| (Your milk proteins (which are normal in women with CF) are in high concentration in the leaner fore-milk and carry the immunological factors. Breastfeed your baby as long as possible because you are giving him the gift of yourself and of life-long optimum health--ed.) If maternal nutrition is adequate, breastfeeding should be encouraged (for women with CF). Click www.cfpc.ca/cfp/2002/Mar/vol48-mar-clinical-1.asp to view the article in entirety Successful breast feeding in mothers who have CF has been achieved. Breast milk from women with CF has been shown to have normal sodium and protein levels and the lipid levels are sufficient for the nursing needs of the infant. Click www.cysticfibrosismedicine.com/htmldocs/CFText/pregnancy.htm to view the article in entirety Milk secreted by women with CF appears to be physiologically normal, safe for the infant, and breast-feeding by mothers with CF should no longer be discouraged. Click www.ajcn.org/cgi/content/abstract/49/4/612 to view the article in entirety. Guidelines are available regarding the advisability of breastfeeding in women with infectious diseases and other maternal conditions . The key to successful breastfeeding in women with special needs is appropriate choice of medications and/or treatments and lactation support from the early prenatal to postpartum period. (Among those conditions listed in this article for which breastfeeding is recommended are cystic fibrosis, insulin dependant diabetes mellitus and gestational diabetes--ed.) Click www.eatright.org/Public/NutritionInformation/92_8236.cfm to view the article and tables in entirety Women with chronic illnesses can almost always breastfeed. If you have Cystic Fibrosis, you can produce normal breastmilk, but must monitor your nutrition carefully. If you are diabetic, breastfeeding offers many advantages. It reduces your stress level, reduces the risk of the baby developing diabetes, and makes the disease more manageable because your body�s natural response to the hormones responsible for lactation are helpful. You will need to monitor your blood-glucose levels carefully because the hormonal changes of pregnancy and childbirth can cause changes in the levels. Insulin is compatible with breastfeeding, because it doesn�t transfer into human milk. Your insulin requirements may be significantly less than before you became pregnant. Click www.familyresource.com/pregnancy/16/289/ to view the article in entirety. Breastfeeding Fact Sheet www.dona.org/PDF/CIMSbreastfeeding.pdf In recent years, breast-feeding has been strongly recommended, and the decision to breast-feed is made by a large percentage of women before pregnancy. We performed a survey to determine the current recommendations given to mothers in cystic fibrosis (CF) centers. For mothers of infants with CF, 77% of centers recommend breast-feeding alone or with pancreatic enzyme supplements and/or hydrolyzed formula. For mothers with CF, the following responses were given: 11% recommend breast-feeding, 8% do not recommend it, 42% make the recommendation according to the health status of the mother, and 32% make the recommendation according to the personal wishes of the mother. The duration of breast-feeding for mothers of infants with CF was reported to be from 3 to 6 months by 43% of centers, whereas for mothers with CF, 41% of centers reported the duration to be less than 3 months. Several centers reported that their experiences were not always positive, thus indicating a need to establish criteria to predict and ensure a successful outcome. Click www.cysticfibrosismedicine.com/htmldocs/CFText/pregnancy.htm to view the article in entirety. (Many factors bear on the breastfeeding experience of a mother. Education and support are two of the biggest factors in encouraging a positive experience--ed.) Although information is scarce, studies have found that mothers with cystic fibrosis can breastfeed their babies and produce milk with normal concentrations of protein, fats, and minerals (Michel and Mueller 1994; Shiffman 1989). Several cases reports confirm that women with cystic fibrosis have breastfed babies who have maintained normal growth (Michel and Mueller 1994; Smith 1992). Although one case report described a mother whose milk had elevated sodium levels, this mother had not been breastfeeding and had expressed her milk for study purposes only. Elevated sodium levels are normal during breast involution and may have been unrelated to her cystic fibrosis (Alpert and Cormier 1983). Because cystic fibrosis impairs normal digestion, a mother should have her