Following the theme for 2019 World Breastfeeding Week: Empower Parents. Enable breastfeeding, we at Abudo wish to make breastfeeding inclusive for all. Be it mothers with HIV, diabetes, or breast cancer!

So, HAPPY BREASTFEEDING WEEK, MAMA. (Celebrated each year August 1st – August 7th)

Yes, we agree that breastfeeding is a matter of personal choice, strictly. However, medical experts including the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists, strongly recommend breastfeeding exclusively (meaning no formula, juice, or water) for AT LEAST 6 months of your child’s life. Research also suggests that breastfeeding not only satisfies the tiny appetite of your baby but also encourages a loving bond between the mother and the baby. 

Now, every mother wants to give the best to their child in terms of mental and physical growth. In doing so, nutrition comes first! 

Abudo asserts that breastfeeding is an organic and most beneficial way as a first step of providing your baby with quality nutrition.

While breastfeeding sounds like an in-built skill all mothers who give birth have. It can be very complicated for mothers who are breastfeeding with breast cancer, HIV infection, or diabetes. You may what do mothers with such medical conditions do to fulfill their child’s need? Could they possibly rely on breastfeeding or whether it’s safe for them? 

Well, let’s begin answering what it is like to breastfeed with breast cancer, HIV, or diabetes:

Women who are breastfeeding without the burden of disease have a very different experience than those with an infection. For them, breastfeeding may be painful, or the medications taken by the mother could pass into breast milk, or due to the risk of the disease-causing agent, breastfeeding is wholly shunned. Some mothers, due to their condition, are so weak that they are automatically asked not to breastfeed to preserve their health status. For example, the American Academy of Paediatrics suggests that radioactive compounds and anticancer drugs should be avoided during lactation. But then what about mothers undergoing chemotherapy?  Let’s look at each of the conditions to better understand their relationship with breastfeeding better.

Breastfeeding with Breast Cancer

The likelihood of breastfeeding when you have breast cancer is dependent upon two things: the stage of your breast cancer journey and the treatments you are receiving. Most of the time, doctors recommend that women who have been diagnosed with breast cancer to stop breastfeeding their children. This would be the last thing you would want to hear, and you will be caught by the indecisiveness of doing what is best for you as well as your baby’s health. No matter how eager you are to breastfeed your baby, remember that continuing a treatment regime that may be detrimental to the baby’s health may complicate the situation. 

An example of such a treatment regime is Chemotherapy

If you are undergoing chemotherapy, you will have to stop breastfeeding during treatment and for some months after that. Research has shown that toxic agents of chemotherapy or radiation therapy can be passed to the baby through breast milk. Sometimes, after the treatment is over, breasts stop producing milk. To ensure that you don’t stop lactating, you can apply the pump and dump practice. This involves pumping breast milk every day and throwing it away to ensure that the supply of milk is continued. Once your doctor approves your condition, you can resume breastfeeding with breast cancer.

Nonetheless, if your doctor’s action plan includes a surgical method, it may or may not affect the ducts that transfer milk. So talking to your doctor regarding the plan and the surgical procedure will help you decide whether or not you should stop breastfeeding or whether or not you will be able to do it in the future. 

The truth is, we know that breastfeeding can be challenging for any new mom, but for a new mom who’s also beaten breast cancer, nursing a baby can be even more complicated. Research suggests that nursing after breast cancer is possible, and in most cases, a breast cancer survivor can try to nurse her baby if she wants to even on the treated breast. And since breastfeeding may protect against breast cancer coming back, nursing may benefit both you and your baby (who’ll reap the rewards from drinking your nutrient-rich breast milk).

As of now, there has been no scientific evidence that breastfeeding with breast cancer is detrimental or milk from a cancer survivor positions any risk to the baby. Especially once all the effects of the treatment have been cleared from the body. 

When we talk about HIV though, the scenario is far more complicated and different. HIV infections are caused by viruses that affect the immune system of the person they infect. The issue is that this virus is passed on through body fluid, INCLUDING breast milk. Scientific evidence shows that mothers with HIV should not breastfeed their babies at any cost. 

Let’s have an in-depth discussion. 

