Nursing Despite My Illness
By Shel Franco
Doing what’s best for Baby is oftentimes the determining factor in a woman’s decision to breastfeed. But what happens when a chronic illness or disease requires much of Mom’s energy and the ingestion of medications that might be harmful to the baby?
For many women, life with chronic conditions and diseases such as depression, arthritis, asthma, and diabetes means more than medications and physical discomfort. If these women follow the advice of many medical professionals, it could also mean life without breastfeeding.
About 99 percent of drugs enter breast milk at less than 1 percent of the mother’s dose.
When Kathy Richard of Saugus, Massachusetts, was diagnosed with clinical depression, her doctors put her on a common antidepressant drug. At the time, she was breastfeeding a 1-year-old. “I consulted many breastfeeding and pharmaceutical experts,” Richard says. “All unanimously agreed that one should not take [this medication] and breastfeed, so I weaned [my son].”
But according to Dr. Thomas Hale, world-renowned researcher and the author of Medications and Mother’s Milk, Richard may have been the victim of misinformation. “We already know that for the most part, with one exception or two exceptions, the antidepressants are reasonably safe for breastfeeding mothers,” Dr. Hale says.
Richard wishes she had known this five years ago when she weaned her son. “I will never forget the last time I nursed my youngest, just before I took my first [dose of the medication],” she says. “I cried all the way through it and for a long time after.”
Why does this misinformation and miscommunication exist? Dr. Hale cites the use of package inserts as the biggest reason for misinformation. “Every package insert in the United States says ‘Do not use for breastfeeding mothers,’ and that is terrible information,” Hale says. In reality, he assures breastfeeding mothers that about 99 percent of drugs enter breast milk at less than 1 percent of the mother’s dose.
Even so, there are some conditions that warrant medications which are not compatible with breastfeeding. Sometimes women with diseases such as multiple sclerosis and rheumatoid arthritis take such high doses of medications that they can be detrimental to the breastfeeding child.
How, then, can a woman know if weaning is the only way to keep her child safe? Dr. Hale offers a three-step process to uncover the truth.
- Meet with a lactation consultant
- Find a copy of Medications and Mother’s Milk
- Take the book to the doctor or specialist who is prescribing your medications
If the medication is found to be harmful but will only be used temporarily, the breastfeeding mother does have a choice. Yvette DeLuca of Arizona, suffers from severe asthma. When her condition required a potentially harmful medication, DeLuca chose not to wean. Instead, she used a breast pump to keep her supply intact, throwing out the drug-laced milk. “As soon as I was finished [with the drug], I resumed breastfeeding,” she says.
Once the medication has been deemed safe, nursing mothers with chronic diseases can turn their attention toward getting comfortable. Finding the best position for feeding means much more to a woman whose body is predisposed to pain.
Moms with forms of arthritis and other diseases that cause joint or muscular pain may find it best to breastfeed supported by several pillows or even while lying down. The key is to enlist the help of a friend or spouse, someone who can help the nursing mom adjust and readjust until the most comfortable position is found.
An emotional discomfort that fewer people seem to think about is what happens to the breastfeeding relationship when mothers are hospitalized. An emergency forced DeLuca to stay in the hospital, but she did not let that stop her breastfeeding relationship. “As soon as I was off the respirator but still in ICU, I explained to [the nurses] that I had a 6-week-old baby and needed a breast pump, because I didn’t want my milk to dry up while in the hospital,” she says. As a result, the hospital staff contacted DeLuca’s pulmonologist, and a breast pump was brought to her that same day.
Some people may wonder why these women should even bother. Yet, mothers with chronic illnesses or diseases take heart in knowing that breastfeeding a baby, though sometimes a struggle, is well worth the effort. Women like DeLuca look at breastfeeding as a way to reduce their babies’ chances of having similar disorders in the future.
But for some women, the benefits may be simply personal. A study in the British Medical Journal suggests that breastfeeding mothers who are also insulin dependent diabetics undergo insulin reductions that are significantly greater than their bottle-feeding counterparts.
And diabetes might not be the only disease that is positively affected by breastfeeding; it is DeLuca’s belief that the hormones secreted during breastfeeding actually improved her asthma. “My doctor said it was possible—that he had seen pregnancy and breastfeeding both improve and worsen asthma,” she says.