"Nobody knows, or seems to know how rheumatology and breastfeeding works": Women's experiences of breastfeeding whilst managing a long-term limiting condition - A qualitative visual methods study.
Denitza Williams, Jessica Webber, Bethan Pell and 7 others
PMID 31404778WHAT IT FOUND
Women with autoimmune rheumatic diseases described receiving contradictory or absent advice on medication safety while breastfeeding, leading to guilt and difficulty balancing disease control with infant feeding.
They felt pressured by targets rather than supported in making personal choices.
Key findings
01Women reported a lack of clear information on the safety of rheumatological medications in breastmilk, often receiving contradictory advice from different healthcare professionals.
02Participants described feeling pressured to breastfeed despite physical pain and fatigue, or pressured to stop to resume medication, resulting in feelings of maternal guilt.
03Physical challenges, such as musculoskeletal pain making it difficult to hold the baby in a breastfeeding position, were significant barriers for these women.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 13 women, which limits the range of experiences captured. Participants were recruited from a specific study (STAR family study) and may have had a higher interest in or awareness of their condition than the general population. The study focused on women with autoimmune rheumatic diseases; findings may not apply to women with other long-term physical conditions. Data were not double-coded, relying instead on team discussion, which may introduce some subjectivity in theme identification.
Declared interests
The study was funded by a Wellcome Trust Institutional Strategic Support Fund grant. The funders had no role in the study design, data collection, analysis, or manuscript preparation. The authors declared no conflicts of interest and stated they had not received money from infant formula or dairy companies.
The easy way to misread this
Do not interpret the lack of medication safety information as evidence that breastfeeding is unsafe for women with autoimmune rheumatic diseases. The study highlights a gap in healthcare professional knowledge and communication, not a biological contraindication. Many women with these conditions can breastfeed safely, but they require tailored, accurate advice to make informed decisions.