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.
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References
Karpouzas GA, Kitridou RC (2007) The mother in systemic lupus erythematosus. In Wallace DJ, Hahn, BH (eds) Dubois’ lupus erythematosus, 7th edn. Lippincott Williams & Wilkins, USA, pp 992–1038
Kavanaugh A, Cush JJ, Ahmed MS et al (2015) Proceedings from the American College of Rheumatology Reproductive Health Summit: the management of fertility, pregnancy, and lactation in women with autoimmune and systemic inflammatory diseases. Arthritis Care Res 67(3):313–325
Andreoli L, Bertsias GK, Agmon-Levin N et al (2017) EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid síndrome. Ann Rheum Dis 76:476–485
Smyth A, Oliveira GHM, Lahr BD et al (2010) A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol 5(11):2060–2068
Al-Herz A, Schulzer M, Esdaile J (2002) Survey of antimalarial use in lupus pregnancy and lactation. J Rheumatol 29(4):700–706
Motta M, Tincani A, Faden D et al (2005) Follow-up of infants exposed to hydroxychloroquine given to mothers during pregnancy and lactation. J Perinatol 25(2):86–89
Izumi Y, Miyashita T, Migita K (2014) Safety of tacrolimus treatment during pregnancy and lactation in systemic lupus erythematosus: a report of two patients. Tohoku J Exp Med 234(1):51–56
Noviani M, Wasserman S, Clowse MEB (2016) Breastfeeding in mothers with systemic lupus erythematosus. Lupus 25(9):973–979
World Health Organization. Breastfeeding health topic. Available at http://www.who.int/topics/breastfeeding/es. Accessed on 15 Jan 2016
American Academy of Pediatrics (2012) Section on breastfeeding: policy statement: breastfeeding and the use of human milk. Pediatrics 129:e827–e841
Dewey KG, Nommsen-Rivers LA, Heinig MJ et al (2003) Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics 112(3 Pt 1):607–619
Theofilogiannakou M, Skouroliakou M, Gounaris A et al (2006) Breast-feeding in Athens, Greece: factors associated with its initiation and duration. J Pediatr Gastroenterol Nutr 43:379–384
Daly A, Pollard CM, Phillips M et al (2014) Benefits, barriers and enablers of breastfeeding: factor analysis of population perceptions in Western Australia. PLoS One 9(2):e88204. doi:10.1371/journal.pone.0088204
Götestam Skorpen C, Hoeltzenbein M, Tincani A et al (2016) The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis 75:795–810
Ministerio de Salud de la Nación, Dirección Nacional de Maternidad e Infancia. Situación de la lactancia materna en Argentina. Año 2011. Available at http://www.msal.gob.ar/images/stories/bes/graficos/0000000215cnt-a11a-Situacion-de-la-lactancia-materna-2011.pdf. Accessed on 15 Jan 2016
UNICEF ARGENTINA. Lactancia materna y su importancia en la iniciativa Maternidades Seguras y Centradas en la Familia (MSCF). Available at www.unicef.org/argentina/spanish/Informe_Argentina.pdf. Accessed on 15 Jan 2016
Available at: http://www.anmat.gov.ar/boletin_anmat/Septiembre_2011/Dispo_6556-11.pdf. Accessed on 10 Dec 2016
Available at: http://www.anmat.gov.ar/boletin_anmat/abril_2012/Dispo_2303-12.pdf. Accessed on 10 Dec 2016
Available at: http://www.ivax.com.ar/productos/Documents/SmPC/EVOQUIN.pdf. Accessed on 10 Dec 2016
Available at: http://www.trbpharma.com/site/trbinfo/cata/docs/Prospect_Polirreumin-3906-04.pdf. Accessed on 10 Dec 2016
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Acevedo, M., Pretini, J., Micelli, M. et al. Breastfeeding initiation, duration, and reasons for weaning in patients with systemic lupus erythematosus. Rheumatol Int 37, 1183–1186 (2017). https://doi.org/10.1007/s00296-017-3750-1
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DOI: https://doi.org/10.1007/s00296-017-3750-1