nutritional needs carefully monitored before, during, and after pregnancy, as well as during lactation. If the mother is having difficulty maintaining her weight of her health, or her baby is not gaining well, breastfeeding may not be recommended. Michel and Mueller (1994) suggest that women with adequate weight and stable cystic fibrosis be considered candidates for breastfeeding. from The Breastfeeding Answer Book by La Leche League International pp. 560-561 A 20-year-old white women with cystic fibrosis who breast-fed her normal infant is described. Extensive breast milk analysis revealed normal sodium and chloride concentrations but elevated total protein and low total fat content; IgG and IgM levels were low to absent. The infant tolerated breast-feeding well, with normal growth and without infections, but the nutritional status of the mother appeared to be adversely affected. This case illustrates that breast-feeding by a mother with cystic fibrosis appears to be feasible but is fraught with difficulties. Click http://archpedi.ama-assn.org/cgi/content/abstract/144/10/1153 to view the article in entirety. (Every breastfeeding experience is unique, even for one mother with several children. There may or may not be difficulties in breastfeeding your infant. In most cases the benefits to you and to your baby greatly outweigh any difficulties encountered. Previous difficulties do not necessarily indicate future problems. The hormones and mechanics involved in breastfeeding actually make it easier for your to deal with difficulties and stresses than if you were not breastfeeding--ed.) Maternal Health and Benefits of Breastfeeding Breastfeeding is "dose-related," meaning the longer you breastfeed�the greater the benefits (for mother and baby). Click www.breastfeedingvideo.com for more Benefits to the mother include reduced postpartum bleeding and delayed resumption of ovulation which increases the spacing between pregnancies. There is also evidence that lactating women have improved postpartum bone remineralization and a reduced risk of ovarian cancer. In addition to the health benefits, breastfeeding is socially and economically advantageous. It is an ecologically sound, efficient and self-reliant food source. And the lower incidence of illness in breastfed babies reduces health care costs. Click www.who.int/child-adolescent-health/NUTRITION/infant_exclusive.htm to view the article in entirety Breastfeeding has been shown to improve maternal health, with demonstrated effects, including reduction in postpartum bleeding, earlier return to prepregnancy weight, reduced risk of premenopausal breast cancer, and reduced risk of osteoporosis, continuing long after the postpartum period. Click www.healthypeople.gov/document/HTML/Volume2/16MICH.htm to view the article in entirety Maternal benefits of breastfeeding http://breastfeeding.lifetips.com/TipSC.asp__Q__id__E__59604 Maternal and infant benefits of breastfeeding list www.upei.ca/~famnut/html/breastfeedingbenefits.html Health gains for breastfeeding women include lactation amenorrhea, maternal weight or fat loss, protection against premenopausal breast cancer and ovarian cancer, bone remineralization to levels exceeding those present before lactation, and more optimal blood glucose profiles in women with gestational diabetes. Extending the duration of breastfeeding also increases maternal benefits of breastfeeding. For example, amenorrhea is increased by exclusive and more frequent nursing (especially at night). Duration of breastfeeding is also related to a reduced risk of premenopausal breast cancer. Strong evidence about the potential public cost savings is provided by two studies of the WIC and Medicaid programs where statistically significant savings were realized in lower cost of the food package for lactating women compared with the cost of human milk substitute (even after adjusting for the substantial manufacturers' rebate) and from lower Medicaid covered pharmacy costs and Medicaid covered medical costs during the first 12 months in breastfed compared to human milk substitute-fed infants. In addition to the savings in direct medical costs, data are emerging that document the economic benefits of breastfeeding support to employers, including lower maternal absenteeism due to infant illness. Click www.eatright.org/Public/NutritionInformation/92_8236.cfm to view the article in entirety Maternal benefits of breastfeeding include hormonal, physical, psychosocial and economic. Hormonal Benefits: Breastfeeding immediately after birth increases maternal hormone levels which