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Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can cause pregnancy complications. However, most women with lupus can breastfeed successfully, especially with a little thinking ahead. If you plan to breastfeed, you may want to consider:
- Your health. Because lupus symptoms such as arthritis, rashes, and fatigue may get worse or "flare" during pregnancy or right after delivery, you may feel ill in the early days with your baby. This can make breastfeeding more of a challenge in the first week or so.
- Your baby's development. Up to half of moms with lupus deliver early, and some babies may be a lot smaller than expected, which can make nursing especially difficult.
- Drug safety. Lupus medication can pass into breastmilk and interfere with milk production or be unsafe for a baby. For example, women with lupus are advised to stop taking methotrexate before pregnancy, and most healthcare providers don't recommend resuming it when breastfeeding. On the other hand, medications like azathioprine, hydroxychloroquine, low doses of prednisone and NSAIDs are considered low-risk when breastfeeding.
Depending on the drug and dose, what's right for another mom may not be right for you. Ask your provider if the medication you're taking is considered safe when breastfeeding. Your provider can recommend an alternative medication, or lower the dose of drugs you're taking if needed.
- Drug side effects. Side effects from lupus medications in breastmilk might be more severe for a premature baby, especially one that is very small or sick.
What can I do to breastfeed successfully if I have lupus?
If your baby is too little or weak to suckle and nurse, you can pump breast milk until you're both ready to breastfeed. You may also be able to use banked breast milk, which you can get with a prescription from your provider. A lactation consultant can help, or you can contact the Human Milk Banking Association of North America.
If you're worried about the safety of the drugs you take to control your lupus, check out LactMed, the U.S. National Library of Medicine's searchable drug and lactation database. LactMed can give you information about the medication you're taking and how it affects breast milk.
LactMed can also help you find alternative medication if the drugs you're currently taking are considered unsafe for a nursing baby. You may need help from your provider to understand all the scientific data, but your research can be a good starting point for a discussion. There's even a LactMed app you can use on your phone.
Visit the Society for Maternal-Fetal Medicine's website for more information and to find an MFM specialist near you.