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Clin Perinatol. 1987 Mar;14(1):71-87.

Maternal disease as a consideration in lactation management.


Breastfeeding for mothers with chronic medical conditions presents important medical decisions for the primary physician. The issues need to be considered in light of the chronic disease, the physiological process of lactation, and the individual Mother for whom breastfeeding is very important. Management plans need to be based on adequate information and coordinated by the mother's physician and the pediatrician.


Health practitioners should not discourage mothers from breast feeding if they acquire an acute self limited illness. Depending on the treatment for a chronic disease, its severity, and its stage, mothers with some chronic diseases may breast feed. If a pregnant diabetic women has good prenatal care, continued good medical care for diabetes, and takes the needed increased insulin, the mammary gland should be able to produce ample milk for a health infant. Further, lactation induces a remission from diabetes. If pregnant women with severe asthma do not take medication, they are likely to experience severe asthma attacks which require large doses of medication to control them. 1 such medication, theophylline, passes to breast milk in a milk to plasma ratio of .6-.73. Mothers who have normal or mildly decreased renal function can breast feed successfully. In those women who experience moderate renal insufficiency, breast feeding can take place in only those cases where the infant is stable and can feed soon after delivery and the mother's condition is sound or improved after delivery. If indeed a woman with severe renal insufficiency can conceive, which is unlikely, she should not breast feed since the stress of pregnancy and delivery alone may have comprised her health. The limited research on breast feeding after a kidney transplant shows that an immunosuppressed women can produce immunocompetent milk with very little azathioprine present. Hypertensive mothers can breast feed their infants, especially if the internist treating her considers the lactation process. Diuretics may diminish milk production, but an active infant who stimulates milk production can counteract this effect. Methyldopa may suppress milk production.

[Indexed for MEDLINE]

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