People with ankylosing spondylitis can successfully breastfeed their babies. Most medications that treat the condition are safe to take while nursing.

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Breastfeeding with a chronic disease can be challenging, and it’s normal to have many questions and concerns.

If you have ankylosing spondylitis, you may be wondering whether it’s safe to breastfeed, how the condition affects nursing, and whether your medication is harmful to your baby.

Here, we will look at the relationship between ankylosing spondylitis and breastfeeding and share evidence-based information about how to successfully nurse your baby if you have this condition.

Read this for more information about ankylosing spondylitis.

Most people with ankylosing spondylitis can successfully breastfeed. In fact, most major health organizations recommend that parents with rheumatic diseases nurse if they are inclined to, including the American College of Rheumatology, Academy of American Pediatrics, and World Health Organization.

Breastfeeding is encouraged because of the health benefits for both parents and their babies, such as the reduced risk of sudden infant death syndrome (SIDS), increased protection from disease, and reduced risk of breast and ovarian cancer for parents.

According to the Arthritis Foundation, there is no evidence that ankylosing spondylitis decreases milk supply. Furthermore, you can’t pass the condition to your baby while nursing.

Sometimes breastfeeding parents experience pain while nursing due to the strain of holding their baby at the breast. Managing your pain through medication can be helpful. A lactation consultant can help you try different breastfeeding positions to maximize comfort, too.

Sometimes misinformation about taking ankylosing spondylitis medication while breastfeeding causes early weaning. According to a 2022 study, while most postpartum parents with ankylosing spondylitis attempt breastfeeding after delivery, having ankylosing spondylitis is a risk factor for ending breastfeeding within the first 6 months of starting.

In some of these cases, lactation was unnecessarily stopped by doctors due to medical treatment for ankylosing spondylitis, according to the study.

Researchers conclude that OB-GYNs and pediatricians may need more training about how to address parental concerns about medications during lactation. This can prevent the stopping of breastfeeding when a nursing parent is taking medications that are safe to take while breastfeeding.

Most people with ankylosing spondylitis need medication to manage their condition. Some commonly used to treat ankylosing spondylitis include:

According to the Centers for Disease Control and Prevention (CDC), in general, most medications are compatible with breastfeeding, and many do not get into breast milk. When they do, it’s usually in low amounts. The milk is usually not harmful to infants.

It’s best to talk with your healthcare professional about each individual medication you’re taking and whether it’s safe while nursing. If they deem a medication unsafe, an alternative medication may be available.

Doctors commonly prescribe biologics to people with ankylosing spondylitis. Biologics are medications formulated to address molecules involved in inflammation. These medications include:

  • IL-17 inhibitors
  • TNF inhibitors
  • IL 12/23 inhibitors
  • JAK inhibitors

According to a 2021 review, most biologics transfer at low rates into breast milk, and some are undetectable in breast milk. Moreover, 2020 American College of Rheumatology guidelines state that biologics, such as TNF-alpha inhibitors and rituximab, are safe to take while nursing.

Besides medication, ankylosing spondylitis is frequently treated with movement exercises and physical therapy. This may include weight training, cardio, and aquatic exercise. Often, these exercises work best when combined with medication, such as anti-inflammatory drugs.

Taking up exercise during nursing is not a problem. Physical activity will not affect your breast milk supply, nor will it affect the nutritional content of your breast milk.

If you are exercising, you will be burning extra calories, and breastfeeding requires additional calories. Make sure to eat regular meals and drink plenty of fluids.

There’s some preliminary evidence that nursing may prevent a child from later developing ankylosing spondylitis.

A 2016 study found that breastfeeding has a protective effect on children born with the HLA-B27 gene that’s associated with developing ankylosing spondylitis. In this study, breastfed babies with this gene were less likely to have ankylosing spondylitis down the road.

Researchers suggest this might have something to do with the ways breastfeeding positively impacts the gut microbiome, as it’s already known that a person’s microbial environment affects the role of the HLA-B27 gene.

Will breastfeeding cause ankylosing spondylitis to flare up?

A 2018 study found that the risk of flare-ups during childbearing was highest during pregnancy itself. The possibility of a flare-up was significantly higher during the second trimester than at 6 weeks postpartum.

The majority of study participants (81%) were breastfeeding at 6 weeks.

Where can I get more information about ankylosing spondylitis medications and breastfeeding?

Your OB-GYN, pediatrician, and lactation consultants are great resources. You can also consult LactMed, a resource from the National Library of Medicine. LactMed is a database that compiles available research about medications and their safety during breastfeeding.

What are the best positions for breastfeeding with ankylosing spondylitis?

Everybody experiences ankylosing spondylitis differently, so there is no one breastfeeding position that works best. However, for people who want to take pressure off of their back, trying a lying-down or laid-back breastfeeding position may help.

Supporting your baby with a nursing pillow or standard pillow can ease some of the strain of holding your baby in place for long periods of time.

People with ankylosing spondylitis are encouraged to breastfeed if they are interested in doing so.

Ankylosing spondylitis won’t affect your ability to make milk for your baby, and your AS is unlikely to worsen during the course of breastfeeding.

Most medications for ankylosing spondylitis are compatible with breastfeeding, but you be in touch with your healthcare team about each medication you are taking and whether it’s safe to continue.