stimulates the uterus to contract, decreases maternal postpartum blood loss, and helps the uterus return to its normal size. Physical Benefits: Exclusive breastfeeding delays the return of fertility, and thus the risk of pregnancy, in most women for at least 6 months. Breastfeeding at a younger age and for longer duration, at least 6 months, lowers the mother's risk of breast and ovarian cancer. Psychological Benefits: Breastfeeding can provide psychological benefits to the mother. Breastfeeding can increase the mother's self-confidence and can increase infant bonding. Economic Benefits: Breast feeding is cost effective. In addition to decreased expenses for formula, breastfed infants have lower medical expenses than infants who are not breastfed. In addition to medical costs, maternal absenteeism from work due to infant illness is less for women who breastfeed. Click www.fcs.okstate.edu/food/nutrition/lifecycle/breastfeeding/feed-cont.htm to view the article in entirety This hormone (oxytocin) not only signals the breasts to release milk to the baby (this is known as the milk ejection reflex, or "let-down"), but simultaneously produces contractions in the uterus. The resulting contractions prevent postpartum hemorrhage and promote uterine involution (the return to a nonpregnant state). Bottle-feeding mothers frequently receive synthetic oxytocin at birth through an intravenous line, but for the next few days, while they are at highest risk of postpartum hemorrhage, they are on their own. Unlike bottle-feeding mothers, who typically get their periods back within six to eight weeks, breastfeeding mothers can often stay amenorrheic for several months (or more). The net effect is a decreased risk of iron-deficiency anemia in the breastfeeding mother as compared with her formula-feeding counterpart. After birth, mothers with a history of gestational diabetes who breastfeed have lower blood sugars than nonbreastfeeding mothers (Kjos 1993). Women with Type I diabetes prior to their pregnancies tend to need less insulin while they breastfeed due to their reduced sugar levels. Breastfeeding mothers tend to have a high HDL cholesterol. Breastfeeding may ultimately pay off with a lower risk of heart problems. Current studies show that after weaning their children, breastfeeding mothers' bone density returns to prepregnancy or even higher levels (Sowers 1995). Women who did not breastfeed have a higher risk of hip fractures after menopause (Cummings 1993). Breastfeeding from six to 24 months throughout a mother's reproductive lifetime may reduce the risk of breast cancer by 11 to 25 percent (Lyde 1989; Newcomb 1994). Mothers who traditionally breastfed on only one side had significantly higher rates of cancer in the unsuckled breast . Overall severity and mortality of rheumatoid arthritis was worse in women who had never breastfed (Brun, Nilson, and Kvale 1995). There have been no other studies showing any detrimental health effects to women from breastfeeding. Prolactin, the milk-making hormone, appears to produce a special calmness in mothers. Breastfeeding mothers have been shown to have a less intense response to adrenaline (Altemus 1995). (Prolactin (also called the "mothering hormone"), even in small doses, has a powerful anti-anxiety, calming, peaceful effect on mothers. This can be very helpful when encountering situations of stress such as maternal illness or changes in your health care routine. This hormone and its effects allow mothers to continue to successfully breastfeed even in the face of obstacles and enhances the connection between mother and child greatly--ed.) In most cases of depression, women do better if they continue to breastfeed. Click www.lalecheleague.org/NB/NBJulAug01p124.html to view the article in entirety Every year a woman nursed reduced her risk of breast cancer by 4.3 percent, while every child she bore reduced her risk by 7 percent. Click www.healthscout.com/excite.asp?page=newsdetail&ap=407&id=508165 to view the article in entirety Lack of Breastfeeding Increases the Risk to the Mother of: Urinary tract infection Pre-and post-menopausal breast cancer Ovarian cancer Osteoporosis . Click www.medela.com/NewFiles/faq/benefitsbfdg.html to view the articel in entirety (Lowering risk of osteoporosis and cancers is of particular importance to women with CF because of our naturally higher risk for these complications as a result of malabsorbtion and transplant, respectively. Lowering blood sugars is also of great importance in reducing risk of diabetes or complications of preexisting diabetes both of which women