study, by Acevedo and colleagues, analysing 36 pregnancies from 31 Argentinian women, breastfeeding was registered after 80% of pregnancies, with a mean duration of 6 months; the most frequent factor associated with non-breastfeeding was occurrence of complication during puerperium; on the other hand, initiation of treatment not compatible with breastfeeding was the main reason for breastfeeding cessation. 19 In agreement with these studies, our data confirm the role of puerperium disease activity and early term delivery in determining breastfeeding initiation and duration.…”

“…Breastfeeding in SLE patients is still a neglected topic: indeed, to the best of our knowledge, only two studies have been published so far. 18,19 Noviani and colleagues analysed 51 pregnancies in 84 women from the Duke Autoimmunity in Pregnancy Registry showing that half of the patients chose to breastfeed. The factors most positively associated with breastfeeding were low postpartum disease activity, full term delivery, and plan to breastfeed early in pregnancy; moreover, 67% of SLE patients declared intention of breastfeeding.…”

“…Unlike the numerous retrospective and prospective studies published about pregnancy in SLE women, 14–17 at today very few data are available about breastfeeding. SLE women seem to have reduced rates of breastfeeding and a reduced duration of breastfeeding; 18 furthermore, low postpartum disease activity, full term delivery and plan to breastfeed early during pregnancy have been significantly associated with breastfeeding. 19 Due to the limited number of data available on breastfeeding in SLE, breastfeeding prevalence and duration should be investigated to identify risk factors associated with early discontinuation in order to provide support and precise information to SLE mothers.…”

Breastfeeding in the systemic lupus erythematosus patient

“…19.5%; p = 0.07) and that mothers with SLE breastfed for a shorter duration (six months) compared with non-SLE mothers (12 months). 1 In a small ( n = 51) prospective registry by Noviani et al., half of SLE patients ( n = 25, 49%) chose to breastfeed. The intention to breastfeed was not affected by the subjects’ socioeconomic status, however, there was an association between breastfeeding and low postpartum lupus activity, term delivery, and a plan to breastfeed early in pregnancy.…”

Drugs for Lupus While Breastfeeding

“…When they did breastfeed, they stopped sooner and 41% of mothers weaned because of receiving a medication, although the medications they received were compatible with breastfeeding. 6 A wide variety of immunosuppressant medications are used to treat SLE. The various drug classes are reviewed in this column.…”