Compared with the general population, women with rheumatoid arthritis (RA) are less likely to breastfeed their children, according to study results published in the Journal of Rheumatology. The results indicated that many women with RA chose to discontinue breastfeeding after restarting medication.
The study was a substudy of the Pregnancy Induced Amelioration of Rheumatoid Arthritis study, which was a nationwide prospective cohort study. The study followed women from pregnancy, until 6 months postpartum from 2002 to 2008 (n=249). The researchers collected data on lactation and medication usage. They used proportion tests to compare percentages of breastfeeding between participants and the general/reference population.
The researchers found that at 4 to 6 weeks postpartum, 43% of participants breastfed their children compared with 63% of the general population (P <.001). At 12 weeks postpartum, 26% of participants breastfed compared with 46% of the general population (P <.001). At 26 weeks postpartum, 9% of participants breastfed compared with 41% of the general population (P <.001).
Participants indicated that the main reason they discontinued breastfeeding was the restart of medication (58.6%, n=129). The researchers noted, however, that more than 40% of these participants were restarting medication considered compatible with breastfeeding.
Other reasons for breastfeeding discontinuation included maternal reasons (n=77), such as a lack of milk or desire, or child-related reasons (n=15) such as struggle to latch and failure to thrive.
“Given the known benefits of breastfeeding on the offspring, more effort in education in the clinical practice and more research into the transfer of medication into breastmilk might enable more RA patients to breastfeed,” the researchers wrote.
Ince-Askan H, Hazes JMW, Dolhain RJEM. In rheumatoid arthritis fewer women breastfeed their offspring compared with women from the general population; results from a nationwide prospective cohort study [published online March 1, 2019]. J Rheumatol. doi: 10.3899/jrheum.180805