AB0573 REASONS FOR BREASTFEEDING AVOIDANCE: A MULTICENTER INSIGHT IN MOTHERS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

• Published in: Annals of the rheumatic diseases Vol. 82; no. Suppl 1; pp. 1483 - 1484
• Main Authors: Foddai, S G, Radin, M, Schreiber, K, Cecchi, I, Signorelli, F, De Jesùs, G, Aso, K, Kono, M, Urban, M L, Bacco, B, S Gallo Cassarino, L Lo Sardo, Arbrile, M, Barinotti, A, Gómez-García, I, Quaglia, M I, Tissera, Y, F Gervasoniuniversity of Turin, Aguirre-Zamorano, M Á, Alba, P, Benedetto, C, Atsumi, T, Amengual, O, Emmi, G, Andrade, D, Marozio, L, Roccatello, D, Sciascia, S
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2023
• Subjects: Autoantibodies; Birth; Breast feeding; Breast milk; Breastfeeding & lactation; Counseling; Fear; Health care; Lupus; Milk production; Neonates; Patients; Pregnancy; Systemic lupus erythematosus; Training; Womens health
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2023-eular.2271

BackgroundEven though the health benefits of breast milk are well established, only a small number of research have looked at breastfeeding in people with systemic lupus erythematosus, with mixed findings. In a previous multicenter cohort investigating 119 SLE pregnancies, one-third of patients did not breastfeed after giving birth.ObjectivesTo study the causes of breastfeeding avoidance with the purpose to increase the standard of care of SLE women.MethodsA priori questionnaire was created and administered to patients by structured-phone interview (Table 1). Pregnancy outcomes were retrospectively collected.ResultsA total of 22 questionnaires of women who did not breastfeed after first birth were collected. Twelve out of 22 (54.5%) patients experienced a disease flare in the 24 months following the delivery. Healthcare professional advice (36.4%) was the most frequently reported reason for not breastfeeding, followed by the mothers’ fear that medications (drugs) taken during pregnancy (22.7%) and/or the circulating autoantibodies (4.5%) could be passed onto the baby and therefore harm the new-born. In 10 (45%) cases, breastfeeding was not possible because of mother’s or neonatal clinical complications. One woman did not breastfeed for a personal choice.After giving birth, only nine out of 22 patients (40.9%) declared to have had adequate breastfeeding training, with 58% of women reporting a breastfeeding-training time of less than 5 minutes in those without an adequate counselling. Most patients (21 out of 22, 95.5%) stated that they would have breastfed their child if they could.ConclusionBreastfeeding avoidance in women with SLE is frequently the result of a confluence of individual preference, clinical advice, and the societal context. An implementation of patients-to-patients network, together with an update of health practitioners, may help to increase the frequency of breastfeeding in women with SLE and subsequently improve patients’ care.In Figure 1 implementation points suggested by patients.References[1]Radin et al. Disease activity at conception predicts flare up to 2 years after birth: A multicentre long term follow-up study.Table 1.1. Have you received pre-conceptional counselling?Y N2. For how long were you able to discuss about pregnancy planning with your HP?-One session -Multiple session3. In pre-conceptional counselling, were you informed on breastfeeding?Y N4. Why did you not breastfeed?-Healthcare professional advice -Fear that the undertaken drugs could be delivered to the baby -Fear that the autoantibodies and the disease might have been transferred to the baby -N/A5. Who, among HP, advised you not to breastfeed-GP -Rheumatologist -Gynecologist -Nurse/obstetrician -Training physician -N/A6. Did you seek out different medical opinions?Y N7. After you gave birth, did you receive detailed information on how to breastfeed, and were you trained to do it?Y N8. For how long have HP informed and trained you about breastfeeding-Less than 5 minutes -15 minutes -30 minutes -Multiple times during my hospitalization -I received training and support for several days after being discharged from the hospital9. Were informative materials on breastfeeding provided to you by HP?Y N10. If you not breastfed because of temporary neonatal complications, were you trained and supported in milk production maintenance?Y N N/A11. The choice of not breastfeeding was influenced by society’s demands?Y N12. Your choice of not breastfeeding was influenced by:-Work-related issue (lack of space and time to breastfeed) -Lack of support from family members and friends -None of the aforementioned13. Have you felt overwhelmed by the delivery and the first days that came after it?Y N14. Your choice of not breastfeeding was influenced by the belief that formula milk was healthier for the baby compared to the mother’s milk?Y N15. Would you have breastfed if you could have?Y N16. Do you think dedicated counseling could have changed your approach to breastfeeding?Y N17. Do you have any suggestions on how to implement breastfeeding awareness?Figure 1.Acknowledgements:NIL.Disclosure of InterestsNone Declared.