Breastfeeding
and Maternal Illness
Very few maternal illnesses require the mother
to stop breastfeeding. This is particularly true
of infections. Most infections are caused by viruses.
Most infections caused by viruses are most infectious
before the mother realizes she is sick. By the
time the mother has fever (or cold, runny nose,
diarrhea, vomiting, rash etc), she has already
passed on the infection to the baby. However,
breastfeeding protects the baby against infection,
and the mother should thus continue breastfeeding,
in order to protect the baby. If the baby does
get sick, he usually is less sick than if breastfeeding
had stopped. But often mothers are pleasantly
surprised that their babies do not get sick at
all. The baby was protected by his mother's continuing
breastfeeding.
The only exception to the above is HIV infection
in the mother. Until we have more information,
it is considered safer for the baby that the mother
who is HIV positive not breastfeed, at least where
the risks of bottle feeding are acceptable. There
are situations, however, even in Canada, where
the risk of not breastfeeding is elevated enough
that the mother who is HIV positive should nevertheless
breastfeed her baby. The final word is not in,
however.
Most other maternal illnesses raise questions
because of the drugs the mother might have to
take. These should rarely be a problem (see above).
X-rays and scans: Ordinary X-rays do not require
a mother to stop breastfeeding even when used
with contrast (e.g. IVP). A CT scan, MRI scan,
even when used with contrast do not require a
mother to stop. A radioactive scan (e.g. lung
scan, bone scan) does not require a mother to
stop. The only exception is a thyroid scan. However,
most of the time the scan does not have to be
done. See below.
A not uncommon problem in the early months after
delivery is a condition called postpartum thyroiditis,
a temporary derangement in the thyroid gland's
function. A useful test to help understand the
condition is a thyroid scan. However, the test
requires that radioactive iodine be given to the
mother and this material must not be given to
nursing mothers. The radioactive iodine will be
found in the milk for weeks, and concentrated
in the baby's thyroid. There are ways of dealing
with postpartum thyroiditis without doing this
test. The drugs a mother might have to take to
treat postpartum thyroiditis are compatible with
continued breastfeeding (e.g. propranolol, propylthiouracil)
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Breast
Problems
Mastitis (breast infection) and breast abscess
are not reasons to stop breastfeeding. Although
surgery on a lactating breast is more difficult,
the surgery does not necessarily become easier
if the mother stops breastfeeding, as milk
continues to be formed for weeks after stopping
breastfeeding.
Mammograms are more difficult to read if the
mother is breastfeeding, but can still be
useful. Once again, how long must a mother
wait for her breast no longer to be considered
lactating? Evaluation of a lump can be done
by other means besides mammography. Discuss
options with your doctor. Let him/her know
breastfeeding is important to you. A needle
biopsy, for example, can be done of a lump
which is of concern.
New
Pregnancy
There is no reason that you cannot continue
breastfeeding if you become pregnant. There
is no evidence that this does any harm to
you, to the baby in your womb or to the one
who is nursing. If you wish to stop breastfeeding,
take your time and wean slowly.
Infant
Problems
Breastfeeding rarely needs to be discontinued
for infant illness. Through breastfeeding,
the mother is able to comfort the sick child,
and, at the same time, the child is able to
comfort the mother.
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| 1 |
Diarrhea
and vomiting. |
| |
Intestinal
infections are rare in exclusively breastfed
babies. (Though loose bowel movements are
very common in exclusively breastfed babies).
The best treatment for this condition if
the baby gets it, is to continue breastfeeding.
The baby will get better more quickly on
breastmilk. The baby will do well with only
breastmilk in the vast majority of situations,
and will not require added fluids except
in extraordinary cases.
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| 2 |
Respiratory
illnesses. |
| |
There
is a medical myth that milk should not be
given to children with respiratory infections.
Whether this is true or not for milk, it
is definitely not true for breastmilk (and
breastfeeding).
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| 3 |
Jaundice.
|
| |
Exclusively
breastfed babies are commonly jaundiced,
even until the 3rd month, though generally
the yellow colour of the skin is hardly
noticeable. Rather than being a problem,
this is normal. (There are causes of jaundice
which are not normal, but these do not require
stopping breastfeeding). If breastfeeding
is going well, jaundice does not require
the baby to stop breastfeeding. If breastfeeding
is not going well, fixing the breastfeeding
will improve the jaundice, whereas stopping
breastfeeding even for a short time may
completely destroy the breastfeeding. Stopping
breastfeeding is not the answer.
If the question you
have is not discussed above, do not assume
that you must  stop
breastfeeding. Do not stop, and get more
information. Mothers have been told they
must stop breastfeeding for reasons too
inane to discuss.
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