Breastfeeding and Psoriasis

Breastfeeding is a special time of bonding between a mother and her infant. If you are dealing with psoriasis, however, breastfeeding may be difficult. That’s because psoriasis can make breastfeeding uncomfortable or even painful.

Psoriasis is a skin condition that affects two to three percent of the population. It causes red, inflamed spots to develop on the skin. These inflamed spots may be covered with thick, scale-like spots called plaques. Other common symptoms of psoriasis include:

  • cracking, bleeding, and oozing from the plaques
  • thickened, ridged nails
  • itching of the skin
  • burning
  • soreness

Psoriasis may cover small areas of your skin. The most common sites include elbows, knees, arms, and neck. It can also cover larger areas, including your breasts. It’s not uncommon for psoriasis to affect a woman’s breasts and nipples. If that happens during breastfeeding, you just need to take a few measures to make the experience as comfortable for you and baby as possible.

Recommendations for Breastfeeding

Many women with psoriasis may be able to continue breastfeeding even if they experience a relapse of the disease while nursing. In fact, the American Academy of Pediatrics recommends that all mothers exclusively breastfeed for the first six months of a child’s life. If you experience a relapse during pregnancy or while nursing, you can and should try to start or continue nursing your infant.

Psoriasis Medications While Breastfeeding

Due to ethical concerns, researchers are unable to study which psoriasis treatments work best in pregnant and nursing women. Instead, doctors must rely on anecdotal reports and best-practice strategies to help people find a treatment that works for them.

Most non-medicated topical treatments are okay for use while nursing. These treatments include moisturizing lotions, creams, and ointments. Some low-dose medicated topical treatments are also safe for use, but you need to clear them with your doctor before you use them. Avoid putting the medication directly on the nipple, and wash your breasts before nursing.

Treatments for moderate to severe psoriasis may not be ideal for all nursing mothers. Light therapy or phototherapy, which is typically reserved for patients with moderate psoriasis, may be completely acceptable and safe for nursing mothers. Narrowband ultraviolet B phototherapy or broadband ultraviolet B phototherapy are the most commonly suggested forms of light therapy.

Oral medications, including systemic and biologic medicines prescribed for moderate to severe psoriasis, are typically not recommended to nursing mothers. That’s because these medicines can cross to the infant via breast milk. Researchers have been unable to study the effects these medicines can have on infants. If your doctor determines your psoriasis needs these medicines for proper treatment, the two of you may discuss alternative ways of feeding your baby. You may also be able to push back the use of these medicines until you’ve been able to breastfeed your baby for a specific window of time and can begin formula feedings.

Home Remedies for Psoriasis

If you can’t use any psoriasis medications, or if you’d like to try easing symptoms with non-medication lifestyle treatments, you may have a few options. These “home remedies” and strategies may help ease the symptoms of psoriasis and make nursing more comfortable for you.

Loosen Up

Avoid tight-fitting clothes and bras. Clothes that are too snug can rub against your breast and increase sensitivity, in addition to potentially worsening psoriatic lesions.

Line Your Cups

Wear removable breast pads that can absorb fluids. Replace them if they get wet so they cannot irritate the sensitive skin.

Soothe Skin

Use wet, warm cloths or heated gel pads to soothe inflamed skin.

Apply Milk

Freshly expressed breast milk is a natural moisturizer. It can even promote healing, so try rubbing a bit into your nipples after feedings.

Switch Things Up

If nursing is too painful, try pumping until the psoriasis clears or is being managed with treatment. If only one breast is affected, nurse from the unaffected side, then pump the more painful side in order to maintain your milk supply and prevent painful side effects.

Considerations If You’re Breastfeeding and Have Psoriasis

Fears and anxieties surround many mothers who are breastfeeding. If you have psoriasis, those worries may be compounded even further.

It’s important to remember that the decision to breastfeed or not is ultimately up to you. In almost every case, it is safe for mothers with psoriasis to breastfeed their babies. After all, psoriasis is not contagious. You cannot pass the skin condition to your infant via breast milk.

Of course, not every mother will feel comfortable or prepared to nurse while also trying to treat psoriasis. In some cases, the psoriasis may be so severe that only powerful treatments are useful. That may mean you cannot safely nurse. Work with your doctor and your child’s pediatrician to find a course of treatment that is both effective for you and safe for your baby.

Speak with Your Dermatologist

Talk with your doctor about support groups. Online support forums can help you meet other nursing mothers who also are living with psoriasis. You may even find a local organization through your doctor’s office or a local hospital that can connect you with mothers who are facing similar situations.

Whether you’re trying to conceive, expecting, or already nursing, you should continue to work with your dermatologist to respond to changes in your skin and adjust treatment where necessary. Continually discuss your options with your doctor. Don’t be afraid to keep seeking new options and ideas until you find the ones that work for you.