Pregnancy, Breastfeeding and Fibromyalgia

Many women of child bearing age who also have fibromyalgia are naturally concerned about the possible affect of the medical condition on their pregnancy or wonder if they should even get pregnant. The good news is that having fibromyalgia doesn’t prevent you from become pregnant. However, if you decide to have a baby, it’s important that you understand the risks. In this way, you can learn to manage and even overcome certain problems that may arise during the course of your pregnancy.

Fibromyalgia and Pregnancy – The Risks

Little is known about the impact of pregnancy on fibromyalgia or its symptoms. Research is ongoing as to whether the syndrome reduces your chances of getting pregnant, but it is already clear that women with fibromyalgia do successfully get pregnant. However, there is also research that indicates there are certain risks associated with pregnancy while you have fibromyalgia. They include:

  • A worsening of symptoms, particularly during the first 3 months of the pregnancy[1]
  • A restriction of intrauterine growth[2]
  • Increased pain
  • Higher levels of fatigue
  • Greater psychological stress
  • Large fluctuations in hormonal levels[3]

While it may be difficult to control the risks, it is possible to manage them sufficiently to prevent ongoing health issues and to have a safe pregnancy.
How to Reduce the Risks: Before Pregnancy

There are various steps you can take to decrease the risks associated with being pregnant and having fibromyalgia at the same time. The starting point is to talk to your doctor about the various ways to manage your pregnancy in a healthy manner. These ways include everything from using safe medications to stress reduction techniques. Ensuring you are at a healthy weight and are actively exercising is also a good pre-pregnancy strategy. In fact, the ideal time to balance fibromyalgia and pregnancy is before you even get pregnant.

  • Make this a planned pregnancy and work on building up your strength through exercise and diet well in advance of getting pregnant
  • Eliminate as much stress in your life as much as possible
  • When deciding to conceive, try to schedule the conception during a time when you are not experiencing a fibromyalgia flare up
  • Take a look at what medications you are currently using and talk to your doctor to see if they are harmful for the fetus during pregnancy. If they should not be taken while pregnant, then you need to talk about options or alternatives.

How To Reduce The Risks During Pregnancy

When you become pregnant, you need to adopt a plan to stay as healthy as possible while pregnant. The goal is to protect the fetus while safely minimizing fibromyalgia symptoms or the chances of a flare up. Many of the steps you should take are simply things you should be doing anyway whether or not you have fibromyalgia.

For example, it’s important to eat nutritionally rich foods if you want to keep yourself and your baby healthy. You also need to include exercise in your daily regimen. This will help keep your muscles strong and joints flexible. Exercising effectively increases the levels of certain natural substances, particularly serotonin, also known as 5-hydroxytryptamine. Serotonin plays a role in the transmission of nerve impulses, and these impulses can affect pain levels and muscle functioning. Serotonin also plays a role in controlling moods.[4] By managing serotonin levels, you can decrease the chances of moods swings and alleviate depression.

The exercises you do should be suitable for someone with fibromyalgia and someone who is pregnant. Appropriate exercises include:

  • Stretching – Stretching exercises can be done alone or as part of an exercise program like yoga or Tai Chi. Stretching exercises involve gentle forms of movement that limber up joints and stretch muscles, ligaments and tendons without causing damage.
  • Swimming – Swimming is another excellent form of exercise for those who have fibromyalgia whether or not they are pregnant. The pool water should not, however, be cold. It needs to be at about 83 degrees Fahrenheit to keep muscles warm and limber.
  • Walking – Walking is a safe and healthy form of exercise that doesn’t require any special facilities or equipment.

If you have found an effective exercise regimen before you got pregnant, you will likely be able to continue this regimen during the pregnancy. In addition to eating healthy and exercising, there are other methods available that can reduce stress and the various symptoms of fibromyalgia. None of these methods include using medications and may actually be a continuation of your normal treatment. They include:

  • Meditation – Medication can calm your mind and relax your body. This reduces overall stress and may help reduce fatigue. Meditation involves visualization techniques and the use of audio. You can learn to meditate on your own and play soothing music in the background to encourage calm thoughts and to raise the level of spirituality. Guided meditation is another good option in which the meditation has a specific and clear focus.

It is possible to teach yourself meditation using lessons. There are also professionals who teach meditation techniques.

  • Focused breathing – Focused breathing is deep breathing that can lead to reduced anxiety and soothe feelings of stress. It also improves oxygen flow in the body which can help muscles.
  • Massage – Gentle massage delivered by a massage therapist can reduce stress and loosen stiff muscles. This relaxation method can help a woman who is both pregnant and has fibromyalgia, but should be delivered by an experienced massage professional. Certain types of massage may be suitable for an individual with fibromyalgia but not for one who is also pregnant which is why the therapist must be knowledgeable.

After Birth

Research on women with fibromyalgia who have delivered is more extensive than research on women who want to get pregnant or are pregnant. A particular focus of several studies has been breastfeeding. Generally speaking, women with fibromyalgia have a more difficult time breastfeeding than those who don’t have fibromyalgia. This is due to:

  • Muscle soreness
  • Pain
  • Stiffness
  • Fatigue
  • Use of medications
  • Lack of milk
  • Sore nipples [5]

Because of these issues, fibromyalgia can often lead to unplanned and unwanted early weaning. In some cases, being forced to end breastfeeding due to pain or fatigue increases the chances of developing one of the serious symptoms associated with fibromyalgia – depression.

Treatment

The difficulty with breastfeeding is mainly the result of pain because women with fibromyalgia have a lower pain threshold. Reducing stress may help to reduce pain. While you can address some issues medically through consultation with your doctor, getting help with daily tasks and chores can reduce the stress associated with caring for a new baby. For example, you can consider hiring a care giver to help you out with the baby or get help with the housework. Ask your family to help you as much as possible too.

Various props that help feed the baby if you decide to breastfeed may also be helpful. For example, pillows can provide excellent support. Another option is to lie down on your bed while breastfeeding instead of sitting up. Above all, make sure the environment is quiet, calm and free of any type of distraction that could raise the level of stress.

If you are having trouble or want to talk to someone before attempting to breastfeed, there are plenty of options.  Support groups and lactation specialists can offer a number of techniques that may help you successfully breastfeed the baby despite fibromyalgia. In addition, it’s always important to discuss any medical issue with your doctor, especially considering the fact that so much needs to be learned about fibromyalgia and pregnancy.

Conclusion

Having fibromyalgia doesn’t prevent pregnancy, though the pain, fatigue and muscle stiffness can cause problems with breast feeding and being able to adhere to the demanding routine of caring for an infant. While complications associated with stress and pain may occur, they are manageable. Pre-pregnancy planning is important if you know that you have fibromyalgia. However, if you get pregnant while dealing with fibromyalgia, the important thing to remember is that there are many ways to manage the symptoms so that you can enjoy your new role as a mother.

References

[1] Mitchell, D (2011). The Complete Guide To Healing Fibromyalgia. New York: St. Martin Press.

[2] Zioni, T; Buskila, D; Aricha-Tamir, B; Wiznitzer, A; and Sheiner, E (2011). “Pregnancy Outcome in Patients with Fibromyalgia Syndrome.” Journal of Maternal-Fetal and Neonatal Medicine, 24(11):1325-1328.

[3] Mitchell (2011)

[4] Marcovitch, H (2006). Black’s Medical Dictionary 41st edition. Lantham, Maryland: Scarecrow Press.

[5] Schaefer, KM (2004). “Breastfeeding in Chronic Illness: The Voices of Women With Fibromyalgia.” MCN, American Journal of Maternal Child Nursing. 29(4):248-253.

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015