4.5 Article

Breastfeeding Patterns in Mothers with Inflammatory Bowel Disease: A Pilot Prospective Longitudinal Study

Journal

INFLAMMATORY BOWEL DISEASES
Volume 28, Issue 11, Pages 1717-1724

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/ibd/izab354

Keywords

Breastfeeding; Pregnancy; IBD

Funding

  1. Centre of Excellence for Gastrointestinal Inflammation and Immunity Research, University of Alberta Department of Medicine
  2. University of Alberta Gastroenterology

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This study investigates breastfeeding practices in mothers with inflammatory bowel disease (IBD) and finds that approximately half of the patients discontinue breastfeeding after 6 months postpartum. The common reasons for discontinuation include perceived insufficient milk production and concerns about medication.
Background Breastfeeding practices in patients with inflammatory bowel disease (IBD) remain unknown. We aimed to characterize these practices and describe factors that may lead to early discontinuation. Methods This was a pilot, prospective, longitudinal study enrolling mothers with IBD from 2014 to 2017. Patients completed surveys on breastfeeding at time of delivery and up to 12 months postpartum. Breastfeeding discontinuation rates were reported for all patients with IBD and compared between patients with ulcerative colitis and Crohn's disease. Reproductive knowledge was defined using the Crohn's and Colitis Pregnancy Knowledge score. The Mann-Whitney U test assessed for differences between continuous variables, whereas categorical variables were compared using the chi-square test. Results A total of 74 mothers with IBD were included, 47 with ulcerative colitis and 27 with Crohn's disease. Breastfeeding rates in mothers with IBD was 94.6% at delivery, 73.9% at 3 months postpartum, 55.2% at 6 months postpartum, and 30.1% at 12 months postpartum. The most common reasons for discontinuing breastfeeding before 6 months postpartum included perceived insufficient milk production and concerns of infant medication exposure through breast milk. Compared with those who continued breastfeeding beyond 6 months postpartum, those who discontinued had lower median Crohn's and Colitis Pregnancy Knowledge scores (14.0 vs 9.0; P = .04). Conclusions Though most mothers with IBD initiate breastfeeding at time of delivery, about half continue beyond 6 months postpartum. Common reasons for this include perceived insufficient milk production and medication concerns. Larger studies are required to validate our findings in more generalizable settings such as primary and secondary care.

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