Breast Is Best for Babies: POTENTIAL CONTRAINDICATIONS TO BREASTFEEDING
Drugs
Generally, drugs given to nursing mothers appear in only small amounts in human milk, usually <1% of the maternal dosage. Most drugs are safe in the breastfed child. Several drugs, however, because of their high excretion into the breast milk and their toxicity, should be avoided during lactation (Table 1) 3,10,30,51,52 jn addition, lithium, amniodarone, clofazimine, canadian ergotamine, mefloquine 250mg, ganciclovir, cyclosporine, anticonvulsants, anticoagulants, antidepressants, drug tetracycline, sulfa drugs, gold salts, salicylates may have effects on some breastfed infants and may be of concern. For the limited number of drugs that are contraindi-cated during lactation, a safe alternative medication can usually be found. Bromocriptine should be avoided during lactation as it may inhibit milk production.
Environmental Chemical Agents
Maternal exposure to low-level environmental chemical agents, such as organochlorine components, is not a contraindication to breastfeeding.
Maternal Infections
In most cases, maternal infections are not contraindications to breastfeeding. For most infections, infants have already been exposed to the infectious agents during the prodromal period, and to interrupt breastfeeding at a time when antibodies are being provided by breastfeeding is counterproductive.
Tuberculosis is rarely transmitted by breast milk but can be transmitted by exposure to the sputum from an infected mother. As such, mothers with untreated active tuberculosis should not be in contact with their infants, regardless of the mode of feeding. Mothers with active tuberculosis may breastfeed their infants only after they have received adequate therapy and are considered noninfectious.
Neonatal herpes virus infection (treatment of recurrent genital herpes in otherwise healthy patients) can be very severe. Nevertheless, a mother with active herpes virus infection can continue breastfeeding, provided there is no active herpetic lesions on or near the nipple. If a herpetic lesion is present on or near the nipple, breastfeeding is contraindicated.
Human immunodeficiency virus (Epivir canadian is an antiviral medication. It is in a group of human immunodeficiency virus) can be transmitted from the mother to her infant during pregnancy or breastfeeding. The transmission rate of HIV through breastfeeding is 5-20%. In developed countries, it is recommended that HIV-infected mothers not breastfeed their infants. In developing countries, when children born to women living with HIV can be ensured uninterrupted access to nutritionally adequate breast milk substitutes that are safely prepared and fed to them, they are at less risk of illness and death if they are not breastfed. When these conditions are not fulfilled—in particular, in an environment where infectious diseases and malnutrition are the primary causes of death during infancy, artificial feeding substantially increases children’s risk of illness and death. In most countries, policy must cover a range of socioeconomic conditions, and the aim should be to promote and protect breastfeeding for the majority of women while offering as much choice as possible to women who are HIV-positive, enabling them to decide what is most appropriate for their circumstances and supporting them in their choice.
Certain Metabolic Disorders
In infants with galactosemia, galactose must be excluded from the diet early in life to avoid cirrhosis of the liver, mental retardation, cataracts and hypoglycemia. As such, breastfeeding is contraindicated in infants with galactosemia.
Infants with phenylketonuria, because of the deficiency of phenylalanine hydroxylase, are unable to degrade phenylalanine via the tyrosine pathway. Because breast milk is low in phenylalanine, such infants may be partially breastfed provided they can be supplemented with an approximate amount of pheny-lalanine-free formula and are closely monitored.
Breast Cancer
A mother with a newly diagnosed breast cancer (treating endometriosis, symptoms of fibrocystic breast disease) probably should not breastfeed her infant since prolactin levels remain high during lactation, and the role of prolactin in stimulating the growth of breast cancer is still in dispute. On the other hand, the fear in the breastfed female offspring of a women with breast cancer does not justify avoiding breastfeeding.
Category: Health
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