Almost Any Mother Can Breastfeed
There are very few medical reasons not to breastfeed. If the mother is taking radioactive isotopes, chemotherapy, lithium, ergotamine, or recreational drugs, she should not nurse. The use of most other medicines is compatible with breastfeeding. If you have a specific question about medications and nursing, you should direct it to your doctor who will have access to one of the many published lists of drugs prohibited during breastfeeding.
Mothers who have exposure to heavy metals or insecticides may transfer these to their infants through their milk. In these situations, samples of the milk should be analyzed to determine how much of these environmental pollutants the infant might receive.
Chronic illness or infections rarely prevent breastfeeding. Chronic illnesses such as systemic lupus erythematosus (more commonly known as lupus), Crohn's disease, hypertension, diabetes, and other problems can almost always be managed successfully under a physician's care without interrupting breastfeeding.
The few exceptions are women in the United States who are infected with the AIDS virus (risk of transmission to the infant increased by about 12 percent) or who are infected with untreated tuberculosis.
According to the AAP, a mom with hepatitis B can nurse if her baby receives the hepatitis B vaccine in the first few days of life. Additionally, the AAP states there is no evidence that hepatitis C is transmitted through breast milk, and a mother with hepatitis C should speak with her doctor before making a decision about nursing.
Is My Baby Getting Enough Milk?
Breastfeeding should be a positive and rewarding experience for mothers and babies. If it is not, there are often simple steps that you can take to make it so. Mothers are often concerned that the baby is not getting enough breast milk, especially in the first few days after birth. If you have questions about milk supply adequacy, you should promptly seek assistance. Here are a few signs that your baby is getting enough to eat:
- Frequent Urination: Beginning on the third or fourth day of life, breastfed infants should have at least six wet diapers a day.
- Pale Urine: An infant's urine should be a light yellow color. If it becomes much darker, such as deep yellow or orange, it is possibly a sign that the infant is not getting enough to eat.
- Alertness: A sleepy baby who will not awaken to eat should prompt an urgent call to your doctor.
- Bowel Movements (Type and Frequency): Breastfed babies typically have two to five yellow semi-liquid stools daily. As your baby gets older, bowel movements may occur less frequently. (Infrequent, hard, green stools may be a sign that your baby isn't getting enough milk.) The stools are usually not yellow until milk comes in, usually around the day 4. Before that the stools are first black, sticky meconium (day 1), brownish (day 2), and greenish (day 3).
- Interest in Nursing: If your baby refuses to eat, call the pediatrician as soon as possible.
- Satisfaction: Infants should appear satisfied after a full nursing session. If your infant does not seem to be satisfied after breastfeeding contact a health care professional.
- Steady Weight Gain: Babies should begin gaining weight steadily at one week of age, and should have regained their birth weight by two weeks. The pediatrician should weigh your child at each visit.