Re: << A mother I've worked with has battled through through a variety of
health problems, for both her and her baby, and is now breastfeeding a
flourishing almost one-year-old. One of the mother's problems has been
colitis. While at the hospital for a CAT scan yesterday for something
unrelated, a helpful nurse told her that breastfeeding could cause or
exacerbate colitis in the breastfeeding mother.

That was sure news to me, but I said I'd do some research, and ask a
knowledgeable circle of LCs... >>


Margaret, I'd ask the mother what scientific references the "helpful" nurse gave her to support what she told her. I did a quick and dirty Pubmed search and came up with very little, but I'm including abstracts below. I tried a lot of different search terms. (Did the best with "inflammatory bowel disease or ulcerative colitis and lactation.") I also hit "related articles" when I found something. Don't know if any of these are worth tracking down...  Karen

Steinlauf AF & Present DH (2004). Medical management of the pregnant patient with inflammatory bowel disease. Gastroenterol Clin North Am, 33(2), 361-385, xi.
Gastroenterologists are not infrequently faced with questions regarding pregnancy when advising or treating their patients with inflammatory bowel disease (IBD). To advise patients effectively, the following factors must be considered: (1) the inheritance patterns of IBD for accurate counseling and family planning; (2) the effects of active IBD versus medications or surgery on fertility; (3) the effects of pregnancy on the course of IBD; (4) the effects and potential risks of active IBD versus those of diagnostic tests, medical treatments, and surgical treatments on the developing fetus; (5) approach to delivery; and (6) the risks of breast-feeding while receiving treatment for IBD.


Friedman S  (2001).Management of inflammatory bowel disease during pregnancy and nursing. Semin Gastrointest Dis, 12(4), 245-252.
The peak age of onset for inflammatory bowel disease (IBD) coincides with the peak age for conception and pregnancy, and gastroenterologists will frequently be called on to treat pregnant IBD patients. The greatest threat to a normal conception and pregnancy is active disease, not active medicine. The majority of IBD medications are safe in pregnancy and nursing and should be used as needed. When in remission, ulcerative colitis and Crohn's disease usually do not affect fertility. Fertility may be impaired, however, by pelvic adhesions and scarring from old operations or disease. Pregnant IBD patients should be followed in a facility where diagnostic tests, such as sigmoidoscopy and ultrasound, and surgery can be performed if necessary.


This one alludes to lactation but no mention is made in the abstract:
Burakoff R, Opper F (1995). Pregnancy and nursing. Gastroenterol Clin North Am, 24(3), 689-698.
The IBD patient should be optimistic about a potential pregnancy. Inactive IBD is not associated with decreased fertility. Inactive IBD does not affect the course of pregnancy; however, IBD has been associated with increased preterm deliveries. Active IBD during pregnancy is associated with increased stillbirths and spontaneous abortions but not with increased congenital abnormalities. Pregnancy does not cause exacerbation of previously quiescent IBD. If the disease is active at conception, it remains active or worsens in approximately two thirds of patients. Corticosteroids, sulfasalazine, and 5-ASA drugs are safe and should be used to maintain or induce remission. Antimetabolites may possibly be proved safe in the future during pregnancy but cannot yet be recommended. Both enteral nutrition and total parenteral nutrition can and should be used safely and effectively during pregnancy. Radiographs are to be used in diagnosis if an emergent condition, such as perforation or toxic megacolon, is suspected. The chance of an offspring developing IBD is about 9% but rises to 34% if both parents have IBD.

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