Breastfeeding with HIV

In the United States and other developed areas where mothers are provided with clean water and nutritious replacement feeding formula milk, it is recommended that mothers infected with HIV opt for replacements of breast milk. On the other hand, in areas where resources are limited or scarce to the point that no clean water is available, the World Health Organization (WHO) endorses that infected mothers breastfeed their babies for the first 6 months and continue to breastfeed for at least 12 months coupled with solid food diet. 

Until recently, the World Health Organization (WHO) advised HIV-positive mothers to avoid breastfeeding if they were able to afford, prepare and store formula milk safely. But research has since emerged. Particularly from South Africa, that shows that a combination of exclusive breastfeeding and the use of antiretroviral treatment can significantly reduce the risk of transmitting HIV to babies through breastfeeding. This is why WHO recommends that breastfeeding mothers with HIV should be given antiretroviral medication and therapies to treat their HIV infection and to minimize the route of its transmission via breastfeeding but should nonetheless be encouraged to nurse their babies to ensure optimal growth and development. 

In addition to that, if your viral load is undetectable, breastfeeding is not a problem. This is because undetectable viral load means that the virus cannot be transferred to another human.

The only health complications in which it is not as alarming to breastfeed is Diabetes. Contrary to the unpopular opinion, Diabetes should not stop you from breastfeeding and giving your child the best of nutrition. 

Diabetic mothers are prone to far more complications than healthy mothers. If you have diabetes, you may wonder if that’s true for you. No worries: If you want to breastfeed, having diabetes shouldn’t prevent you from doing so. Besides, breastfeeding will help you and your baby reap some pretty impressive benefits. 

Breastfeeding with Diabetes

All mothers experience metabolic and hormonal changes after giving birth. But mothers with diabetes who nurse their babies have an added advantage; the impact of hormonal changes in their body makes their blood glucose levels unstable. 

Research suggests that babies who are breastfed by diabetic mothers are less likely to develop type 1 or type 2 diabetes. The reason is that breastfeeding helps in stabilizing blood sugar levels by improving insulin response by the body.

Another good news is that Diabetes Management through treatments such as metformin and insulin are harmless to your baby as they cannot penetrate and enter the breast milk. However, we recommend having yourself checked by a doctor to seek expert opinion as cases vary. Although breastfeeding diabetic mothers may fear a drop in their blood glucose level after feeding their baby, breastfeeding has been shown to. 

It is important for Diabetic mothers to know that if they are nursing for the first time, their milk production might be slightly delayed. This is due to the lower concentration of lactation agents like lactose and prolactin in women with diabetes mellitus. Lactation agents in diabetic mothers take an additional 24 hours to attain the concentrations that dictate an onset of proper milk production. 

There is absolutely nothing to worry about though, the delay can be easily managed. A diabetic mother can aid milk production without any interventions by the third or fourth day by managing blood glucose levels. 

Since insulin treatment is compatible with breastfeeding, that should not be a problem either. Experts say the molecules of insulin are usually too large to pass into your milk. Even if there were any insulin present in the milk, it would be destroyed in the baby’s stomach. 

All in all, Diabetes MUST not stop you from breastfeeding your baby, especially if your diabetes management is on track!

References

  1. Kotsopoulos, J., Lubinski, J., Salmena, L., Lynch, H. T., Kim-Sing, C., Foulkes, W. D., … & Ainsworth, P. (2012). Breastfeeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Breast cancer research, 14(2), R42.
  2. Chun, C., & Galan, N. (2018). Breast cancer while breast-feeding: What you need to know. Retrieved 1 August 2019, from https://www.medicalnewstoday.com/articles/322004.php 
  3. Human Immunodeficiency Virus (HIV) | Breastfeeding | CDC. (2018). Retrieved 1 August 2019, from: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/hiv.html 
  4. If I Have Diabetes, Can I Breastfeed My Baby?. (2019). Retrieved 1 August 2019, from https://www.webmd.com/diabetes/breastfeeding-and-diabetes#2
  5. Coutsoudis, A. (2005). Breastfeeding and the HIV positive mother: the debate continues. Early human development, 81(1), 87-93.
  6. Weinstein, M. E., Oleske, J. M., & Bogden, J. D. (2006). A selected review of breast-feeding recommendations. Nutrition research, 26(8), 379-384. 

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