Hello,

Thanks for writing in and uploading the report. I have read through it.

It probably seems like postpartum flare of rheumatoid arthritis. So if you wish to continue breastfeed, careful attention must be given to the choice of medication as some drugs taken by you can pass through the milk to your infant.

To control your disease you have to take anti-inflammatory drugs and Disease modifying anti-rheumatoid drugs (DMARD).

Non steroidal anti-inflammatory drugs (NSAIDS) which are safe in lactating mother are Diclofenac, ibuprofen, piroxicam .Etoricoxib (you are taking currently) are not safe in lactating mother.

Steroid (Doses of up to 40mg a day of prednisolone) can be taken by you without any likely adverse effect on the infant, after discussing with your doctor.

In disease modifying anti-rheumatoid drugs, sulphasalazine, the antimalarials (Hydroxychloroquine) and azathioprine are probably the safest options.

So discuss with your doctor regarding these options.

Hope I have answered your query. Let me know if you have any more concerns.

Wishing you good health.

Regards.

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