with CF are at greater risk of--ed.) Breastfed Infants Globally, all governments and experts promote exclusive breastfeeding for six months and extended breastfeeding as long as possible. Click www.breastfeedingvideo.com for more Human milk has also been successfully used for infants with cleft palate; inborn errors of metabolism, especially phenylketonuria; cystic fibrosis (with pancreatic enzyme replacement); and Down syndrome. In each of these situations, the major challenge remains the achievement and maintenance of an adequate milk supply. Click www.eatright.org/Public/NutritionInformation/92_8236.cfm to view the article in entirety Breastfed Infant Health and Development Breastfeeding is an important contributor to overall infant health because human breast milk presents the most complete form of nutrition for infants; Breastfeeding has been shown to reduce rates of infection in infants. The American Academy of Pediatrics considers breastfeeding to be �the ideal method of feeding and nurturing infants.� Breast milk is widely acknowledged to be the most complete form of nutrition for infants, with a range of benefits for infants� health, growth, immunity, and development. The benefits of breastfeeding include decreased new cases or severity of diarrhea, respiratory infections and ear infections among others, and reduced cost to the family. Click www.healthypeople.gov/document/HTML/Volume2/16MICH.htm to view the article in entirety Breastmilk is the natural first food for babies, it provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a child�s nutritional needs during the second half of the first year, and up to one-third during the second year of life. Click www.who.int/child-adolescent-health/NUTRITION/infant_exclusive.htm to view the article in entirety Breastfeeding was associated with a lower incidence of RSV infection during the first year of life. from "Risk Factors for RSV Associated Lower Respiratory Illnesses in the First Year of Life" by C.J. Holberg in the American Journal Epidemiology, 1991:133 (135-51) as excerpted in The Home Birth Advantage by Mayer Eisenstein, M.D. Children who consumed mother's milk in the early weeks of life had a significantly higher IQ at 7.5 to 8 years, than those who has received no maternal milk, even after adjustment for differences between groups and mothers' educational and social class. from "Breast Milk and Subsequent Intelligence Quotient in Children Born Preterm" by A. Lucas in Lancet 1992:339 (261-61) as excerpted in The Home Birth Advantage by Mayer Eisenstein, M.D. A statistically significant protective effect against Hodgkin's disease (is seen) among children who are breast-fed at least 8 months compared with children who were breast-fed no more than 2 months. from "An Exploratory Study of Environmental and Medical Factors Potentially Related to Childhood Cancer" by J. Schwartzbaum in Medical & Pediatric Oncology, 1991:19(2) (115-21) as excerpted in The Home Birth Advantage by Mayer Eisenstein, M.D. Breastfeeding seems to protect against wheezing and respiratory tract illnesses in the first four months of life, particularly when other risk factors are present. from "Breastfeeding and Lower Respiratory Tract Illnesses in the First Year of Life" by A.L. Wright as excerpted in The Home Birth Advantage by Mayer Eisenstein, M.D. (The protective effect of breastfeeding against respiratory illnesses is particularly important to a parent with CF who is more susceptible when exposed to these illnesses themselves--ed.) Lack of Breastfeeding Increases the Risk to the Infant of: Ear infections Childhood diabetes Obesity Gastrointestinal and diarrheal infections Childhood cancers SIDS Respiratory infections Allergies Click www.medela.com/NewFiles/faq/benefitsbfdg.html to view the article in entirety Cow's milk has been implicated as a possible trigger of the auto immune response that destroys pancreatic beta cells in genetically susceptible hosts thus causing diabetes mellitus. by Karjalainen, et al. in the New England Journal of Medicine, July 30, 1992 as excerpted in The Home Birth Advantage by Mayer Eisenstein, M.D. Lack of breastfeeding was a risk factor associated with later development of Crohn's Disease in Childhood. from British Medical Journal, 1989 as excerpted in The Home Birth Advantage by Mayer Eisenstein, M.D. Potential problems with artificial feeding: more ear infections, more gastrointestinal illness, greater risk of allergy, SIDS, childhood leukemia, juvenile diabetes, and other health problems. Studies have shown that breastfed children have an intellectual