| In Case of Illness If the Mother Is Sick: Breastfeeding can continue during most illnesses. However, breastfeeding is not recommended if the mother has untreated tuberculosis, chicken pox, an active herpes lesion on the breast, or is HIV positive. (Some of these condidtions are currently under investigation to determine if and how breastfeeding may safely continue--ed.) If the Infant Is Sick: Continued breastfeeding during a bout of diarrhea or fever can prevent dehydration and speed an infant's recovery. Even an infant who is vomiting should continue to be offered small, frequent breastfeeding�s. Click www.fcs.okstate.edu/food/nutrition/lifecycle/breastfeeding/feed-cont.htm to view the article in entirety. When you are sick, you and your baby will almost always benefit from continuing to breastfeed. There are very few illnesses that require a mother to stop nursing. Continuing to breastfeed will help protect your baby from the infection, because your body produces antibodies to the specific bug that is causing the infection, and you pass them on to the baby in your milk. Often, a breastfed baby will be the only member of the family who doesn�t get sick. If he does get sick, he will usually have a much milder case than the older members of the family. Diagnostic and Routine Tests X-rays: human milk is not affected by diagnostic x-rays, and you can safely nurse immediately afterward. Ultrasound and CAT scans: these are non-invasive procedures that should not affect your milk or interfere with breastfeeding. Click www.familyresource.com/pregnancy/16/289/ to view the article in entirety. (This article containts helpful information about other maternal procedures, illness and over-the-counter medications and their safety during breastfeeding--ed.) Medications and Breastfeeding Most medications needed for treatment of CF are safe to take during breastfeeding. Click www.cfpc.ca/cfp/2002/Mar/vol48-mar-clinical-1.asp to view the article in entirety. Safety Rating of Medications in Pregnancy and Breastfeeding www.perinatology.com/exposures/druglist.htm Dr. Thomas W. Hale's Breastfeeding Pharmacology http://neonatal.ama.ttuhsc.edu/lact/ (This is a good comprehensive site for determining the safety of medications during breastfeeding.Dr. Hale's Medications in Mother's Milk is the leading publication to which to turn for information. This site and the publication both address not only the actual drug but the method of delivery for safety--ed.) Almost all drugs transfer into breast milk and this may carry a risk to a breastfed infant. Factors such as the dose received via breast milk, and the pharmacokinetics and effect of the drug in the infant need to be taken into consideration. Problems should not be overstated however, as many drugs are considered 'safe' during breastfeeding. Transfer of drugs into breast milk is influenced by protein binding, lipid solubility and ionisation . Calculation of infant exposure to drugs can be used to help guide safe use . Milk composition varies within and between feeds and this may also affect transfer of drugs into breast milk. An arbitrary cut-off of 10% has been selected as a guide to the safe use of drugs during lactation. For drugs with greater inherent toxicity such as cytotoxic agents, ergotamine, gold salts, immunosuppressives and isotretinoin, the cut-off of 10% is too high and breastfeeding is contraindicated. As a general rule, maternal use of topical preparations such as creams, nasal sprays or inhalers would be expected to carry less risk to a breastfed infant than systemically administered drugs. Feeding immediately prior to a dose may help to minimise infant exposure as concentrations in milk are likely to be lowest towards the end of a dosing interval. However, for some drugs, milk concentrations lag behind plasma concentrations. For drugs that have an infant dose greater than the arbitrary cut-off of 10% of the weight-adjusted maternal dose, it may be reasonable to reduce infant exposure by alternating breast and bottle-feeding. For drugs that are not considered safe in breastfeeding, breast milk may be expressed and discarded for the treatment duration. Breastfeeding may be resumed after the drug has been eliminated from the maternal blood stream. Antibiotics such as penicillins, cephalosporins and macrolides are considered to be compatible with breastfeeding although there are risks of alterations to infant bowel flora and allergic sensitisation.(see health and wellness link for recommendations on minimizing side-effects--ed.) Click www.perinatology.com/exposures/druglist.htm then click DRUG SAFETY IN LACTATION (Prescriber Update) link to view the article in entirety. Sudden weaning exposes both mother and baby to significant health risks and emotional stress. Physicians who do not treat a lot of nursing mothers or who have no personal experience with breastfeeding may not realize that there's more involved than just how a baby gets nourishment. Even if they're aware of the nutritional and immunological benefits of breastfeeding, many don't know that weaning the baby from the breast will also affect how the mother comforts and cares for her baby. A second reason for talking further with a doctor about weaning is that formula-feeding is not risk-free. Formula-feeding may have subtle negative effects on a child's development. Actually, there are very few drugs that are not safe to take while breastfeeding Health care givers often turn to the Physicians' Desk Reference (the PDR) for information about drugs. However, this is not a good source for information about drugs and breastfeeding. Information in the PDR comes directly from pharmaceutical companies, whose first