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Background: Worldwide information on breastfeeding (BF) in Autoimmune Rheumatic Diseases (ARDs) is mainly focused on the safety of medications; however, acknowledgment of the patterns and practices is paramount in the development of the newborn and the mother-baby dyad.
Objectives: To describe the mother’s intentions, patterns, and attitudes of BF in patients with ARDs.
Methods: A cross-sectional nested study in a multicenter reproductive health cohort with ARDs was conducted in Mexico, in 4 different states of the country. Women between 15 and 50 years old, with at least one child born after diagnosis, were recruited to answer the Rheuma Reproductive Behavior questionnaire [1]. We used the BF definitions established by the Interagency Group for Action on Breastfeeding [2] as follows: Exclusive BF (EBF), almost exclusive BF (AEBF), partial BF (PBF), and exclusive feeding with formula milk.
Results: Four hundred twenty-nine women were included in this study, with a mean age of 37.7 standard deviations (SD 8.9). 28.9% had at least a high school degree, 364 (84.8%) were from a rural area, and 349 (81.35%) lived with a partner. The mean time of diagnosis of ARDs was 5.9 years (SD 8.7); 20% had a flare during pregnancy that needed a change in their treatment. The total number of births was 680 (97.6% were born alive), 51.8% by cesarean-section, the most frequent delivery method, and 48.1% due to medical decision. 96.8% intended to breastfeed, and 89.6% reported knowing BF was the best practice for feeding the infant. 58 (7.4%) reported they practiced BF less than one month, 103 (13.2%) practiced BF for 2 – 4 months, 170 (25%) for 4 – 6 months, 72 (10.6%) for 6 -12 months, and 112 (16.5%) for more than one year. Women that reported that they never breastfed were 62 (14.4%). Table 1 specifies the patterns of BF and the reasons for the decisions made.
Conclusion: Of the 318 (74.1%) of BF women with ARDs, 96.76% expressed that they wanted to breastfeed their baby, but only 39.3% practiced EBF, showing lack of information on the subject, even amongst health professionals. It is essential to establish safe and effective BF patterns in patients with ARDs. To ensure this, it’s crucial to have a multidisciplinary team in reproductive health clinics, including obstetrician-gynecologists, neonatologists, geneticists, and rheumatologists. This information is vital for the well-being of both the mother and the baby.
Patterns of breastfeeding. Exclusive breastfeeding (EBF), almost exclusive breastfeeding (AEBF), and partial breastfeeding (PBF).
| Item |
EBF
|
AEBF
|
PBF
| Exclusive feeding with formula n(% ) |
Total
|
|---|---|---|---|---|---|
| Number of born children, mean (SD ) | 288 (42.3) | 56 (8.2) | 251 (36.9) | 85 (12.5) | 680 (100.0) |
| Cesarean section | 146 (50.7) | 27 (31.7) | 113 (45.1) | 41 (73.21) | 327 (48.1) |
| Flare ARD’s | 48 (16.7) | 5 (8.9) | 57 (22.7) | 26 (30.6) | 136 (20.0) |
|
Counseling:
|
|
|
|
|
|
| Mother and infant dyad, minutes of Skin-to-skin contact, mean (SD ) |
| 1750.59 (3059.0)
| 4502.87 (7579.5)
| 1906.73
| 3346.2 (6014.7)
|
|
Reason to stop BF:
|
|
|
|
|
|
REFERENCES: [1] Perez-Barbosa L, Skinner-Taylor CM, Lujano-Negrete AY, Barriga-Maldonado ES, Peláez-Ballestas I, Espinosa-Banuelos LG, et al. Construction and validation of a reproductive behavior questionnaire for female patients with rheumatic diseases. Clin Rheumatol. 2023;42(9):2453-60.
[2] Labbok M, Krasovec K. Toward consistency in breastfeeding definitions. Stud Fam Plann. 1990;21(4):226-230.
Acknowledgements: NIL.
Disclosure of Interests: None declared.