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When Not To Breastfeed

When Breast Isn’t Best

Summary

  • Medications and drugs you take will affect your breast milk
  • Your baby’s doctor and the NIH are good resources to determine drug safety
  • Infections within you can affect your baby
  • Rare diseases such as galactosemia will prevent you from breastfeeding
  • Breast surgery or augmentation may or may not interfere with breastfeeding
  • Often times, breastfeeding can be resumed once the initial problem is addressed

 

Unfortunately, there are times when one should not breastfeed. These include potential toxic exposure to your baby, maternal health issues, baby health issues and lack of breast milk production. You should be aware of these four main reasons and don’t lose sight of the main goal which is to keep your baby as healthy as possible.

  • Toxic Exposure to Baby. Has your doctor put you on medication that can be harmful to your baby? Maybe you are taking a dangerous medication sold at the store. Perhaps you were exposed to toxic substances at work? There is also the possibility that you are using a drug that isn’t safe. Whatever goes in you will make its way to your breast milk. Instead of providing an ever-changing list of potentially dangerous medications, let’s turn to a few reliable sources. Start by asking your doctor and your baby’s doctor. Also turn to the LactMed database at the National Institute of Health (NIH) at LactMed. This database is updated monthly and likely the source that your doctor will use to determine the safety of a medication. For the dangers of chemicals you may have been exposed to at work, the Occupational Safety and Health Administration website (www.osha.gov) would be your source. And if you are abusing drugs such as heroin, cocaine or anything else, such substances are especially dangerous to your baby and are reason enough not to breastfeed.
  • Maternal Health Issues. Should you be infected with AIDS (or HIV), tuberculosis, hepatitis A or hepatitis B, your doctor will likely warn you against breastfeeding until you and your baby have been properly treated. In such instances, you may wish to pump to maintain your milk supply until it’s safe for your baby to nurse from you. Be sure to discard any breast milk that is deemed unsafe by your doctor. If you are seriously ill or have lost a lot of weight, breastfeeding may not be feasible. Your health is just as important as your baby’s health. Listen to your body and listen to your doctor.
  • Baby Health Issues. Rare genetic disease such as galactosemia are now readily detected with newborn screening and will prevent you from breastfeeding. In this rare condition, your baby is not able to convert galactose into glucose and a breastfed baby will start vomiting, experience severe weight loss and will eventually develop mental retardation and damage to the liver. A special formula, when introduced early, can prevent such damage and will be lifesaving. Other conditions such as phenylketonuria (PKU) or lactose intolerance may require you to temporarily stop breastfeeding until proper treatment is established. Structural conditions such as cleft lip and/or cleft palate may require you to pump and feed with a special bottle until the deformity is fixed
  • Lack of Breast Milk Production. For whatever reason, a previous breast surgery because of breast cancer or other reasons, augmentation, inadequate glandular breast tissue, or reasons unknown, there are times when women will simply not produce enough breast milk. Often times some patience and a good lactation consultant will overcome slow letdown, but in instances where your milk supply isn’t adequate, formula will be necessary. To be clear, this isn’t necessarily a reason not to breastfeed. Your baby may still be receiving some nutritional benefit and the importance of bonding can’t be overstated. But proper nutrition is key to your baby’s health. If your baby’s physician is concerned about your baby’s weight gain, it’s time to introduce formula

Reasons not to breastfeed are few. Some are potentially serious and make breastfeeding impossible. Alternately, the introduction of breast milk to your baby may be delayed until the underlying problem has been addressed. Take heart in knowing that the decision you ultimately reach or the choice you are confronted with is based on putting your baby first. Should this result in you not being able to breastfeed, that is the right decision and that is what’s best for your baby. Nutrition and love are key.

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