RT Journal Article
SR Electronic
T1 In rheumatoid arthritis fewer women breastfeed their offspring compared with women from the general population; results from a nationwide prospective cohort study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.180805
DO 10.3899/jrheum.180805
A1 Hilal Ince-Askan
A1 Johanna M.W.  Hazes
A1 Radboud J.E.M.  Dolhain
YR 2019
UL http://www.jrheum.org/content/early/2019/02/25/jrheum.180805.abstract
AB Objective The World Health Organization recommends to exclusively breastfeed infants until the age of six months. The first objective was to compare breastfeeding frequencies and time of cessation between women with rheumatoid arthritis(RA) and the general population. Second, to identify why patients with RA discontinue breastfeeding. Methods This study was embedded in the Pregnancy induced Amelioration of Rheumatoid Arthritis study, a nationwide prospective cohort study. From 2002–2008 in total 249 pregnancies were followed from pregnancy until 6 months postpartum. Data on lactation and medication use were collected. Proportion tests were used to compare percentages of breastfeeding between the study population and the general/reference population. Results At 4-6, 12 and 26 weeks postpartum 43%, 26% and 9% of the RA patients breastfed their offsprings respectively, compared with 63%, 46% and 41% in the general population(pvalues < 0.001). The main reason for women to discontinue breastfeeding was the restart of medication(n=129, 58.6%). Nevertheless, more than 40% of these patients restarted medication that was considered compatible with breastfeeding. Conclusion This large prospective study demonstrates that RA is associated with lower proportions of women breastfeeding their offspring and earlier cessation compared with the general population. A considerable amount of patients discontinue breastfeeding so that they could start medication, despite the fact that many of the medications are considered safe to use during lactation. Using the results of this study, intervention strategies supporting RA patients who wish to breastfeed may be developed.