concern is avoiding liability. A better source is the American Academy of Pediatrics Committee on Drugs, which in 1994 published an article titled "The transfer of drugs and other chemicals into human milk." This listing of drugs is based on hundreds of reports from the medical literature and is easily available in medical libraries. La Leche League Leaders also have access to other resources on medications in mother's milk with references that can be passed along to a physician. Medical journals publish new information about medications in human milk all the time. Seeking out additional information can make it possible for a mother to continue to breastfeed with complete peace of mind, or to know that in her special medical situation, weaning was indeed necessary. Even if the two of you must agree to disagree about a course of action, your doctor must know how you are treating your condition and whether your baby is continuing to nurse at the breast. Click www.lalecheleague.org/NB/NBMarApr00p55.html to view the article in entirety. Drugs that Contraindicate Breastfeeding The few classes of drugs that contraindicate breastfeeding during use include radioactive isotopes, chemotherapeutic drugs, lithium, ergotamine, lactation suppressing drugs, and recreational drugs. In situations where maternal exposure and probability of transfer in breast milk lipids are determined to be significant, analysis of milk is recommended with decisions regarding safety made from estimated average intake. Click www.eatright.org/Public/NutritionInformation/92_8236.cfm to view the article in entirety. Nutrition In recent years, research has confirmed that even if some nutrients are missing in a woman�s daily diet, she will still produce milk that will help her child grow. There is very little difference in the milk of healthy mothers and mothers who are severely malnourished. Breastfeeding is a normal stage in the reproductive life of a woman, where just as in all the other stages in her life, her diet needs to be healthy, balanced, and adequate, taking into consideration any specific medical conditions. While women are often advised to consume about 500 extra calories daily while they are breastfeeding (compared to before pregnancy), research now indicates that this could be too much for some women, while for others it could be insufficient. If the diet is balanced and varied, the increase in calories will automatically be accompanied by an increase in all the other nutrients. Although the process of how human milk is synthesized is still not completely understood, we do know that it doesn�t take a lot energy. It has been shown that, during lactation, the metabolism of the mother�s body becomes more efficient, not just in regard to calories, but also to minerals. It has been seen that even in cases bordering on malnutrition in poor countries, the milk produced by these mothers satisfies the needs of the child, who will grow adequately if he is breastfed on cue. Human milk contains a small amount of iron in a form that is easy for babies to absorb. As with calcium, the levels of this mineral in human milk are constant, despite variations in the maternal diet or the mother�s body stores. An important advantage of breastfeeding -- especially breastfeeding on cue -- is that a mother usually does not resume her menstrual cycle for at least a few months, conserving the iron that would otherwise be lost every month. Click www.lalecheleague.org/NB/NBMarApr04p44.html to view the article in entirety. (Some) micronutrients (such as folate, calcium, iron, copper and zinc) remain at relatively high levels in breastmilk even when the mother's reserves are low...Additional calcium and iron, in particular, are often needed to protect maternal reserves. Unless extremely malnourished, virtually all mothers can produce adequate amounts of breastmilk. When the breastfeeding mother is undernourished, it is safer, easier and less expensive to give her more food than to expose the infant to the risks associated with breastmilk substitutes. from Breastfeeding and Maternal Nutrition: Frequently Asked Questions by LINKAGES from phishare.org Click www.phishare.org/documents/LINKAGES/372 to download the article in entirety. Milk Supply Issues For the most part, milk production is a "use it or lose it" process. The more often and effectively your baby nurses, the more milk you will make. Click www.kellymom.com/bf/supply/milkproduction.html to view the article in entirety. Milk Supply Issues Click www.lalecheleague.org/NB/NBmilksupplyissues.html to view a list of articles and their links. If baby is having an adequate number of wet and dirty diapers then the following things do NOT mean that you have a low milk supply: Your baby nurses frequently Your baby suddenly increases the frequency and/or length of nursings Your baby nurses more often and is fussy in the evening Your baby doesn't nurse as long as she did previously Your baby is fussy Your baby guzzles down a bottle of formula or expressed milk after nursing Your breasts don't leak milk, or only leak a little, or stop leaking Your breasts suddenly seem softer You never feel a let-down sensation, or it doesn't seem as strong as before You get very little or no milk when you pump These things can cause or contribute to a low milk supply: Supplementing Nipple Confusion Pacifiers Nipple Shields Scheduled Feedings Sleepy Baby Cutting short the length of feedings Offering only one breast per feeding Health or Anatomical problems with the baby Milk production is a demand & supply process. If you need to increase milk supply, it's important to understand how milk is made - understanding this will help you to do