Feeding an Infant While Living with Arthritis
Whether breastfeeding or bottle feeding — or a combination of both — ensuring your infant gets all the nutrients they need is not always as simple as it sounds. Use these tips to help.
By Maria Z. Leach | April 19, 2023
Caring for a newborn is a lot of work for any parent and a significant part of the job is feeding your new baby. According to the American Academy of Pediatrics (AAP), newborns need to eat eight to 12 times each day. For parents living with inflammatory arthritis who may also be dealing with a postpartum flare, deciding how to approach infant feeding can require careful thought.
Fed is best
Whether you are considering breastfeeding, bottle feeding pumped milk, bottle feeding donor milk, bottle feeding formula, or some combination of those options, the most important consideration for infant feeding is to make sure your baby receives all the necessary nutrients to continue growing and developing. Parents should be supported to make whatever infant feeding decision is best for their family.
The decision whether or not to breastfeed should always be a personal one, but many mothers report feeling a great deal of pressure to breastfeed from doctors, family members and society in general. While it’s true that the AAP recommends babies be exclusively breastfeed for at least the first six months of life, the benefits of breastfeeding also need to be balanced with the mother’s physical and mental health — particularly for mothers who are already living with their own health issues. Any mother may have personal reasons for choosing not to breastfeed.
Breastfeeding isn’t all or nothing
For mothers who do choose to breastfeed, each individual will have a different experience — from their milk supply to their infant’s ability to latch properly to the amount of physical and mental effort breastfeeding takes. Breastfeeding experiences can also vary with each baby for the same mother. Mothers living with rheumatic diseases may also need to consider the impact of a potential postpartum disease flare.
When choosing between infant feeding options, keep in mind that it generally does not need to be a strict choice between breastfeeding or formula-feeding. If you aren’t producing enough milk or you need more rest to maintain your physical health, donor milk or combination feeding (feeding your baby both breastmilk and infant formula) are both options to discuss with your doctor and pediatrician. Any amount of breastfeeding will allow the baby to receive some of the benefits of breastmilk, particularly if the baby can receive some of the nutrient-dense colostrum mothers produce right after birth.
Medication considerations
Mothers living with rheumatic diseases may also have medication concerns during breastfeeding, but here there is good news. “Women with inflammatory arthritis no longer need to choose between treating their arthritis and feeding their baby,” says Dr. Megan Clowse, MD, MPH, Director of the Duke Autoimmunity in Pregnancy Clinic and one of the authors of the comprehensive reproductive health guidelines released by the American College of Rheumatology in 2020.
“Because almost all medications prescribed for inflammatory arthritis are compatible with breastfeeding,” Dr. Clowse continues, “women should be able to do both: treat their arthritis and continue to breastfeed safely and comfortably.” If you choose to breastfeed, talk to your doctor about what medications are compatible. You can also speak to an expert (for free, in English or Spanish) at MotherToBaby, the nation’s most trusted source of evidence-based information on the benefit or risk of medication exposures during pregnancy and breastfeeding.
Ergonomic recommendations for infant feeding
In any form, infant feeding is a very repetitive task that can put you at a higher risk of overuse injuries or exacerbated arthritis symptoms, so it’s important to consider the ergonomics of feeding. You may want to consider having a designated feeding spot in your home, with a comfortable and supportive place for you to sit as well as a footstool. A nursing pillow can also be very useful for positioning your baby and reducing the need to support your baby’s full weight, whether you are breastfeeding or bottle feeding.
If you are bottle feeding, try to choose a bottle that is easier for your hands to open, close and wash, as this is a repetitive task that will need to happen multiple times each day. The AAP also advises that you avoid bottle propping (leaning your baby’s bottle on a pillow or other support rather than holding the bottle) as it can be unsafe for your baby.
If you choose to breastfeed, consider your clothing choices. While there are a variety of breastfeeding-specific options (including nursing bras and special tops), test these to make sure the clasps and hooks don’t place additional strain on your hands. If you plan to use a breast pump, consider a hands-free pumping bra to assist with the process.
Breastfeeding moms can also consider different breastfeeding positions to reduce repetitive physical strain. The cradle hold, cross-cradle hold, or football hold can be done from a seated position, while side-lying nursing allows you to lay down. If a position doesn’t seem to work for you and your baby, it may still be worth revisiting that position later, because your preferences may change as your baby develops.
Get some support
If it is physically difficult for you to feed your infant, help is available. For breastfeeding moms, a lactation consultant can help with issues like milk supply, sore nipples, latching and positioning. An occupational therapist can also help you find strategies for the activities of daily living, including infant feeding, while a physical therapist can help treat any overuse injuries or flares that may occur. Lastly, it can be helpful to reach out to other moms with similar experiences for advice and support. No matter how you decide to feed your baby, remember that your physical and mental health should also be a priority.
