Knowledge, intentions, and practices of breastfeeding among women with systemic lupus erythematosus: A cross-sectional survey.

INTRODUCTION

Breastfeeding in systemic lupus erythematosus (SLE) is often influenced by concerns about medication safety, with limited data on patients' perceptions and decision-making.

OBJECTIVES

To assess breastfeeding knowledge, intentions, and practices among women with SLE, focusing on disease activity and medication-related perceptions, particularly regarding hydroxychloroquine and prednisone.

METHODS

A cross-sectional survey was conducted with women diagnosed with SLE. Participants answered questions on demographics, previous pregnancy and breastfeeding experiences, knowledge of breastfeeding with SLE, and perceptions of breastfeeding safety with hydroxychloroquine and prednisone. The survey also assessed their intention to breastfeed in future pregnancies, especially during active disease.

RESULTS

The survey was completed by 85 patients, with a mean age of 35 years (SD 9). Of these, 56% reported at least one pregnancy, 53% had breastfed, and 32.9% had a child after being diagnosed with SLE (SLE&Child group). When considering future pregnancies, 88% intended to breastfeed, but 62% prioritized treatment over breastfeeding if SLE was active (p<0.001). After reading patient information leaflets (PILs), 64% considered breastfeeding on prednisone, while only 26% thought it safe with hydroxychloroquine. Breastfeeding knowledge was higher in the SLE&Child group. Initiation rates were 79.3% in the SLE&Child group and 93.2% in controls (p=0.08). The average breastfeeding duration was 14 months in the SLE&Child group and 17 months in controls (log-rank test=0.5).

CONCLUSIONS

Most patients with SLE intended to breastfeed, but this intention decreased during active disease. Hydroxychloroquine PILs appeared to discourage breastfeeding despite the drug's safety.