When you Can’t or Shouldn’t Breastfeed
For some women they have no choice when it comes to the topic of breastfeeding. They don’t have the option of nursing because of their health or their baby’s. If your medical history includes any of the following, you will almost certainly be advised not to breastfeed.
Serious debilitating illness (such as heart or kidney disease, or severe anemia), or extreme underweight (your body needs fat stores to produce milk).
Serious infection, such as HIV/AIDS, TB, and possibly hepatitis B. (You may be able to nurse in spite of the hepatitis if your baby is treated postpartum with gamma globulin and hepatitis B vaccine.)
A condition requiring regular medication that passes into the breast milk and might be harmful to the baby, such as antithyroid, anticancer, or antihypertensive drugs; lithium, tranquilizers, or sedatives. (The need for temporary medication should not, however interfere with breastfeeding).
Present drug abuse including the use of tranquilizers, amphetamines, barbiturates, or other pill, heroin, methadone, cocaine, marijuana, tobacco, and the moderate or heavy use of caffeine or alcohol.
Inadequate glandular tissue in the breasts (this has nothing to do with the size of your breasts) or damage to the nerve supply to the nipple (as from injury or surgery). In some cases you may be able to attempt breastfeeding under careful medical supervision to be certain your baby is thriving. If you’ve had surgery for breast cancer in one breast, ask your doctor about the possibility of nursing from the other.
From present information it isn’t clear whether it is safe of not, though it does appear that a mother does not transmit cancer- causing substances to her baby through breast milk. Future research may be able to tell us more about the safety of breastfeeding following cancer surgery. There are also conditions of the newborn that can interfere with breastfeeding.
A metabolic disorder, such as PKU or lactose intolerance that makes the baby unable to digest human milk.
A deformity, such as cleft lip and/or cleft palate, that makes suckling at the breast difficult or impossible. (However, in some cases, especially when only cleft lip is present, it is possible to breastfeed. Ask to see a lactation consultant before you make a feeding decision. It may also be feasible to express breast milk until after surgery, and to begin breastfeeding then.)
If you can’t breastfeed, or if you just don’t wish to, be assured that a commercial baby formula will almost certainly nourish your baby adequately (rare exceptions would include infants with multiple allergies who require special formulas). Millions of healthy, happy babies have been raised on the bottle, and your baby can be, too, especially if you remember to make bottle feeding as loving an affair as breastfeeding.