Breastfeeding and psoriasis

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

Psoriasis is a skin condition that affects 2 to 3 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
  • 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, take a few measures to make the experience as comfortable for you and your 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 all mothers exclusively breastfeed for the first 6 months of a child’s life. If you experience a relapse during pregnancy or while nursing, you can try to start or continue nursing your infant.

Psoriasis medications while breastfeeding

Researchers are unable to study what psoriasis treatments work best in pregnant and nursing women due to ethical concerns. 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, but check with your doctor before using them. Avoid applying 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 women with moderate psoriasis, may be 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, are prescribed for moderate to severe psoriasis. But these treatments are typically not recommended to nursing mothers. That’s because these medicines can cross to the infant via breast milk.

Researchers haven’t studied the effects these medicines in infants. If your doctor thinks you need 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 have breastfed your baby for a certain 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 some options. These home remedies and strategies may help ease the symptoms of psoriasis and make nursing more comfortable.

Loosen up

Avoid tight-fitting clothes and bras. Clothes that are too snug can rub against your breasts 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 won’t irritate sensitive skin.

Soothe skin

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

Apply milk

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

Switch things up

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

Considerations if you’re breastfeeding and have psoriasis

Many mothers who are breastfeeding experience anxiety. If you have psoriasis, those worries may be compounded.

It’s important that the decision to breastfeed or not is ultimately up to you. In most cases, it’s safe for mothers with psoriasis to breastfeed. Psoriasis is not contagious. You cannot pass the skin condition to your infant via breast milk.

But not every mother will feel comfortable or prepared to nurse while 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 and safe.

Speak with your dermatologist

Continue to work with your dermatologist to respond to changes in your skin and adjust treatment when necessary, whether you’re trying to conceive, expecting, or already nursing. And discuss your options with your doctor. You may need to make a plan with your doctor once your baby is born as psoriasis affects women during pregnancy differently. Don’t be afraid to keep seeking new options until you find something that works.

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 facing similar situations.