Table 2.

Teaching points

Pregnancy and breastfeeding in cystinosis
•Preconception counseling is necessary in women with CKD and should include a discussion regarding use of renal protective medications, delaying pregnancy if kidney transplantation is anticipated in the near future, and strategies to reduce the risk of pre-eclampsia.
•Regular monitoring of kidney function and frequent discussion with the patient and multidisciplinary care team can aid decision-making about reinitiation of cysteamine during pregnancy.
•Low amounts of cysteamine were detected in breastmilk and are unlikely to be clinically significant. This is reassuring for individuals with cystinosis who desire to breastfeed, including in resource-limited settings where replacement feeding may be less accessible.

CKD, chronic kidney disease.