Caring for a newborn is a lot of work for any parent and a significant part of the job is feeding your new baby. According to the American Academy of Pediatrics (AAP), newborns need to eat eight to 12 times each day. For parents living with inflammatory arthritis who may also be dealing with a postpartum flare, deciding how to approach infant feeding can require careful thought.
Fed is best
Whether you are considering breastfeeding, bottle feeding pumped milk, bottle feeding donor milk, bottle feeding formula, or some combination of those options, the most important consideration for infant feeding is to make sure your baby receives all the necessary nutrients to continue growing and developing. Parents should be supported to make whatever infant feeding decision is best for their family.
The decision whether or not to breastfeed should always be a personal one, but many mothers report feeling a great deal of pressure to breastfeed from doctors, family members and society in general. While it’s true that the AAP recommends babies be exclusively breastfeed for at least the first six months of life, the benefits of breastfeeding also need to be balanced with the mother’s physical and mental health — particularly for mothers who are already living with their own health issues. Any mother may have personal reasons for choosing not to breastfeed.
Breastfeeding isn’t all or nothing
For mothers who do choose to breastfeed, each individual will have a different experience — from their milk supply to their infant’s ability to latch properly to the amount of physical and mental effort breastfeeding takes. Breastfeeding experiences can also vary with each baby for the same mother. Mothers living with rheumatic diseases may also need to consider the impact of a potential postpartum disease flare.
When choosing between infant feeding options, keep in mind that it generally does not need to be a strict choice between breastfeeding or formula-feeding. If you aren’t producing enough milk or you need more rest to maintain your physical health, donor milk or combination feeding (feeding your baby both breastmilk and infant formula) are both options to discuss with your doctor and pediatrician. Any amount of breastfeeding will allow the baby to receive some of the benefits of breastmilk, particularly if the baby can receive some of the nutrient-dense colostrum mothers produce right after birth.
Medication considerations
Mothers living with rheumatic diseases may also have medication concerns during breastfeeding, but here there is good news. “Women with inflammatory arthritis no longer need to choose between treating their arthritis and feeding their baby,” says Dr. Megan Clowse, MD, MPH, Director of the Duke Autoimmunity in Pregnancy Clinic and one of the authors of the comprehensive reproductive health guidelines released by the American College of Rheumatology in 2020.
“Because almost all medications prescribed for inflammatory arthritis are compatible with breastfeeding,” Dr. Clowse continues, “women should be able to do both: treat their arthritis and continue to breastfeed safely and comfortably.” If you choose to breastfeed, talk to your doctor about what medications are compatible. You can also speak to an expert (for free, in English or Spanish) at MotherToBaby, the nation’s most trusted source of evidence-based information on the benefit or risk of medication exposures during pregnancy and breastfeeding.
Ergonomic recommendations for infant feeding
In any form, infant feeding is a very repetitive task that can put you at a higher risk of overuse injuries or exacerbated arthritis symptoms, so it’s important to consider the ergonomics of feeding. You may want to consider having a designated feeding spot in your home, with a comfortable and supportive place for you to sit as well as a footstool. A nursing pillow can also be very useful for positioning your baby and reducing the need to support your baby’s full weight, whether you are breastfeeding or bottle feeding.
If you are bottle feeding, try to choose a bottle that is easier for your hands to open, close and wash, as this is a repetitive task that will need to happen multiple times each day. The AAP also advises that you avoid bottle propping (leaning your baby’s bottle on a pillow or other support rather than holding the bottle) as it can be unsafe for your baby.
If you choose to breastfeed, consider your clothing choices. While there are a variety of breastfeeding-specific options (including nursing bras and special tops), test these to make sure the clasps and hooks don’t place additional strain on your hands. If you plan to use a breast pump, consider a hands-free pumping bra to assist with the process.
Breastfeeding moms can also consider different breastfeeding positions to reduce repetitive physical strain. The cradle hold, cross-cradle hold, or football hold can be done from a seated position, while side-lying nursing allows you to lay down. If a position doesn’t seem to work for you and your baby, it may still be worth revisiting that position later, because your preferences may change as your baby develops.
Get some support
If it is physically difficult for you to feed your infant, help is available. For breastfeeding moms, a lactation consultant can help with issues like milk supply, sore nipples, latching and positioning. An occupational therapist can also help you find strategies for the activities of daily living, including infant feeding, while a physical therapist can help treat any overuse injuries or flares that may occur. Lastly, it can be helpful to reach out to other moms with similar experiences for advice and support. No matter how you decide to feed your baby, remember that your physical and mental health should also be a priority.
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