edge during the elementary school years, which means that formula-feeding may have subtle negative effects on a child's development. Click www.lalecheleague.org/NB/NBMarApr00p55.html to view the article in entierty What�s Normal for Breastfeeding? Click www.kellymom.com/bf/normal/index.html to view the article Healthy children often shift percentiles for both length and weight in the first 24 months of life before settling into a growth curve The growth rates of breastfed infants are significantly different than the rates of infants fed human milk substitutes, particularly after 4 months. Click www.eatright.org/Public/NutritionInformation/92_8236.cfm to view the article in entirety. The WHO Child Growth Standards http://www.who.int/nutrition/media_page/en/ (These are based on cross-cultural norms for breastfed children. Scroll to the lower part of the page for the actual charts in French, Spanish, or English. For reference there are 2.54 centimeters per inch and 454 grams in one pound. So to calculate cm multiply inches by 2.54, and to calculate kg, multiply pounds by 454 and divide by 1000--ed.) Suggested Reading & Resources Books The Breastfeeding Book by William Sears, M.D. and Martha Sears, R.N. The Womanly Art of Breastfeeding by La Leche League International Breastfeeding and Natural Child Spacing by Sheila K. Kippley (This book is a wonderful resource for understanding how natural, ecological breastfeeding works--ed.) International Organizations La Leche League International www.llli.org (La Leche League International is considered the world's foremost authority on breastfeeding. This site has country and state listings for groups and leaders and information in multiple languages. It also has FAQs, breastfeeding legislation, support/info on working while nursing, and a form for submitting your own questions all under "breastfeeding info." There are numerous articles on various breastfeeding topics under "breastfeeding info" then click the link for New Beginnings articles. LLL leaders have access to a library of current information for specific scenarios and concerns as well as professional liaisons who can assist in determining the best course of action during health flare-ups and crisis. I have used these professional liaisons and the library archives myself and found them very helpful. La Leche League also offers local support in the form of group meetings. You can find a group near you on the website. Local leaders offer telephone support and through the group you have access to a lending library of helpful books, pamphlets and tear-off information sheets and indispensible mother-to-mother support. Groups also offer pertinent books for sale. LLL is not just for mothers. Fathers can also find support and information through their resources--ed.) There are few mothers attending La Leche League meetings who fail at nursing. from The Home Birth Advantage by Mayer Eisenstein, M.D. Promotion of Mother�s Milk, Inc. www.promom.org (this site has a discussion forum as well as information--ed.) World Alliance for Breastfeeding Action www.waba.org.my Breastfeeding Videos (International) www.breastfeedingvideo.com ($1.00 USD from the sale of each video will go to the CFF--ed.) Breastfeeding Comprehensive (This video has documented nursing mothers and children in many cultures and has assembled a large panel of world authorities on breastfeeding. It addresses nursing with multiples, special needs children, health issues, and hospitalizations--ed.) Breastfeeding Technique (This video has exclusive footage not contained in the Breastfeeding Comprehensive. It will teach you all you need to know about proper positioning of a single infant or multiple infants. This is the next best thing to actually inspecting the technique of a nursing mother in person--ed.) Links Searchable Directory of Lactation Consultants (International) www.doulaworld.com International Links www.tarayoga.net/links-p.html USA www.moonlily.com/breastfeed/default.htm Canada www.kidalog.com/breastfeeding.html www.infactcanada.ca/InfactHomePage.htm UK www.natural-parenting.com |
| Excerpts from various sources on the issue of breastfeeding for women and/or infants with CF and in general |
| Specific Concerns of Breastfeeding Illness, Medications, Nutrition, Adoption, and more |
 |
| And out happened, as He spoke these things, that a certain woman from the crowd raised her voice and said to Him, "Blessed is the womb that bore You, and the breasts that nursed You!" But He said, "More than that, blessed are those who hear the word of God and keep it!" Luke 11:27-28 |