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JAMA Pediatrics Patient Page
August 2014

Breastfeeding for Mothers With Ongoing Illnesses

JAMA Pediatr. 2014;168(8):784. doi:10.1001/jamapediatrics.2013.3361

Breastfeeding has many beneficial effects for both mothers and children. Benefits for mothers include reduced risk of postpartum bleeding and faster return to prepregnancy weight. Many mothers also feel joy and fulfillment at the connection they experience with their child while nursing. Benefits for babies include numerous health benefits such as prevention of infections, protection against some illnesses, and obesity prevention. However, it is well understood that breastfeeding is not always an easy decision or an easy task. Some mothers who have ongoing or chronic illnesses may have concerns about breastfeeding, particularly if they are taking medications.

Common Concerns for Mothers With Ongoing Illnesses Who Are Considering Breastfeeding
Will I Pass My Illness to My Baby Through Breastfeeding?

If you have an ongoing illness such as diabetes or arthritis, remember that most ongoing or chronic conditions are caused by changes in the immune system or genetics and are not passed on to a baby by breastfeeding. However, certain infections, such as human immunodeficiency virus, can be passed to the baby through breast milk.

Does Breastfeeding Interfere With Vaccinations?

Breastfeeding does not interfere with your baby’s immune response to most routine immunizations. Breastfeeding may even protect against your baby having a fever after receiving vaccinations. If you need vaccinations after having a baby, the vaccine will often protect both you and your baby.

Can I Breastfeed if I Am Taking Medications?

For mothers who are breastfeeding, most any medication will go into the breast milk. However, most medications are not present in a way that is harmful to the baby. The most common medications of concern for mothers who are breastfeeding are pain medications, antidepressants, and drugs to treat substance or alcohol abuse or smoking cessation. Ask your pediatrician to review your medications with you either before your baby is born or while you are in the hospital so you know all the information you need to make a safe decision. You can also look up any medications you are taking using this resource from the federal government: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT.

The Special Case for Antiepileptic Medications

Epilepsy is a condition in which patients have seizures. Medications, known as antiepileptic drugs (AEDs), are often used to prevent seizures. These medications include carbamazepine, lamotrigine, phenytoin, or valproate. Mothers who take AEDs are often warned against taking these medications during pregnancy because of known risks to the baby during pregnancy. Mothers who are taking AEDs may have concerns about breastfeeding while taking these medications. In the past, concerns have included risks to the child’s brain development and intelligence potential. A research study in this month’s JAMA Pediatrics included mothers who were taking AEDs while breastfeeding. The research team studied their children’s health up to age 6 years. This research study found no negative effects on the children’s health or brain development from breastfeeding by mothers who were taking these drugs. If you are a new mother taking AEDs, this study provides support that it is safe to breastfeed your baby.

The JAMA Pediatrics Patient Page is a public service of JAMA Pediatrics. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your child’s medical condition, JAMA Pediatrics suggests that you consult your child’s physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.