When Should I Not Breastfeed?
Benefits of Breastfeeding
Women often wonder when it is not safe to breastfeed. Some women think that when they are sick, they should not breastfeed, but most common illnesses, such as colds, flu, or diarrhea, cannot be passed through the breast milk. In fact, if you are sick, your breast milk will have antibodies in it. These antibodies will help protect your baby from getting the same sickness or it may help so baby does not get as sick as mom did.
Although in nearly all cases it is the best thing to breastfeed, there are certain times when it is not safe. It is important to know when it is recommended to not breastfeed.
- Health Conditions of a Breastfeeding Mother
- Health Conditions of an Infant or Child
- Contraindicated Medications
- Over-the-Counter Medications and Prescription Medications
- Reducing Exposure to Medication in Breast Milk
- Pumping and Dumping
- Do I Need to Pump and Dump after Drinking Alcohol?
- Other Situations Where it is Not Recommended to Breastfeed
Health Conditions of a Breastfeeding Mother
If a mother has any of the following, she should talk to her doctor about whether she should stop breastfeeding. These conditions include:
- If mother has an active herpes simplex outbreak. It is safe for a woman to nurse unless she has lesions on her breasts. If the mother has a lesion on the breast it is recommended that she not nurse from the affected breast until lesions resolve.
- A woman with certain health conditions should not breastfeed because she risks transmitting the infection to her infant through her breast milk:
- Active tuberculosis
- HIV or AIDS
- Women who actively use illegal drugs, drinks excessive amounts of alcohol, or if a women have a history drug and alcohol abuse may be advised not to breastfeed.
- Women who are taking certain medications that are not safe during breastfeeding. Always talk to your doctor if you are or plan to breastfeed. There may be another medication option that a mother can use and still breastfeed safely.
- Women with certain chronic illnesses may be advised not to breastfeed, or they may need to take special steps to ensure their own health while breastfeeding. For example, women who have diabetes may need to change how much they eat while they breastfeed to prevent their blood sugar levels from dropping too low.
- Women who had breast surgery or trauma to the breast in the past may face some difficulties producing enough breast milk for the baby. If a mother does not produce enough breast milk, she may need to supplement with formula.
Health Conditions of an Infant or Child
Breastfeeding rarely needs to be stopped for a baby who is ill. Breastfeeding gives the sick child comfort along with many other health benefits. One thing to remember, in most cases, a sick baby does not need less breast milk, she needs more!
There is a rare condition, called galactosemia, when a baby should not be fed breast milk. This is when the body cannot break down the sugar galactose. Breast milk has galactose that some babies may not digest. A baby with classic galactosemia must be fed a special diet that is free of lactose and galactose. If a baby with galactosemia eats galactose they may have:
- Eye problems
- Liver problems
- Malnutrition
- Mental retardation
Contraindicated Medications
Many breastfeeding mothers will at some time need to take a medication. It is important to know the medication you are taking and if it is safe while breastfeeding. Some examples of medications that may be harmful to the baby are anticancer drugs, methotrexate, and certain antimanic drugs such as lithium. Talk to your doctor about your options. There may be a medication you can take that will be safe while you breastfeed.
Over-the-Counter Medications and Prescription Medications
Fortunately, there are many medications that are safe during breastfeeding. This is because less of the medication actually goes into human milk. Always check with your doctor to find out if the medication you need to take is safe while you breastfeed. Some tips to help you know what is safe are:
There are some medications that require you to stop breastfeeding or to pump and dump while you are taking them.
- Chemotherapy
- Therapeutic levels of radioactive elements
- Some thyroid medications
While most medications such as pain relievers and cold and cough medicines are safe while breastfeeding, a single ingredient product is the best choice.
Remember that any antihistamine medications will likely cause you to produce less breast milk.
Remember to tell your doctor that you are breastfeeding so that a safe yet effective medicine can be prescribed, if possible.
Breastfeeding mothers should call their health care providers before starting to take any over-the-counter medication.
Reducing Exposure to Medication in Breast Milk
Breastfeeding mothers can reduce exposure to medications following these tips:
- Take the medication just after nursing or right before the infant sleeps for a long stretch of time.
- Avoid long-acting preparations of the medication.
- When the mother has to use a medication for only a short-term, she can still maintain her milk supply. Mother will need to express breast milk as often baby would eat using a pump or hand expression. It is then important to throw the contaminated breast milk out. Once the medication is no longer needed the mother can breastfeed baby again.
Pumping and Dumping
There are times when baby should not drink breast milk. If the baby is at a high risk of being exposed to harmful substances in the breast milk, the baby should not drink it. Examples of harmful substances are some medications and radioactive material. In these situations a mother may need to pump and dump. This means to use a breast pump or hand express to empty the breasts and then you throw out the milk that was collected. Mom will need to do this as often as baby would normally eat. This will help keep up the milk supply. The baby will need to be given a temporary substitute. The substitute can be expressed breast milk produced before the medication or harmful substance was started, or an infant formula.
If the mother is only on a medication or harmful substance for a short term, she may only have to temporarily wean the baby. She can continue to maintain her milk supply. If the mother will be on a medication or harmful substance for a long time she may need to permanently wean baby. You will want to learn how to wean safely. If the mother must wean, the length of time it will take will vary and will depend on:
- The specific medication or radioactive material
- The dosage used
- The age of the baby
- Whether the baby is taking other foods
- If the mother is receiving radioactive treatment she can pump frequently to help get rid of the radioactivity from her body more quickly.
Do I Need to Pump and Dump after Drinking Alcohol?
As alcohol leaves the bloodstream, it leaves the breast milk. Since alcohol is not "trapped" in breast milk, pumping and dumping will not remove it. Pumping and dumping also will not speed up the rate of the elimination of alcohol from your body. It is best to limit or avoid consuming alcohol while breastfeeding. Alcohol in the breast milk can make the baby sleepier. If the mother drinks too much it can also affect her ability to take care of baby. If you drink alcohol you may want to have a limited amount of alcohol just after nursing or right before the infant sleeps for a long stretch of time. Some also choose to pump breast milk before drinking alcohol so someone can give the baby this milk when she is hungry.
Other Situations Where it is Not Recommended to Breastfeed
There may be other times when baby should not breastfeed. If you develop health problems or require medication always talk with your doctor about breastfeeding. While breast milk is the best food for the baby, there may be situations when it is not the best option. If it is possible to breastfeed safely, this would be the best choice. If it is not safe to breastfeed talk with your doctor, lactation specialist, and registered dietitian about your options.
