Supportive conversation between two people in a calm room.

After birth

Breastfeeding and HS

Breastfeeding with HS is among the least researched topics — and one with the most practical questions. This article names both.

← Back to the Pregnancy & Family Planning hub

Breastfeeding is the part of this hub with the thinnest evidence. Barely any studies have specifically examined how HS behaves during lactation. An international survey reports that a share of previously pregnant participants said HS interfered with their ability to breastfeed — and that one of the most common barriers was the belief that nothing could be done about HS during pregnancy and breastfeeding at all.

That belief is the real reason this article exists. Little research does not mean there is nothing to discuss.

In short

  • Involvement of the breast or underarm can make breastfeeding harder in practice — positioning, latch and pain are the most common issues.
  • Questions about treatment and breastfeeding should be settled before the birth, not in the postpartum weeks.
  • Every feeding decision is legitimate; breastfeeding is not a measure of good parenting.
  • Midwives and lactation support are the right people to involve, even if they do not know HS.

When the breast or underarm is involved

Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.

HS typically occurs in skin folds — under the breasts and in the armpits are among the common sites. Both are exactly where contact, pressure and movement happen while feeding.

Three things matter most in practice: pain while holding and latching, open or draining lesions close to the feeding position, and dressings that get in the way or shift during a feed. None of these problems is unusual, and none has to be solved alone.

Positioning and practicalities

Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.

Feeding positions can be changed, and that is where the practical room lies. Which position works in your case depends on where you are affected — that cannot be stated in general terms, but it can be worked out with a midwife or lactation supporter.

  • Tell your midwife or lactation supporter early where you are affected, so positions can be adapted specifically.
  • Clarify in advance which dressings can be used near the breast and how they are handled during a feed.
  • Clothing that presses on the fold under the breast can be especially bothersome in this period; this site has a dedicated guide on that.
  • Expressing, partial breastfeeding and bottle feeding are possible routes if feeding is too painful — that should be discussed, not endured.
  • Exhaustion and pain reinforce each other; practical support at home is a medically relevant factor here.

Treatment and breastfeeding: a conversation, not a lookup

Limited evidence Rests mainly on case series, preliminary studies, or expert consensus.

Whether and how a treatment continues while breastfeeding is an individual medical decision. This website deliberately names no substances and makes no statements about use during lactation.

What can be said is something else — and in practice often more important: this conversation should happen before the birth. In the postpartum weeks there is no time, no appointment and no energy to catch up on it, and the frequently reported belief that nothing can be done during this period means the question often never gets asked.

When breastfeeding does not work out

Patient experience Reported by individual patients — not scientific evidence.

Some people with HS breastfeed without particular difficulty. Others decide against it after pain, wound healing or exhaustion — or choose something in between.

That is not a failure. The pressure around breastfeeding is considerable in any case, and a painful skin condition in exactly that area adds another layer. An informed, well-supported decision is the goal — not one particular outcome.

Questions to discuss with your healthcare team

These are prompts, not advice. Take the ones that fit your situation to your next appointment — the printable checklist collects them all.

  • How does my current treatment affect breastfeeding — and when do we discuss that?
  • What wound care is possible near the breast while I am feeding?
  • Who do I turn to if breastfeeding does not work because of HS symptoms?
  • Can a lactation supporter who knows about my HS be involved?
  • What do I do about a flare in the armpit or under the breast while breastfeeding?
  • What alternatives are there if feeding is too painful?

Questions to Ask Before Pregnancy →

Frequently asked questions

Can I breastfeed with HS?

Many people with HS breastfeed. Whether it works well in your case depends among other things on whether the breast or underarm is involved and on your treatment — both belong in a conversation before the birth.

Can my baby catch HS through breast milk?

No. HS is not contagious and is not transmitted through breast milk.

What if an affected area is directly on the breast?

That is a good reason to involve a midwife or lactation supporter and your dermatology clinic early. Positioning, wound care and pain management can be adapted together — general recommendations on that are not something this website can give.

Continue in this hub

Scientific research and editorial review

Last editorially reviewed: · Next scheduled review:

Reproductive health in HS is an area where patient need clearly outruns the evidence. The disease course during pregnancy has been described in cohort studies and pooled in a meta-analysis; fertility and breastfeeding have barely been studied at all. Every page in this hub therefore carries an evidence grade, and sections state explicitly where the evidence stops.

Population-level findings about pregnancy outcomes are reported here as associations that overlap with co-occurring conditions — they are presented as a reason for coordinated care, never as a prediction about any individual pregnancy.

No page in this hub names an individual medicine or states whether a treatment is suitable during pregnancy or breastfeeding. Those questions are routed back to the clinicians who prescribe your care, because they are the only people who can weigh them for your situation.

This hub is source-linked and reviewed at least once a year. If a cited guideline, review or study changes, these pages are updated.

How we work: Editorial Policy

Sources

  1. Adelekun AA, Villa NM, Hsiao JL, Micheletti RG. Pregnancy in Hidradenitis Suppurativa — Patient Perspectives and Practice Gaps JAMA Dermatology, 2021;157(2):227–230 — survey of counselling gaps on conception, heritability, medicines and sexual health
  2. Seivright JR et al. Impact of Pregnancy on Hidradenitis Suppurativa Disease Course: A Systematic Review and Meta-Analysis Dermatology, 2022;238(2):260–266 — pooled rates of improvement, worsening and postpartum flares
  3. Lyons AB et al. Evaluation of Hidradenitis Suppurativa Disease Course During Pregnancy and Postpartum JAMA Dermatology, 2020;156(6):681–685 — cohort study; frequent postpartum worsening alongside little dermatology care
  4. Fitzpatrick L, Hsiao J, Tannenbaum R, Strunk A, Garg A. Adverse pregnancy and maternal outcomes in women with hidradenitis suppurativa Journal of the American Academy of Dermatology, 2022;86(1):46–54 — population-level analysis; associations overlap with co-occurring conditions
  5. Barnes LA, Rinderknecht FB, Hsiao JL, Naik HB. Global barriers to sexual health, pregnancy, and breastfeeding in hidradenitis suppurativa International Journal of Women's Dermatology, 2026 — international survey of barriers to sexual health, pregnancy and breastfeeding care
  6. Özbek Ç et al. Hidradenitis Suppurativa Treatment During Pregnancy and Lactation: Navigating Challenges International Journal of Dermatology, 2025 — review of care during pregnancy and lactation
  7. Collier EK et al. Pregnancy and breastfeeding in hidradenitis suppurativa: A review of medication safety Dermatologic Therapy, 2021;34(2):e14674 — a review written for clinicians; a basis for medical judgement, not for self-directed decisions
  8. MedlinePlus Genetics (U.S. National Library of Medicine): Hidradenitis suppurativa Patient information on genetics; roughly 30 to 40 per cent of affected people have at least one other affected family member
  9. European S2k guideline for hidradenitis suppurativa / acne inversa, part 2: treatment Journal of the European Academy of Dermatology and Venereology, 2025 — framing of treatment and self-management