The symptoms of autoimmune diseases can worsen after pregnancy, so your NYU Langone rheumatologist and obstetrician monitor your health after delivery. A high-risk pregnancy expert called a neonatologist monitors your newborn closely.
You may also consult other experts, including Neonatal Intensive Care Unit (NICU) specialists, pediatric cardiologists, pediatricians, lactation specialists, nurse practitioners, and social workers.
Some women with autoimmune diseases experience symptom flare-ups after delivery. Your NYU Langone rheumatologist and obstetrician work together to help you get your symptoms under control. Doctors test your blood, kidneys, and urine, and your medications are adjusted, as needed.
Women with some types of autoimmune diseases may deliver babies before they’re full term, which is 37 weeks of pregnancy. The NICU at NYU Langone is designated a Level IV NICU, meaning our neonatologists, nurses, and other specialists are highly trained to care for babies born before 37 weeks, including those with a very low birth weight and other medical conditions caused by prematurity.
If a baby is born prematurely, a NICU staff member is present during labor and delivery to determine if any special care is required. Our NICU doctors and nurses are available around the clock to provide you with the latest updates on your baby’s health.
Medication can enter breast milk, and some prescribed for autoimmune diseases are not considered safe for the baby. Your doctor can help you weigh the benefits of breastfeeding against the risks.
Because most babies don’t develop the nursing reflex until 32 weeks of pregnancy, premature infants may have difficulty breastfeeding. Our lactation specialists can teach you how to breastfeed your premature baby and use an electric breast pump. You may express milk using the pump and store it for feedings in the NICU and later at home, as needed. Very premature babies may be fed breast milk through a tube that is passed through the nose and esophagus to the stomach.
Two percent of babies born to mothers with anti-Ro antibodies in the blood—regardless of whether they have lupus, Sjogren’s syndrome, rheumatoid arthritis, or no apparent health issues—are born with neonatal lupus. The term “neonatal lupus” is confusing, since the mother herself may not have lupus, and the baby does not have what is considered “real” lupus. The doctors at NYU Langone are among the world leaders in recognizing and treating this rare condition.
A rare but serious sign of neonatal lupus is congenital heart block, a potentially life-threatening condition that slows the heart rate. At NYU Langone, pediatric cardiologists treat babies with heart rates of less than 55 beats per minute by surgically implanting a pacemaker, a battery-operated device that sends electrical signals to the heart, restoring its normal rhythm. Heart block with rates higher than 55 usually does not require pacing or any other treatments.
Babies with neonatal lupus may also have a skin rash, which typically appears on the face around the eyes giving the baby a raccoon appearance, neck, or scalp. The rash disappears at around six months, when the mother’s antibodies are cleared from the baby’s bloodstream.
Your NYU Langone rheumatologist can refer you to physiatrists—doctors who specialize in rehabilitation medicine—and physical therapists at Rusk Rehabilitation for help in relieving pain, stress, and fatigue. Our specialists use a variety of techniques, including physical therapy, acupuncture, meditation, and bodywork, such as massage therapy.
To help you cope with an autoimmune condition as a pregnant woman or new parent, your doctor may refer you to an NYU Langone psychologist or social worker for group or one-on-one therapy.
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