the right things to increase production. To speed milk production and increase overall milk supply, the key is to remove more milk from the breast and to do this frequently, so that less milk accumulates in the breast between feedings. Things that can help increase your milk supply: Make sure that baby is nursing efficiently Nurse frequently Take a nursing vacation Offer both sides at a feeding Switch nurse Avoid pacifiers and bottles Give baby only breastmilk Take care of Mom Consider pumping Consider a galactagogue Click www.kellymom.com/bf/supply/low-supply.html to view the article in entirety. Special Circumstances Breastfeeding an Adopted Child (Induced Lactation) Developing a milk supply requires nipple stimulation (via baby nursing, hand expression, pumping or a combination) and milk removal (once there is milk to remove). If your baby will nurse, regular and frequent nursing sessions (even if baby is just learning in the beginning) will be very helpful. Adoptive moms, even those who have never been pregnant, can generally get a partial milk supply (some mothers will be able to induce a full supply). Even if baby is not getting any milk at first, the nursing will be signaling your breasts to make milk. Consider giving your baby his feedings via an alternative feeding method (rather than a bottle), such as a nursing supplementer (sns - supplemental nursing system, available through a lactation consultant--ed.), feeding syringe, finger feeding setup, flexible cup, spoon, medicine/eye dropper, etc. If your baby is latching well, a nursing supplementer can be a big help: it will encourage your baby to nurse at your breast by giving him a constant flow of milk (expressed milk and/or formula) while he stimulates your breasts to produce more milk. Click www.kellymom.com/bf/supply/relactation.html to view the article in entirety. Induced Lactation Protocols www.asklenore.info/breastfeeding/induced_lactation/gn_protocols.html Nursing an Adopted Infant FAQs lact-aid.com/library.htm Breastfeeding While Pregnant Lactation into the third trimester of pregnancy is a risk factor for poor pregnancy weight gain. Therefore, although breast-feeding during pregnancy should not be discouraged, attention must be given to meeting the additional energy and nutrient demands of this practice. from Journal of the American Dietetic Association Many mothers nurse one child while they are pregnant with another. Often infants naturally wean during this period because of changes in the taste and the supply of breast milk. Mothers who want to continue to breastfeed throughout their pregnancy need to eat a well-balanced diet and get plenty of rest. Nursing More than One Child Whether a woman in nursing an infant and a toddler, or a set of twins, nursing more than one is possible. Remember, milk production is determined based on demand. As long as breastfeeding continues milk will be produced. Breastfeeding provides more than just nutrition, and continuing as long as possible can provide an infant important emotional benefits. The warmth and security felt during nursing can soothe a cranky, frightened, or tired infant. The immune benefits also continue throughout the course of breastfeeding and beyond. When the time comes to wean a baby completely from the breast, it should be done gradually. Substitute one feeding at a time with other kinds of loving care, such as reading a story together, doing puzzles, or going for a walk. Complete weaning will take several weeks, depending on how often the baby has been nursing. Click www.fcs.okstate.edu/food/nutrition/lifecycle/breastfeeding/feed-cont.htm to view the article in entirety. Reading and Resources The Womanly Art of Breastfeeding by La Leche League International (contains information and letters from nursing mothers in a variety of circumstances. This is a great foundational book. It covers all the bases--ed.) The Ultimate Breastfeeding Book of Answers by Jack Newman and Teresa Pitman, 2000. (This book has an extensive section on relactation and adoptive breastfeeding--ed.) The Breastfeeding Book by Martha Sears, R.N. and William Sears, M.D. (contains information about nursing through maternal and infant illnesses and tests, adoption (with which the authors have personal experience) and much more--ed.) Breastfeeding the Adopted Baby by Debra Peterson, 1994 www.breastfeedingvideo.com (contains information on breastfeeding in numerous situations including multiples, pregnancy, tandem, illnesses, and prematurity--ed.) |
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| Selected excerpts from resources detailing specific issues and concerns of breastfeeding for women with CF or wives of men with CF |
| Back to Breastfeeding |
| Then the women said to Naomi, "Blessed be the LORD, who has not left you this day without a near kinsman; and may his name be famous in Israel! And may he be to you a restorer of life and a nourisher of your old age; for your daughter-in-law, who loves you, who is better to you than seven sons, has borne him." Then Naomi took the child (her grandson) and laid him on her bosom and became a nurse to him. Ruth 4:14-16 Rejoice with Jerusalem, and be glad with her, all you who love her; Rejoice for joy with her, all you who mourn for her; That you may feed and be satisfied with the consolation of her bosom, that you may drink deeply and be delighted with the abundance of her glory." For thus says the LORD: "Behold, I will extend peace to her like a river, and the glory of the Gentiles like a flowing stream. Then you shall feed; On her sides shall you be carried, and be dandled on her knees. As one whom his mother comforts, so will I comfort you." Isaiah 66:10-13a |