I did an inservice years ago for pp nurses on Lupus (we know very much
more about Lupus since then). The most critical time for a lupus flare
*is* postpartum (massive hormonal shifts are thought to trigger it). It
is purely anecdotal (from my caseload), and speculative in the
literature, that the hormones of BFing, as they taper in, may ease the
impact of those going out, and may keep the Lupus in check (depending on
the type of Lupus she has)(rheumatic diseases are known to sometimes
improve during pregnancy/BFing). The very important task for this mom is
to keep her stress and fatigue levels at all time lows for her - which
may require some work (help her rally people in her life to cook, clean,
fetch and carry for her; she just breastfeeds.) Have her get in touch
with  the Lupus Foundation of America at
http://internet-plaza.net/lupus/ , and the Arthritis Foundation
http://www.arthritis.org  for their excellent Lupus Self-Help Course
(search their web site at http://www.arthritis.org/search.shtml.) There
may be some Lupus Support Groups in her area (her local Arthritis
Foundation will know) as they are a very well-networked group. A WWW
search will keep you busy for days. Also, UCLA has done some excellent
research (presence of anti-cardiolipins) on Lupus and pregnancy, but I
beleive the focus of their work has not included BFing or postpartum
issues at this time.

Katharine West, BSN, MPH
Sherman Oaks, CA