Factors To Consider And Specific Guidelines For Breastfeeding

Factors To Consider And Specific Guidelines For Breastfeeding

The U.S. Dietary Guidelines for Americans 2020-2025 recommend that infants be exclusively breastfed for about the first six months with continued breastfeeding while introducing appropriate complementary foods for one year or longer. Breast milk provides nurture and immunity to the baby and decreases the incidence of certain diseases in the mother. Despite the profound benefits of breastfeeding for baby and mother, there are certain situations where a mother may need to consider alternative feeding methods.

Let’s discuss five situations where breastfeeding may not be recommended, and we should consult with a medical professional.

Maternal HIV or drug-resistant TB

If a mother has ongoing HIV or Ebola virus infection, there is an increased risk of transmitting the disease through breast milk. In such cases, avoiding breastfeeding until the infection resolves is better. The American Academy of Pediatrics (AAP) listed three infections that limit breastfeeding, as mentioned below.

• Human immunodeficiency virus (HIV),
• Untreated brucellosis, or
• Suspected or confirmed Ebola virus disease

Infant with classic Galactosemia

Classic Galactosemia is a rare genetic disorder affecting the body’s ability to metabolize galactose, a sugar in breast milk. It is caused due to a deficiency of an enzyme called galactose 1-phosphate uridyltransferase deficiency. Infants diagnosed with Galactosemia may need an alternative source of nutrition that does not contain galactose.

Maternal Substance Abuse

If a mother is struggling with severe substance abuse issues with opioids, cocaine, or PCP (phencyclidine), breastfeeding is not recommended due to the potentially harmful effects of these substances on the baby. In such cases, health professionals usually recommend formula or donor milk.

Often, mothers inquire about breastfeeding recommendations in other maternal conditions like hepatitis B, C, COVID-19, or mastitis. There’s no need to stop breastfeeding in such infections. Similarly, breastfeeding is recommended even if the mother has a febrile illness. Now, let’s discuss common queries related to breastfeeding in mothers who smoke or drink alcohol.

Special Conditions and recommendations

1) Breastfeeding and smoking

Smoking is not a contraindication of breastfeeding, although it increases the risk of an infant’s respiratory problems, including sudden infant death syndrome (SIDS). The American Academy of Pediatrics recommends exclusive breastfeeding for the same period in mothers who smoke tobacco.

2) Breastfeeding and alcoholism

Just like smoking, occasional drinking is not a contraindication of breastfeeding. However, it would be best if you waited at least two hours per beverage after alcohol consumption before breastfeeding.

3) Breastfeeding and medications

Although many medications do pass into breast milk, most have no known adverse effect on milk supply or infant well-being. On the other hand, a few medicines, like Lithium, Amphetamines, and Chloramphenicol, are contraindicated in breastfeeding. However, the decision to take or stop such medications during breastfeeding depends upon a licensed healthcare professional’s recommendation.

Take home

While breastfeeding is highly encouraged for its numerous benefits to both infants and mothers, there are specific situations where alternative feeding methods should be considered. Maternal infections like HIV, drug-resistant TB, and rare genetic disorders like Galactosemia prompt the use of formula or donor milk. Additionally, maternal substance abuse, particularly with opioids, cocaine, or PCP (phencyclidine), limits breastfeeding.