Aids; Arthritis; Asthma;
or a Mild Infection;
Poisoning; Giardia; Headaches;
Hepatitis, A, B or C; Herpes
Simplex I (Cold Sores) or II
(Genital Herpes); Lupus; Lyme
Disease; Measles (Rubella, German);
Multiple Sclerosis; Myasthenia
gravis (MG); Postpartum
Depression (PPD); STDs
(Chlamydia, Gonorrhea, syphilis); Shingles;
Many mothers wonder if they can breastfeed if they
have a chronic health problem, or even if they have a simple cold.
In most cases, a breastfeeding mother can continue to nurse, benefiting
both mother and baby.
Mom may worry if her illness and/or medications
she may need to take will affect her nursing baby. If mom's illness
is more serious, she needs to know that her fears and worries are
very real, and that there is help out there to get through whatever
she may be facing.
To date, research has not determined if Aids can
be transmitted through breastfeeding. Most women who are HIV positive
are urged to avoid breastfeeding until further research has been
done. For more information on HIV and breastfeeding, click here.
Scroll down to the HIV information.
Arthritis, Lupus, Fibromyalgia,
Myasthenia gravis (MG), Multiple Sclerosis (MS)
Rheumatoid Arthritis (RA) is a chronic inflammatory
disease. A mother with RA might experience pain and swelling of
the joints and fatigue. Other chronic conditions such as Lupus,
Fibromyalgia, Multiple Sclerosis (MS) and Myasthenia gravis (MG)
also fall into this category. All of these conditions may make it
painful for mother to do her normal daily activities.
A mother with any of these conditions may worry
that her condition may somehow be passed on to her baby by breastfeeding.
Most of these chronic conditions are caused by alterations in mother's
immune system or are genetic and cannot be passed on through breastfeeding.
She may think (or others may suggest to her) that it would be easier
to use formula rather than nurse, however breastfeeding may actually
There is very little physical "work" to
nurse a baby, unlike what is required in the preparation of infant
formula. A breastfeeding mother can nurse lying down, permitting
her to get more rest and relaxation. In addition, the breastfed
baby is usually healthier, preventing mother from stressing over
illnesses, financial worries related to illnesses, etc. Stress is
associated with the flare-ups of most of these conditions.
Using lots of pillows for support, slings, and nursing
lying down are a few suggestions that help these mothers nurse their
babies successfully. In addition, family members can help by offering
to do light housework, run errands, etc. These are the same types
of suggestions often used for mothers who do not have any chronic
conditions, but they are especially helpful to moms who may have
A mother with a chronic condition such as those
listed above needs to be aware that the hormonal changes in pregnancy
may cause a remission in the condition during her pregnancy. Somewhere
between two and eight months after the baby is born, many mothers
indicate that their symptoms returned and often seem worse than
they were prior to pregnancy. Breastfeeding is not the cause of
the return of the symptoms, but the return of the symptoms may be
related to a natural cycling of hormones.
There are medications that are considered to be
compatible with breastfeeding for moms who have these chronic conditions.
Mom should check with her doctor to see what course of treatment
is advised. She can then do some research (i.e. checking Dr Hale's
book, Medications & Mother's Milk) to see if the suggested medication
is compatible with breastfeeding, and if not, what alternative medications
may be okay. She can then share this information with her health
For more information:
Mothers who have asthma need not worry if they can
breastfeed. Asthma therapy can be continued as needed while breastfeeding,
and generally does not have to be changed. If mother is concerned
about the type of medication she uses, she can check with her local
LC or her doctor, to see what information there is available on
that particular medication. Another resource she can use is Dr Thomas
Hale's book, Medications and Mother's Milk, or via his website,
The very thought of cancer is often very frightening,
and for a new mother, who is breastfeeding, the feelings can be
quite overwhelming. If a lump is found and mom is facing testing
to determine if she does have cancerous cells, she should be encouraged
to seek support from not only women who have been there and came
through it, but also a knowledgeable group that can help support
her needs and feelings in relation to her new baby and breastfeeding.
She needs to be aware that in most cases, many types of cancer,
if detected early and treated promptly, can be completely cured.
The first step she may face is testing to determine
if she does (or does not) have cancer. Several
tests may be used. They may include X-rays, ultrasound, mammograms,
and fine-needle aspirations. These particular diagnostic tests do
not affect mother's milk, so breastfeeding can continue.
If a mother needs a biopsy, she can still continue
breastfeeding. In this case she would need to discuss her options
and what medications will be used with her physicians, so that they
can choose medications that would be compatible with breastfeeding
during and after the surgery. If the area that the biopsy is done
is close the nipple, she may temporarily suspend nursing on that
side until the site has healed a little, then resume normal nursing.
(Supply most likely will "catch up") She can nurse normally
from the other breast.
