Being a new parent is never easy, but it can be especially challenging for patients with a chronic disease such as rheumatoid arthritis (RA). Here are some tips I have given to my patients with RA over the years—I hope you find them helpful for use in your practice!
- Let’s get the big question out of the way first: Breastfeeding. Depending on what medications mom is on, breastfeeding may be safe for the baby. Breastfeeding can be wonderful for a number of reasons that I won’t go into here. However, for a new mom with RA, breastfeeding might not be the best choice. I tell my new moms to consider that they need their sleep in order to help keep their RA under control and that they cannot get an adequate amount of quality sleep if they are the only ones feeding the baby every 2-4 hours. I typically encourage them to consider pumping and storing so that another adult can take some of the night shift.It’s also important to remind new moms that the world won’t end if formula ends up being the best choice for the patient and her family. I tell my patients to carefully consider the pros and cons of every option and come up with what works for them.
- While we’re on the topic of rest: I tell my patients to get enough! They need to accept help when it is offered, and ask for it when it isn’t. Every chore or task the new parent doesn’t have to complete means more energy to take care of him or herself and the baby. So when the neighbor offers to bring dinner over or a sibling offers to come over to do laundry, a hearty “Yes, please!” is the correct answer.
- New parents need to be especially careful about staying hydrated. As silly as it sounds, sometimes the basic things are the first to get lost in the shuffle of new parenthood. Dehydration can make joint pains worse, and nobody wants that.
- As much as possible, try to stay on a schedule for eating (I’m talking about the new parents here, not the baby!). This not only helps with overall health, but it can counteract some of the effects of the inevitable sleep deprivation that occurs.
- If mom is the one with the RA, I remind her that RA may naturally be less active during pregnancy, so be on the lookout for symptoms to return post-partum. Waiting for a full-fledged flare will just make it harder to get her disease under control; patients need to call at the first sign of increased disease activity.
- This isn’t specific to RA but is important for every new mom so I make sure to bring it up: Postpartum depression (PPD) is real, it is not just “baby blues,” and it is NOT a sign of not being “cut out” for motherhood. I remind my patients of the signs and symptoms of PPD and urge them to contact their OB/GYN if they have them.
- Last but not least—relax and enjoy! The days when baby spits up on your clothes five times in a row and decides that napping is optional are tough, but blink… and that baby is off to her first day of kindergarten. Savor the moments (even the vomit-filled ones)!
Elizabeth Kirchner, CNP, RN-BC, is a nurse practictioner at the Cleveland Clinic in Cleveland, Ohio, and the Education and Curriculum Chair of the Rheumatology Nurses Society.