Last update: Feb. 11, 2020
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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An autoimmune disease where the immune system mistakenly attacks cells and tissues, and can damage joints, kidneys, heart, skin, lungs, arteries, veins and the brain. It is more common in women than in men as well as in African-American and Hispanic women. The disease usually occurs in the form of outbreaks with intermediate periods without symptoms (MedlinePlus 2019).
Maternal lupus increases the risk of prematurity, temporary neonatal lupus and congenital heart block in the newborn (Saavedra 2015, Goldsmith 1989).
Mothers with lupus have lower rates and shorter duration of breastfeeding (Acevedo 2017).
Breastfeeding figures improve if the disease is not very active in the postpartum period, if the pregnancy is at term and if the decision to breastfeed was taken and prepared early in pregnancy (Noviani 2016).
There are no known effects of breastfeeding on lupus (Francis 2109); Breastfeeding is not associated with worsening of lupus.
There are so many benefits of breastfeeding for mothers and infants that expert authors and medical associations agree that mothers with lupus should be supported so they can breastfeed, as well as to know and disseminate which medication to use that is compatible with breastfeeding (Francis 2019, Phillips 2018, Acevedo 2017, Götestam 2016).
Prolactin levels are elevated in lupus and correlate with the disease’s activity (Song 2017, Wang 2017) although these results are not always found (Wang 2017, Aulestia 2016).
Non-steroidal anti-inflammatories, low doses of aspirin, corticosteroids (prednisone, methylprednisolone), antimalarials (hydroxychloroquine, chloroquine), azathioprine, cyclosporine and immunoglobulins can be used safely during breastfeeding (Bitencourt 2018, Nahal 2018, Bermas 2017, Bălănescu 2017, Götestam 2016, Noviani 2016, Flint 2016). Calcineurin inhibitors such as tacrolimus are well tolerated and their excretion in breastmilk is insignificant (Hiramatsu 2018, Flint 2016, Izumi 2014).
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.
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