Psoriasis and breastfeeding: What to know
The World Health Organization (WHO) recommend exclusively breastfeeding infants for the first 6 months of life. They then suggest gradually introducing foods while continuing to breastfeed, until the baby is 2 years or older.
In this article, learn about the connection between psoriasis and breastfeeding, as well as which treatments are safe for the woman and baby.
Psoriasis and breastfeeding
A doctor can advise a woman about treatments for psoriasis while breastfeeding.
Psoriasis is an autoimmune disease that mainly affects the skin and joints. It causes red, raised, scaly patches of skin, and these can itch, burn, or sting.
Most of the time, psoriasis patches form around the major joints, on the lower back, and on the scalp, but they can appear anywhere, including on the chest and breasts.
If psoriasis affects the breasts while a woman is breastfeeding, it can be very uncomfortable. However, there are many ways to ease pain and other symptoms without jeopardizing the baby's health.
When in doubt, talk to a doctor who is knowledgeable about both psoriasis and breastfeeding. They can develop an individualized treatment plan.
How to treat psoriasis while breastfeeding
Some psoriasis medications are safe to use while breastfeeding, but others are not. According to the National Psoriasis Foundation, very limited research has considered the impact of psoriasis medication on breastfeeding.
However, the experts do recommend topical treatments as the first approach for breastfeeding women. These treatments can include over-the-counter moisturizers and emollients, such as petroleum jelly.
If topical moisturizers do not provide relief, a woman can apply low-dose topical steroids to the areas of affected skin.
Oral steroids such as prednisone and prednisolone are also safe to use while breastfeeding. Prednisone is very similar to hormones the body produces, and only a small amount passes through the breast milk.
It is important to note that the National Psoriasis Foundation generally advise against taking systemic or biologic drugs while breastfeeding, "unless there is a clear medical need."
Beyond these treatment options, doctors consider some kinds of phototherapy, such as UVB therapy, safe for breastfeeding women.
However, the experts warn against using other types, such as PUVA phototherapy. The medication in this treatment, psoralen, can pass through the breast milk and cause infants to be very sensitive to light.
Can breastfeeding trigger a psoriasis flare-up?
Sore skin around the nipples can trigger a psoriasis flare-up.
Breastfeeding does not always cause psoriasis symptoms to appear, recur, or worsen.
Some women experience relief from psoriasis during pregnancy and breastfeeding. Others find that pregnancy aggravates psoriasis symptoms, which continue during breastfeeding.
Also, certain aspects of breastfeeding make flare-ups more likely to occur.
Many women experience sore and cracked nipples, and these skin issues can trigger flare-ups of psoriasis in the area.
Doctors also recognize stress as a cause of flare-ups. Breastfeeding, sleep deprivation, and the many responsibilities of caring for a newborn can create a significant amount of stress, and this can worsen psoriasis symptoms.
When psoriasis flares up, a person may experience the following symptoms:
- dry, thick, raised patches of skin, called plaques
- scaly or silvery skin on some patches
- patches that itch or burn
- red bumps on the torso, legs, and arms
- sore, painful skin
- pus-filled bumps on the hands and feet
- peeling skin
Symptoms can vary, based on the severity and type of psoriasis.
Tips for management
Yoga and meditation may help reduce stress.
Managing psoriasis while breastfeeding can be challenging, and it may involve switching to a new medication.
Taking the following steps can help:
- reducing stress with meditation, therapy, or gentle yoga
- doing light exercises, once a doctor says it is safe
- keeping the skin moisturized
- taking cool showers instead of hot showers
- using ice packs on areas of itchy skin
If no lifestyle modifications or home remedies work, discuss other options with a doctor.
Psoriasis can make breastfeeding challenging, and certain treatments are unsafe.
However, other treatments and some management techniques can provide relief from psoriasis symptoms without jeopardizing the health of the breastfeeding woman or the infant.
Always consult a doctor about whether psoriasis treatments pose risks during breastfeeding.