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炎症性肠病与母乳喂养:一篇叙述性综述。

Inflammatory Bowel Disease and Breastfeeding: A Narrative Review.

作者信息

Hoxha Tedi, Youssef Michael, Huang Vivian, Tandon Parul

机构信息

Division of Internal Medicine, University of Toronto, Toronto, Ontario, Canada.

Division of Gastroenterology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

出版信息

Inflamm Bowel Dis. 2025 Jan 6;31(1):210-219. doi: 10.1093/ibd/izae033.

Abstract

Inflammatory bowel disease (IBD) frequently affects women of childbearing age who may consider breastfeeding. Although breastfeeding has numerous benefits, there remain concerns regarding the safety of breastfeeding among women with IBD. Breastfeeding is important in developing the immune system of infants and has been shown to protect against the development of IBD. The risk of developing an increase in disease activity postpartum is the same regardless of breastfeeding status. Most IBD medications are also considered safe in breastfeeding and have no major risks to infants. Despite this, breastfeeding rates remain low among women with IBD, mostly due to concerns about the safety of IBD therapy with breastfeeding. Many women self-discontinue their IBD medications to breastfeed, and there is often uncertainty among health professionals to make recommendations about therapy. Dedicated IBD clinics can greatly support mothers during pregnancy and breastfeeding periods to enhance their knowledge, optimize their medication adherence, and improve their postpartum outcomes. This review aims to provide the most recent evidence-based literature regarding the safety of breastfeeding in women with IBD and the current recommendations about medical therapies with breastfeeding.

摘要

炎症性肠病(IBD)经常影响育龄期女性,这些女性可能会考虑母乳喂养。尽管母乳喂养有诸多益处,但IBD女性母乳喂养的安全性仍令人担忧。母乳喂养对婴儿免疫系统的发育很重要,并且已被证明可预防IBD的发生。无论母乳喂养状况如何,产后疾病活动增加的风险是相同的。大多数IBD药物在母乳喂养中也被认为是安全的,对婴儿没有重大风险。尽管如此,IBD女性的母乳喂养率仍然很低,主要是因为担心IBD治疗与母乳喂养的安全性。许多女性为了母乳喂养而自行停用IBD药物,而且医疗专业人员在提出治疗建议时往往存在不确定性。专门的IBD诊所可以在孕期和哺乳期为母亲提供大力支持,以增加她们的知识、优化药物依从性并改善产后结局。本综述旨在提供关于IBD女性母乳喂养安全性的最新循证文献以及当前关于母乳喂养药物治疗的建议。

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