Despite My Disease

Breastfeeding With Chronic Illnesses

By Shel Franco

© Lori Thompson Photography

Doing what's best for Baby is oftentimes the determining factor in a woman's decision to breastfeed. But what happens when a chronic illness or disease requires much of Mom's energy and the ingestion of medications that might be harmful to the baby?

For many women, life with chronic conditions and diseases such as depression, arthritis, asthma and diabetes means more than medications and physical discomfort. If these women follow the advice of many medical professionals, it could also mean life without breastfeeding.

When Kathy Richard of Saugus, Mass., was diagnosed with clinical depression, her doctors put her on a common antidepressant drug. At the time, she was breastfeeding a 1-year-old. "I consulted many breastfeeding and pharmaceutical experts," Richard says. "All unanimously agreed that one should not take [this medication] and breastfeed, so I weaned [my son]."

But according to Thomas Hale, Ph.D., world-renowned researcher and the author of Medications and Mother's Milk (Pharmasoft Medical Pub, 2002), Richard may have been the victim of misinformation. "We already know that for the most part, with one exception or two exceptions, the antidepressants are reasonably safe for breastfeeding mothers," Hale says.

Richard wishes she had known this five years ago when she weaned her son. "I will never forget the last time I nursed my youngest, just before I took my first [dose of the medication]," she says. "I cried all the way through it and for a long time after."

Why does this misinformation and miscommunication exist? Hale cites the use of package inserts as the biggest reason for misinformation. "Every package insert in the United States says 'Do not use for breastfeeding mothers,' and that is terrible information," Hale says. In reality, he assures breastfeeding mothers that about 99 percent of drugs enter breast milk at less than 1 percent of the mother's dose.

Even so, there are some conditions that warrant medications which are not compatible with breastfeeding. Sometimes women with diseases such as multiple sclerosis and rheumatoid arthritis take such high doses of medications that they can be detrimental to the breastfeeding child.

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