Breastfeeding would need to be suspended temporarily
if the doctors feel radioactive testing needs to be done. This is
because radioactive materials accumulate in mother's milk and would
be passed on to the baby.
If mother has to temporarily suspend breastfeeding
due to use of radioactive testing, she should pump regularly to
maintain her milk supply. The milk should be discarded. Once treatment
is complete, mother can return to breastfeeding if she desires to
do so, and after her milk has been tested to be sure that there
is no radioactivity there. Pumping frequently after the treatment
is complete can help eliminate the radioactivity more quickly from
Radiation therapy does not affect human milk but
because there is a question of whether or not radiation therapy
affects long-term ability to nurse from the affected breast, it
is often advised that mother nurse from the unaffected breast only.
In addition, radiation causes a reaction to the skin in much the
same way sunburn would, so mom may find that the breast being treated
would be too sore to comfortably nurse from anyway.
Breastfeeding during chemotherapy would not
be advised nor recommended. It is almost always considered hazardous
to a nursing baby.
If mother comes down with chickenpox after her baby
is born, she should see if covering sores may be acceptable to the
doctor, so that she can continue breastfeeding. If the doctor feels
a temporary separation is warrented, mom needs to regularly express
her milk to maintain her supply. The milk is not "contaminated"
and should be given to her baby, as it contains precious antibodies
to help protect the baby from the virus. Once she passes through
the contamination period (the sores are all crusted and no new sores
have appeared for at least 72 hours), she should be able to safely
Flu or a Mild Infection
Although many mothers worry about exposing their
babies to a cold, flu, or an infection, she needs to know that even
before she knew that she had the "bug", her body started
producing an increase of specific antibodies that will help protect
her baby from that particular "bug".
By the time that mom feels sick, the boost in antibodies
is in "full force", so there is no need to suspend breastfeeding.
While there is no guarantee that her baby will not come down with
the same "bug", those specific antibodies the baby receives
while breastfeeding should ensure that it's a milder case.
If mother were to put the baby on formula thinking
that it would be better, her baby would then lose the protection
of those specific antibodies to help fight the illness. In addition,
it could very well result in her not only having to cope with feeling
sick, but also with the physical discomforts of abrupt weaning (i.e.
engorgement), and can be hard baby, who may be very bewildered by
not being able to nurse, and become difficult to comfort.
Most moms find when they are feeling sick, it's
easier for them to bring their babies into bed with them so that
they can just "nurse and rest". For information on cold
remedies compatible with breastfeeding click here.
Many diabetic mothers have enjoyed a successful
breastfeeding relationship. While she needs to remain under the
supervision of her doctor, the diabetic breastfeeding mom can certainly
benefit from nursing her baby. Many breastfeeding mothers have said
that they feel healthier than they have in a while, and they feel
"normal", because they can nurse their babies much like
a non-diabetic mother can.
Breastfeeding can reduce stress. This is important
because stress aggravates diabetes. Breastfeeding while lying down
which can help her get a little extra rest and relaxation, also
very important to diabetic mothers. Breastfeeding may be beneficial
to the diabetic mom, because the extra energy used to produce breastmilk
may decrease the amount of insulin the mother needs.
What the mother may not know is that there are studies
indicating that breastfeeding appears to offer some protection to
the baby in reducing its risk of developing diabetes.
Mothers who have epilepsy have successfully breastfed
their babies. The medications commonly used to control their seizures
are not necessarily contraindicated when breastfeeding. Dilantin,
for example is one medication commonly used to control seizures,
and according to information from Dr Thomas Hale, author of Medications
and Mother's Milk, hundreds of women have breastfed while taking
Dilantin and their infants were just fine. Another medication commonly
used for breastfeeding mothers is Tegretol (carbamazepine). It is
listed in Dr. Hale's text as category L2 or "safer" for
use in lactation. This drug is one of the most commonly used seizure
medications in pediatrics.
Usually a mother can feel a seizure "coming
on", and will have time to put her baby down in a safe place.
Having a playpen or porta-crib in each room of the house, and on
each floor if the house is not one level, is a common suggestion
that can be very helpful to a mother with epilepsy.
Nursing in a large padded chair, or using pillows,
blankets or towels to help pad a regular chair is another common
suggestion. For moms who like to nurse lying down, another idea
is to use guardrails on the bed, or pad the floor and nurse there.
Using gates across doorways and stairs is particularly
helpful once baby becomes mobile, and is often a standard procedure
used even if mom is not epileptic.
For additional support to the mother who has epilepsy,
there is a newsgroup, alt.support.epilepsy, which provides an online
meeting place for people with the disorder to share experiences
Additional info on breastfeeding and epilepsy
can be found:
Food poisoning sounds scary, but is not normally
harmful to the nursing baby. It usually stays localized in mom's
intestinal tract and will not pass into her milk.
