Autoimmune diseases are chronic health conditions caused by the immune system attacking normal healthy cells in the body.
Normally, an immune response is not triggered against normal healthy cells in our body but only against potentially harmful pathogens (e.g. viruses or bacteria) that can invade our body.
But with an autoimmune disease, the immune system attacks normal healthy cells leading to a variety of symptoms and consequences that range from mild to severe.
Autoimmune diseases commonly occur in women, including of childbearing age. The hormonal activity of menstrual cycles is thought to be why women of childbearing age are at higher risk of autoimmune diseases.
Autoimmune Diseases & Breastfeeding
A mother with an autoimmune disease can face difficult decisions regarding optimising her health and supporting breastfeeding. This article helps answer four pertinent questions about autoimmune diseases and breastfeeding.
#1: What Are Examples Of Autoimmune Diseases?
There are many types of autoimmune diseases. The following table describes features of some of the more common autoimmune diseases.
|Name Of The Autoimmune Disease||What Cells The Immune System Attacks||Results Of The Autoimmune Disease|
|Coeliac disease||Small intestine, when gluten is consumed||Nutrient deficiencies|
|Rheumatoid arthritis||Joints||Joint deformation, pain and stiffness|
|Type 1 diabetes||Pancreas||Inability to make insulin|
|Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)||Digestive system||Digestive problems, nutritional deficiencies|
|Multiple sclerosis||Nervous system||Pain, paralysis|
|Graves’ disease and Hashimoto’s thyroiditis||Thyroid gland||Under or over production of thyroid hormones|
|Systemic lupus erythematosus||Any bodily system (e.g heart, lungs, kidneys, skin, digestive, nervous system)||Damage to system(s) involved|
#2: What Is The Treatment For Autoimmune Diseases?
Depending on the disease severity, some autoimmune diseases (e.g. lupus, rheumatoid arthritis, inflammatory bowel diseases) may be treated with medication that decreases the immune response (immune suppressant medications), as well as anti-inflammatory medication to reduce pain and inflammation. Other autoimmune diseases are treated with hormone replacement medication (e.g. type 1 diabetes with insulin, Hashimoto’s thyroiditis with thyroid hormone replacement agents). Since the trigger is known for coeliac disease, gluten avoidance is the treatment.
There can be months or even years when people with autoimmune diseases have minimal to no symptoms. In between these times, there can flares ups where symptoms can be much worse, even debilitating. For others, there may be no times where the disease regresses and it’s flared up all the time.
#3: Can A Mother With An Autoimmune Disease Breastfeed?
Having an autoimmune disease does not preclude breastfeeding per se. Occasionally, a mother with an autoimmune disease might be told that if she breastfeeds she will pass on antibodies to her baby causing her baby to acquire the autoimmune disease. This is completely ridiculous and untrue.
The main concerns mothers with an autoimmune disease have when it comes to breastfeeding is how they can:
- Manage their symptoms
- Ensure safety for their baby
There may be specific situations where:
- Certain medications are needed for a mother’s wellbeing which may not be compatible for breastfeeding (e.g. because the risks cannot be managed)
- Medications may be deemed compatible with breastfeeding
- The risks of a medication may be able to be managed during breastfeeding
For each situation, a mother should be encouraged to discuss all options with her health care provider to find out:
- The possible effects of not treating her autoimmune disease
- Treatment options (including their possible effect on her breastfed baby)
Interestingly, for multiple sclerosis, exclusive breastfeeding might actually stall a mother’s symptoms returning. The suppression of the menstrual cycle returning (which can occur with exclusive breastfeeding) may be a possible mechanism for this.
In addition, since autoimmune diseases most likely have a genetic factor, it’s important to be aware that the development of some autoimmune diseases (e.g. rheumatoid arthritis and Crohn's disease) is associated with a lack of exclusive breastfeeding.
All these things as well as the importance of breastfeeding for both a mother and her child need to be taken into account so that a mother with an autoimmune disease can make her own fully informed decisions about how it’s best to manage her autoimmune disease.
#4: Can Autoimmune Diseases Affect Milk Supply?
Various hormones are involved in normal breast development and with a mother’s milk coming in. Hence, some of autoimmune diseases which affect hormonal function (e.g. type 1 diabetes, Hashimoto’s thyroiditis) may impact milk supply. Typically, correcting hormone levels helps manage this possibility.
If you are worried about your hormone levels, see you doctor.
Working with a lactation consultant can help you get breastfeeding off to the best start possible to help establish and then maintain a good milk supply.
Dealing with an autoimmune disease as a mother can be very challenging, especially during flare ups. Getting as much evidence based information from your health care providers as possible can help you make fully informed decisions about what works best for you.