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Page: When Breastfeeding Might Harm the Infant
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For the vast majority of mothers, breastfeeding is best for both them and their babies as medical contraindications to breastfeeding are rare. However there has been identified some situations where breastfeeding is not the best choice.
Infants with classic galactosemia cannot digest lactose and therefore cannot benefit from breast milk. Breastfeeding might harm the baby also if the mother has untreated pulmonary tuberculosis (see paragraph below); is taking certain medications that suppress the immune system; uses potentially harmful substances such as cocaine, heroin, and amphetamines; has had unusually excessive exposure to heavy metals such as mercury; or has HIV. However, research published in the Lancet has highlighted a lower risk of HIV transmission with exclusive breastfeeding by HIV positive mothers (4 percent risk), compared to mixed feeding (10-40 percent risk). This research is of particular importance in developing countries where infant formula is not widely available or safe to prepare.
The vast majority of medicines are compatible with breastfeeding, but there are some that might be passed onto the child through the milk.
Caffeine, tobacco, and alcohol might be noticeably harmful to the baby, if consumed enough. (See Health, diet and substance abuse section.)
The baby's risk from something unsafe in breast milk depends on how much of that substance the baby gets. The level of risk depends on the concentration of the substance in the breast milk and how much milk the infant consumes. Finally, that risk is weighed against the risks of using a substitute for breast milk.
Tuberculosis
It is not safe for mothers with active, untreated tuberculosis to breastfeed until they are no longer contagious. According to the American Academy of Pediatrics 2006 Redbook:
"Women with tuberculosis who have been treated appropriately for 2 or more weeks and who are not considered contagious may breastfeed. Women with tuberculosis disease suspected of being contagious should refrain from breastfeeding or any other close contact with the infant because of potential transmission through respiratory tract droplets (see Tuberculosis, p 678). Mycobacterium tuberculosis rarely causes mastitis or a breast abscess, but if a breast abscess caused by M. tuberculosis is present, breastfeeding should be discontinued until the mother no longer is contagious. "
In areas where BCG vaccination is the standard of care, the WHO provides treatment recommendations and advises mothers to continue breastfeeding. TB may be congenitally acquired, or perinatally acquired through airborne droplet spread.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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