It may cause vomiting, cramps and diarrhea, and
almost always passes within a few days. As long as the symptoms
are localized in the abdominal area, breastfeeding can continue
In rare cases, the food poisoning
becomes systemic, or gets into the bloodstream. In this case
mother would become extremely ill, and breastfeeding
would need to be suspended until she has antibiotics to clear the
infection (when the infection is systemic the infection would pass
into the milk). Regular pumping to prevent engorgement and maintain
supply is recommended, so that she can resume nursing once the infection
is under control.
Additional information on food poisoning and
breastfeeding can be found here:
Giardia is a parasitic infection that causes diarrhea.
It appears the medication most commonly used to treat Giardia is
Flagyl (metronidazole). This is used commonly in pediatrics to treat
gastrointestinal infections. Additionally, according to information
from Dr Hale's site, many breastfeeding mothers have used Flagyl
with no adverse reactions reported in their babies. The amounts
passed to the nursing baby appear to be far lower than what the
baby would receive if he were being treated directly (pediatric
dose). An alternative drug used to treat Giardia is Furazolidone.
Drug resources indicate that the use of this drug is compatible
with breastfeeding, except in infants with the rare G6PD deficiency.
Many women who suffer from severe, or migraine headaches,
are concerned about treating their headaches while breastfeeding.
There are medications
used to treat these headaches, such as Imitrex or Fioricet, which
can be used while breastfeeding.
Frequent headaches might be hormonally related,
as many women report severe headaches prior to the onset of their
periods or ovulation each month, however there seem to be less instances
of severe headaches while they are breastfeeding.
For information on natural healing techniques for
migraines, click here.
B or C
Hepatitis A, ("infectious hepatitis")
is the short-incubation form of viral hepatitis. There is no need
to suspend or stop breastfeeding if mother contracts Hepatitis A.
Hepatitis B, ("serum hepatitis"), is the
long-incubation form of viral hepatitis. Hepatitis B symptoms, though
similar to those of Hepatitis A, are often more severe and longer
lasting. If a mother is diagnosed with Hepatitis B, (after pregnancy)
her baby can be given a vaccine that will allow breastfeeding to
continue without interruption. If a mom is diagnosed prior to delivery,
and her baby is treated immediately, the baby may be breastfed.
Hepatitis C does not appear to be transmitted by
breastfeeding. Mothers with chronic hepatitis C are often advised
that they can nurse their infants, but they should discuss this
with their physician. Other types of infections need to be evaluated
by the obstetrician and pediatrician, but nearly all will be found
to be safe for breastfeeding.
More information can be found here:
Simplex I (Cold Sores) or II (Genital Herpes)
The Herpes virus is spread through contact with
open sores. A mother who has herpes should take care to cover the
sores so that her baby does not touch the open sore. If there are
sores on mom's breast(s), and they can be covered so that the baby
doesn't touch them, breastfeeding can continue. She should wash
her hands before holding the baby and after any sores are touched.
If mom has cold sores on or near her mouth, avoid kissing the baby.
If the sore is on the nipple or areola, or anywhere
where baby may come into contact with it while nursing, it may be
best for mom to express her milk until the sore(s) heal. If the
other breast is unaffected, breastfeeding can continue on that side
Mother should be careful not to contaminate her
milk via hand contact with sores, or from contact with breast pump.
Milk that might be contaminated should be discarded. Milk that has
been carefully expressed and contamination avoided can be given
to the baby.
While a mother should discuss these issues with
her doctors, breastfeeding can be initiated and continued with proper
More on herpes and breastfeeding can be found
There is currently no evidence that Lyme disease
can be transmitted by breastfeeding. More research needs to be done.
Most breastfeeding experts advise that there seems to be no danger
in continuing to breastfeed if Lyme disease is suspected or diagnosed.
Infected deer ticks carry Lyme disease. Symptoms
include a circular - or "bulls-eye" - rash (which usually
appears within three to thirty-two days after being bitten by the
infected tick); fever; headache; chills, and fatigue.
Mothers should receive proper evaluation by her
doctor if Lyme disease is suspected, and if diagnosed, should begin
proper treatment immediately. Breastfeeding can then continue. For
additional information on Lyme disease:
Measles - While it does happen, most women
have either had measles or received a measles vaccine as a child,
so having the measles as an adult is rare. If mom is unsure if she's
ever had measles or a vaccine for measles, she should consult with
The real danger is to the unborn baby, or the newborn,
so if mother catches measles some time after giving birth, no special
precautions are necessary. Mom's milk will not transmit the virus,
and it will contain antibodies to help the baby fight it off. If
the baby catches the measles after birth, it is almost always a
Rubella is a mild infectious disease that
is usually no more serious than a common cold is. Again, the concern
is to an unborn baby whose mother catches rubella before the babe
is born, not to a baby whose mother catches it in the weeks following
birth. If mother contracts rubella, her baby will have been exposed
to it long before she begins to have the symptoms of it. The baby
will do better if breastfed, as the immunities will help protect
him. Human milk may even provide a natural immunization to rubella.
