postpartum
How do chronic illnesses affect breast-feeding?
In the case of diabetes, thyroid disorders, or hypertension, Dr Liebenberg explains:“ Mothers with diabetes may experience a delay in milk production, particularly if blood sugar control was difficult during pregnancy or delivery.”
According to Dr Liebenberg, untreated hypothyroidism( an underactive thyroid) can cause severe fatigue and a depressed mood in the mother, which may negatively impact her willingness or ability to breastfeed.“ It can also delay the onset of milk production and affect the mother’ s breast milk supply.”
For those with hypertension, breastfeeding is not contraindicated.“ However, if a mother’ s blood pressure is very high during or after labour and she requires close monitoring or treatment in an intensive care setting, skin-to-skin contact and breast-feeding initiation may be delayed,” he adds. In some cases, mothers may develop pre-eclampsia or eclampsia( serious forms of high blood pressure during pregnancy and labour), which can result in seizures, further delaying breast-feeding.
Autoimmune diseases can also influence breast-feeding in subtle but important ways. Conditions such as lupus, rheumatoid arthritis, or multiple sclerosis may affect a mother’ s energy levels, pain tolerance, and overall health, which in turn can impact her ability to initiate and sustain breast-feeding. Some autoimmune disorders are associated with delayed lactogenesis( the onset of milk production), while certain medications used to manage these illnesses may require careful consideration to ensure safety for the infant. Despite these challenges, many mothers with autoimmune conditions are able to breast-feed successfully.
“ Maternal mental health conditions such as postpartum depression, anxiety
www. babysandbeyond. co. za disorders, or bipolar disorder may require closer monitoring and additional support to improve the overall success of breast-feeding.”
Certain maternal infections may also require extra attention.“ Localised breast abscesses need to be treated or drained, and care should be taken to prevent the baby from ingesting infected milk,” says Dr Liebenberg. Respiratory viral infections and tuberculosis require appropriate treatment, and the baby may need monitoring because of the close contact associated with breastfeeding.“ Mothers living with HIV are well supported in South Africa, and established protocols are in place to protect the breast-feeding infant.”
Medication and your breastmilk
The real question we should be asking is: how does medication affect breast milk?
“ All registered prescription medicines are generally required to have accompanying Patient Information Leaflets,” Dr Liebenberg points out. Inside these leaflets you’ ll find all the information you need, including whether a medication is safe to use during breast-feeding.“ If a leaflet is not available, it can usually be accessed through the South African Health Products Regulatory Authority,( SAHPRA) website or obtained directly from a pharmacist,” he says.
If you are still unsure, ask your doctor( in this case, Google and ChatGPT should not be trusted).
Dr Liebenberg cautions that you should seek immediate advice if your baby refuses to feed, becomes lethargic, or has fewer wet nappies or bowel movements than expected.
How to advocate for yourself
Maternal and infant wellness is a collaborative effort involving many healthcare professionals, including gynaecologists, paediatricians, nurses, and lactation consultants.“ If a mother feels that her concerns are being dismissed, she should not hesitate to request a second opinion from another qualified healthcare professional,” says Dr Liebenberg.
So, what questions should you ask your doctor in order to balance treatment with breast-feeding goals? Dr Liebenberg suggests starting with:“ Considering my health condition and the treatment I may need, which option would be safest for both me and my baby while allowing me to continue breast-feeding, if possible?”
Advocating for yourself ensures your voice is heard and your breast-feeding journey is supported with the best possible care. �
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