Most women who want to breastfeed their children can do so. There are very few medical reasons not to breastfeed, but what is more frequent are the false contraindications for breastfeeding, some misconceptions about what would prevent breastfeeding.
In these cases, due to ignorance or unsubstantiated fear you can reach suspend breastfeeding unreasonably as evidenced by scientific evidence. Factors and situations that, in fact, against the sometimes widespread belief, do not contraindicate breastfeeding.
From infrequent diseases in our environment such as tuberculosis to much more common conditions such as fever, there is a general ignorance and false myths that contraindicate breastfeeding.
M.T. Hernández Aguilar and J. Aguayo Maldonado, of the Breastfeeding Committee of the Spanish Association of Pediatrics, in an interesting study on how to promote and support breastfeeding in pediatric practice expose these false contraindications to breastfeeding.
False contraindications for breastfeeding
- Maternal infection hepatitis B virus (HBV) Children of a mother with hepatitis B should be vaccinated and receive immunoglobulin at birth.
- Maternal infection hepatitis C virus (HCV). There are no described cases of HCV transmission through milk or breastfeeding increases the incidence of vertical transmission, despite having been isolated in breast milk, so for years the Center for Disease Control and Prevention (CDC) of States United does not consider this disease as a contraindication for breastfeeding, regardless of the maternal viral load.
- Maternal cytomegalovirus (CMV) infection. The mother who carries antibodies against CMV (without recent seroconversion) can safely breastfeed her term healthy infant. It has not been shown that premature babies with birth weight less than 1,500 grams, children of a mother carrying CMV antibodies, have worse evolution if they are breastfed and, in most cases, the contagion occurs at the time of delivery and Not during breastfeeding. In addition, it should be taken into account that the mother has antibodies against CMV, so that in general the benefits of breastfeeding outweigh the risks. Freezing and pasteurization of breast milk significantly reduces the risk of transmission.
- Active tuberculosis in the mother does not contraindicate breastfeeding. If the mother is a bacilliferous (eliminates contagious bacilli in her secretions), antituberculous treatment should be started immediately and the infant should be given prophylaxis with isoniazid for six months and a bacillus Calmette-Guérin (BCG) after the end of treatment.
- Maternal fever, except if the cause is one of the true contraindications (in Spain, in cases of maternal disease due to human immunodeficiency virus (HIV, although in sub-Saharan Africa it is the best option), as well as due to human leukemia virus (HTLV) I and II, in mothers dependent on drugs of abuse, radioactive isotopes while there is radioactivity in breast milk or with some drugs such as chemotherapeutics or antimetabolites until these are eliminated from milk. Classic infant galactosemia also contraindicates breastfeeding.) We remind you at this point the medical reasons for not breastfeeding.
- The maternal disease you need breastfeeding compatible medication. For most processes there is adequate treatment compatible with breastfeeding. Although, in many cases the establishment of these treatments is outside the scope of the pediatrician, this is often consulted by the mother, the family or by the treating doctor; It is convenient to be informed and to be able to give an adequate response by consulting appropriate sources, such as the e-lactancia.org website (the vademecum is not an appropriate source).
- Smoking Maternal care is not a contraindication for breastfeeding, although the mother and father should be advised to always smoke outside the home and away from the child and encourage them to seek help to quit. In any case, the nursing child of a smoking mother will be more protected if her mother breastfeeds her.
- Alcohol intake should be discouraged from the nursing mother as it is concentrated in breast milk, may inhibit breastfeeding and may impair the brain development of the newborn, but occasional drinking of a low-grade alcoholic beverage (wine, beer) may admit warning the mother not to breastfeed in the two hours following the intake.
- Mastitis Not only does it not contraindicate breastfeeding, but the most effective treatment is the emptying of the breast affected by the infant and a greater number of shots of said breast should be favored.
- Neonatal jaundice does not justify the suppression of breastfeeding, being able to be treated while it is being maintained and if it develops during the first week, it may be necessary to increase the number of breastfeeding. If the neonate requires phototherapy, joint admission with the mother should be sought to allow frequent demand breastfeeding and double phototherapy to reduce hospital stay and minimize the risk of abandonment.
- Phenylketonuria, a congenital and inherited metabolic disease that is caused by the lack of an enzyme that the body uses to transform an essential amino acid, does not contraindicate breastfeeding. Phenylketonuric infants fed with breast milk supplemented with formula poor in phenylalanine in the amounts determined by analytical controls maintain better disease control. The phenylketonuric mother can also breastfeed her baby, maintaining proper dietary control.
To these points I would add others regarding those that exist doubts, as if it is possible to breastfeed when pregnant or cold, frequent situations but unknown by many people and that can lead to unreasonably interrupted breastfeeding.
Mothers, their families and medical staff should know about these false contraindications for breastfeeding, so that the woman is encouraged, allowed and facilitated to breastfeed whenever she wishes to her baby, to offer her the best food in her first months of life.