Depression is more common than many realize, and although it
may be more frequent among non-breastfeeding mothers, those who
nurse their babies may also have ppd.
Breastfeeding can help because of the hormonal influences
having a calming effect, but in some cases, especially if there
is a family history of ppd, mom may need some "outside"
help. Sharing the ups and downs with close family or friends can
help her work through the issues, and not bear it alone. If it becomes
difficult to function on a daily basis, talking with her doctor
is recommended. There are medications available for mothers who
suffer with ppd that are compatible with breastfeeding.
(Chlamydia, Gonorrhea, syphilis)
Chlamydia, Gonorrhea and Syphilis are probably the
most common STDs. Clamydia and Gonnorrhea are not transmitted through
breastfeeding. In the case of syphilis, the baby can continue to
breastfeed if there is no contact with the sores. All of these STDs
are treated with antibiotics, and breastfeeding can continue.
It is important if a mother suspects she has
an STD that she go to her doctor for an exam and discuss with him/her
options for treatment. In most cases, STDs (such as those
listed above) can be cured, HIV and Herpes being two of very few
For more information on these and other STDs:
Shingles is not a contraindication to breastfeeding
or using the milk. It may be treated with Acyclovir (zovirax) which
is AAP approved for breastfeeding mothers.
Hormonal changes during pregnancy and/or breastfeeding
can cause thyroid levels to temporarily increase or decrease, even
if the mother has never experienced any thyroid problems before.
Lactation, however, does not cause thyroid dysfunction. For many
this is also a temporary condition.
The thyroid gland controls the rate of all the body's
metabolic processes. For the mother who wishes to nurse her baby,
thyroid issues are not a problem and not a reason for her NOT
to nurse. She should of course be under the care of a doctor
who supports her desire to breastfeed and monitors her thyroid function
and medications carefully. Most cases of either type of
thyroid concerns (over active or under active thyroid) can be diagnosed
by the use of simple blood tests. Mother may want to talk to her
doctor about having an ultrasound of the thyroid done first. There
is no need to stop breastfeeding for this, and it might be a good
first step, as opposed to radioactive tests. Occasionally, however,
the need for radioactive testing and visualization of the thyroid
If radioactive testing is unavoidable, temporary
weaning is necessary. This is necessary any time radioactive
testing (radioactive iodine injection) is necessary. Breastfeeding
while the radioactivity is still present in the milk would expose
the baby to radioactivity.
The length of time the mother needs to suspend breastfeeding
will depend on the type and dose of radioactive material used for
the test. Technetium-99m (Tc-99m) pertechnetate is usually the preferred
agent used (cessation of breastfeeding only required for 30 hours).
A test will need to be done to make sure the radioactivity
is completely gone. This is done by a facility that has access to
a Geiger counter. Baby should be kept away from the area that will
be injected (around the thyroid gland) because just being near that
area can expose him to "excess" radioactivity.
During the temporary suspension of breastfeeding,
mother should express her milk regularly to maintain supply. Frequent
pumping can also help to eliminate the radioactive materials from
her system. Milk expressed during this time should be discarded.
When supplementing during the time breastfeeding must be suspended,
use a bottle nipple that is either a newborn or slow flow size so
that the baby does not begin to prefer the "ease" of the
bottle, and balk at returning to the breast.
The under active thyroid, or HYPOthyroidism,
is very common. Symptoms may include fatigue, depression and poor
appetite. It may also result in a low milk supply and thus affect
baby's weight gain. The symptoms may be overlooked or blamed on
being a new mother and/or on breastfeeding itself.
Medications for hypothyroidism are NOT contraindicated
during breastfeeding. The supplements that mother takes to treat
this condition will not harm the nursing baby.
The overactive thyroid, or HYPERthyroidism,
requires some close monitoring but does not demand weaning. There
are medications used for hyperthyroidism that are compatible with
breastfeeding, but the nursing baby should be frequently checked
to be sure that it's thyroid levels are okay. For the overactive
thyroid, the preferred drug for nursing mothers is PTU.
"If" the baby's thyroid levels drop as
a result of mom's intake of the thyroid medication, rather than
weaning, it should be a consideration to give the baby a thyroid
Additional information on thyroid issues can
be found here:
Sources for above information include, but are
not limited to:
The Breastfeeding Answer Book, LLL
Breastfeeding and Human Lactation, Riordan & Auerbach.
Medications and Mother's Milk, Thomas Hale, PHD