Abstract 237: Breastfeeding is Not Associated With Worse Outcomes for Women With Peripartum Cardiomyopathy

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Background: Women diagnosed with peripartum cardiomyopathy (PPCM) are frequently advised not to breastfeed their infants because of concern that the nursing hormone prolactin drives the pathogenesis of PPCM. However, this remains controversial. We sought to determine whether women with PPCM who breastfed had lower rates of recovery.

Methods: Patients with PPCM at the University of Michigan (2000-2011) were retrospectively reviewed. Demographics, clinical data, and outcomes were collected. Questionnaires requesting information about breastfeeding status and duration were mailed to women with PPCM. This data was correlated with recovery status, defined as left ventricular ejection fraction ≥ 50% at 1 year after diagnosis.

Results: Of 27 women with PPCM with known breastfeeding status, 13 women breastfed (48%) and 14 did not (52%). Among women who breastfed, 8 recovered (62%) and 5 did not (38%). Among women who did not breastfeed, 11 recovered (79%) and 3 did not (21%). This was not statistically different (p=0.29). There were no significant differences between breastfeeding and non-breastfeeding women related to their mean age or treatment with heart failure medications. Of the 16 patients who completed additional survey questionnaires, 11 (69%) reported their physician had instructed them not to breastfeed.

Conclusions: Contrary to some expert opinions, breastfeeding was not associated with lack of recovery. While larger prospective studies are needed to clarify this conclusion, it appears that a diagnosis of PPCM should not be an absolute contraindication to breastfeeding.

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