Hi Alicia,
Thanks for the references.
A friend/client of mine who is breastfeeding her 14-month old (first) baby has had RA for several years.  She has told me that the condition has only had mild flares since her baby came.  She has also been very happy to be able to lie down to breastfeed, as she then does not have to support the baby's weight in any way. 
Since the baby was about 6 months old this woman has had well-meaning advice from friends and professionals that she ought to wean and take anti-inflammatory medication.  However she is very happy with the management at present (occasional paracetamol).

Joy Johnston
-----Original Message-----
From:   Alicia Dermer [SMTP:[log in to unmask]]
Sent:   Tuesday, December 09, 1997 8:23 AM
Subject:        Re: rheumatoid arthritis and breastfeeding

Mary Alice:  I have a few references about rheumatoid arthritis.  The
first two showed an association between flare-ups or new onset of RA with
breastfeeding, but the third one shows decreased mortality and morbidity
from RA in mothers who have breastfed:

Brennan P, Silman A.  Breast-Feeding and the onset of rheumatoid
arthritis.  Arthritis & Rheumatism 1994;6:808-13.

Jorgensen C, Picot MC et al.  Oral contraception, parity, breast feeding,
and severity of rheumatoid arthritis.  Annals of the Rheumatic Diseases
1996;55:94-8.

Brun JG, et al.  Breast feeding, other reproductive factors and rheumatoid
arthritis.  A prospective study.  Br J Rheum 1995;34:542-6.

These studies were with small numbers, and the postpartum period is a
common time for onset of RA, so it's hard to draw any firm conclusions.
However, IMHO, it's fair to say that it's possible that she may have a
flare-up while breastfeeding but long-term may have less morbidity.
If she should have a flare-up, there
are medications which are compatible with breastfeeding (I had one patient
who had her first episode of RA at 1 month postpartum, and did well on
prednisone for several months; although she could also have used plaquenil
[hydroxychloroquine], she didn't want to because there was a genetic
retinal condition in her family; she went on the plaquenil after weaning
the child, and has done very well).
Hope this helps.  Alicia Dermer, MD, IBCLC.