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A large pregnancy registry has published their results showing rheumatoid arthritis (RA) patients who become pregnant are less likely to breastfeed compared to non-RA women from the general population, with many women stopping breastfeeding so that they could start medication, even though many of these meds are safe to use during lactation.
The World Health Organization recommends that infants be exclusively breastfed until the age of 6 months. The
Data was drawn from the Pregnancy-induced Amelioration of Rheumatoid Arthritis (PARA) study, a nationwide prospective cohort study (2002 to 2008). They followed 249 pregnancies through pregnancy and until 6 months postpartum. Data
Postpartum breastfeeding rates in RA patients (vs general population) were:
- 4-6 weeks = 43% (gen. Population - 63%)
- 12 weeks = 26% (gen. Population - 46%)
- 26 weeks= 9% (gen. Population - 41%)
Breastfeeding by RA women was significantly lower than the general population (p < 0.001).
The main reason for women to discontinue breastfeeding was the restart of medication (n = 129, 57.8%). Nevertheless, more than 40% of these patients restarted medication that was considered compatible with breastfeeding.
This large prospective study of RA women shows that postpartum they are less likely to breastfeed and demonstrate earlier cessation compared with the general population.
Education and intervention strategies supporting RA patients who wish to breastfeed are needed.