Breastfeeding with Addison's Disease

Addison's disease, also known as primary adrenal insufficiency, is a rare condition where the adrenal glands don't produce enough of certain hormones. This can affect various aspects of health, including energy levels, metabolism, and the body's response to stress. If Addison’s disease is well-managed, breastfeeding can be very successful.

What are the challenges of breastfeeding with Addison's disease?

Hormonal Imbalances: Addison's disease can lead to imbalances in cortisol and aldosterone, hormones that can influence milk production and your energy levels. These imbalances might make it more challenging to establish and maintain a healthy milk supply.

Fatigue: A common symptom of Addison's disease is fatigue, which can be exacerbated by the demands of breastfeeding. Managing your energy and ensuring you're getting enough rest is vital for both you and your baby.

Stress Management: Stress can negatively impact milk supply, and since individuals with Addison's disease may have a reduced capacity to cope with stress, finding ways to relax and stay calm is essential.

Medication: Some medications used to manage Addison's disease may affect breastfeeding. It's important to consult with healthcare providers to ensure your medications are safe for breastfeeding and won't impact your milk supply. The LactMed Database may be a helpful resource for you and your healthcare provider in determining if your specific medications are compatible with breastfeeding.

How can Addison's disease affect milk production?

Addison's disease might lead to difficulties in milk production due to hormonal imbalances. Cortisol, one of the hormones affected by Addison's, plays a role in the body's overall health and energy balance, which can indirectly affect milk supply. Regular monitoring and adjustment of your treatment plan, in consultation with your healthcare team, can help manage these effects.

What should I watch out for while breastfeeding with Addison's disease?

• Signs of Low Milk Supply: Keep an eye on your baby's weight gain, diaper output, and feeding behaviors to help monitor your milk supply.
• Increased Fatigue: While it's normal to feel tired as a new mama, excessive fatigue can indicate that your Addison's disease needs better management.
• Symptoms of Addison's Crisis: An adrenal crisis is a medical emergency. Symptoms include severe weakness, nausea, fever, and dizziness. If you experience these symptoms, seek medical help immediately.

When should I seek medical advice?

• If you notice a significant drop in your milk supply without any changes in breastfeeding patterns.
• If you're experiencing symptoms of an adrenal crisis or if your Addison's symptoms worsen.
• Whenever you have concerns about the effects of your medication on breastfeeding.

Are there any related issues I should be aware of?

Autoimmune Conditions: Since Addison's disease is often caused by an autoimmune response, be aware of other autoimmune conditions that might affect breastfeeding, such as thyroid disorders.

Tips for successful breastfeeding with Addison's disease:

• Work Closely with Your Healthcare Team: Regularly update your healthcare providers about your condition and any changes in your breastfeeding.
• Manage Your Energy: Prioritize rest and seek help with baby care to manage fatigue.
• Stay Hydrated and Nourished: Eat a well-balanced diet and stay hydrated to maintaining your health and milk supply.
• Stress Management: Mindfulness, gentle exercise, and support groups can help manage stress levels.

Breastfeeding with Addison's disease may be challenging, but with the right support and management, you can have a successful breastfeeding experience. Always consult with your healthcare providers and an IBCLC for personalized advice and support.

Sources

• https://pubmed.ncbi.nlm.nih.gov/13009186/
• https://www.addisonsdisease.org.uk/blog/how-adrenal-insufficiency-affected-my-pregnancy
• Anand G, Beuschlein F. MANAGEMENT OF ENDOCRINE DISEASE: Fertility, pregnancy and lactation in women with adrenal insufficiency. Eur J Endocrinol. 2018 Feb;178(2):R45-R53. doi: 10.1530/EJE-17-0975. Epub 2017 Nov 30. PMID: 29191934.