Breastfeeding can be very beneficial for both mothers and babies and experts recommend exclusive breastfeeding for the first 6 months of a baby’s life. While nearly every mother and baby can breastfeed, there are some rare instances for a small number of mothers who cannot and should not nurse their children.
These usually involves mothers or babies with specific medical conditions or mothers who need certain diagnostic tests are also counselled not to breastfeed or to stop for a short time. The CDC (Center for disease control and prevention) publishes a regularly updated list of medical conditions that precludes breastfeeding. Here are some of a few reasons why some woman can’t or shouldn’t breastfeed:
1. Low breast milk supply
Only a small percentage of women can’t breastfeed due to lactation failure or a true low breast milk supply. This is usually the result of an underlying condition and with treatment, some issues can be corrected. Hence a mother can then go on to build a milk supply.
Some causes of true low milk supply include hypothyroidism, a previous breast surgery, polycystic ovary syndrome, insufficient glandular tissue and prior radiation treatment for breast cancer. Even though women with lactation failure have very little breast milk, any amount that you can give to your child is good for them.
Many medications are compatible with breastfeeding but some are not. Certain prescription drugs can be harmful to the baby and some may also cause a decrease in the milk supply. It is important to talk to your doctor before starting any new medication and to inform the doctor that you are breastfeeding.
Chemotherapy drugs, antiretroviral medication, radioactive iodine and some sedatives are some of the medications that are not compatible with breastfeeding. Those that decrease the supply of breast milk include cold and sinus medications that contain pseudoephedrine and certain types of hormonal birth control.
3. Infectious Disease
Most common infections are easily treated and do not have an impact with breastfeeding or harm the baby, however there are a few that can pass through breast milk and the risk of transmission outweighs the benefits of breastfeeding. Some of these conditions include HIV – The virus that causes AIDS.
A mother with HIV can pass the virus to her child through breastfeeding and her breast milk. Since AIDS does not have a cure, a mother who is HIV positive should not breastfeed if a safer alternative is available. However in countries where alternatives may be a problem, exclusive breastfeeding may be recommended.
HTLV – The human T-cell lymphotropic virus 1( HTLV -1) is a virus that can lead to leukemia and lymphoma. HTLV -2 can cause brain and lung issues. These may not cause any symptoms at all but they are lifelong conditions to which there is no cure. They can both be passed to a baby through breast milk and so the baby should not be breastfed.
4. Active tuberculosis infection
This is a bacterial infection in the lungs passed through respiratory droplets and not by breastfeeding or breastmilk. However it is easily passed to a child through contact due to the mother constantly sneezing and coughing and therefore should not be in close contact with her child. The baby can however receive pumped breast milk until breastfeeding can begin after two weeks of treatment. If both mother and baby have tuberculosis together, they can breastfeed.
5. Dependency on illegal Drugs
The use and abuse of illegal drugs is generally not compatible with pregnancy, breastfeeding or parenting in itself. These drugs get into the milk and pass to the baby and can cause irritability, sleepiness, growth problems, neurological damage and even death in the baby. It also puts the mother at risk of contracting infectious diseases such as HIV and HTLV and impairs her ability to take care of her child. Former drug users however, may be able to breastfeed. Those who have recovered or are in treatment and are drug and infection free can discuss their desire to breastfeed with healthcare professionals.
6. Classic Galactosemia
This is the body’s inability to break down galactose which is part of the milk sugar lactose. Lactose is the main sugar in breastmilk so if a baby tests positive for classic galactosemia, they cannot breastfeed or take breastmilk in a bottle and will need special instant formula as well as a galactose free diet. This prevents severe complications such jaundice, vomiting, diarrhea and long term developmental problems and in worst case, death.
A baby with PKU can not break down an amino acid called phenylalanine and with its build up in the body could cause brain damage. Breastmilk is however low in phenylalanine and so a baby with PKU may be able to combine breastfeeding and a special instant formula. The amount of breastfeeding needs to be controlled and the baby must have regular bloodwork and careful monitoring.
Apart from these medical conditions, there are cosmetic and social reasons as to why a mother may find it difficult to breastfeed her child. A few of these reasons are as follows:
- A woman may believe that if she breastfeeds her child, her breasts may reduce in size or may become saggy and due to this she will rather not breastfeed.
- A woman may also want to return to the workforce early enough and so might stop breastfeeding before the required six months.
- Breastfeeding can be emotionally and physically stressful, involving waking up late at night to feed, so some women may become emotionally overwhelmed or may suffer from post partum depression and hence would not want to breastfeed their baby.
- These days, formulas are being advertised a lot more and some mothers may prefer to feed their babies with formula than breastmilk.