Additional considerations for women with asthma

Comorbidities

Women with asthma are disproportionately affected by several chronic comorbidities – namely, obesity, gestational diabetes, and smoking – which have independent impacts on maternal and child health outcomes, including breastfeeding.

  • Overweight and obesity is associated with a lower likelihood of breastfeeding initiation, and obese women are more likely to cease breastfeeding earlier than women of a healthy weight, which is further compounded by excess gestational weight gain (Huang et al. 2019).
  • Infants exposed to gestational diabetes have higher rates of in-hospital formula supplementation, shorter breastfeeding duration and lower breastfeeding rates at 12 months (Manerkar et al. 2020).
  • Smoking in pregnancy/early postpartum has been linked to lower breastfeeding initiation and shorter duration (Council et al. 2019, Moss et al. 2021).

Women with asthma, who have a higher prevalence of these comorbidities, may therefore require additional support with breastfeeding; however, research in this particular area is currently lacking.
 

Medications

Women may be concerned about medication use during lactation. Reassurance is warranted with most medicines used to treat asthma demonstrated to be safe during breastfeeding (Better Health Channel 2021). Therefore, women with asthma should be encouraged and supported to breastfeed their child(ren) for as long as is comfortable and acceptable for the mother and child, and to use asthma medication as normal during breastfeeding, in line with their doctor’s recommendations.

Useful Resources

  • Lact Med (NIH) database
    The LactMed® database contains information on drugs and other chemicals to which breastfeeding mothers may be exposed. It includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the breastfeeding infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate
  • Australian Breastfeeding Association Resources for Heath Professionals
  • Medicines in Breastfeeding – Factsheet for women & families from the Royal Women’s Hospital, Victoria, Australia.