There’s so much talk about how wonderful breastfeeding can be. After all, breastfeeding has plenty of proven benefits for mothers as well as babies: “In general, women are strongly encouraged to breastfeed since it helps to bond mother to baby, gives baby antibodies that help fight infection, promotes good gut bacteria in the baby, is the ‘perfect’ nutrition for the baby. So there are actually very few ‘medical’ reasons not to encourage breast feeding,” explains Dr. Karen Brodman, MD, an OB/GYN in New York. However, those medical reasons in favor of skipping the practice do exist. Plus, sometimes women simply choose not to breastfeed — and that’s totally okay.
If you’re on the fence about breastfeeding your own baby, you’re not alone. Here are a few real women’s stories about their decisions not to breastfeed — as well as insight from gynecologists about possible medical complications.
You have osteoporosis
When you breastfeed, calcium can leach out of your bones, so you might want to not breastfeed or not breastfeed for too long if you have lower bone density.
“If you are at high risk of osteoporosis (long history of anorexia and low BMI) then nursing for prolonged time will keep your estrogen levels low and may cause your bone density to decline,” says Brodman.
However, this is generally not a reason to avoid nursing totally, unless the condition is very severe, she says. “Women are strongly encouraged to breast feed, at least for 6 weeks to give the baby immunologic protection against infection. So perhaps, consider nursing for a few weeks or months and then stop,” she says.
You have poor milk supply
You’ll need to put your baby’s best interest first, so if your milk supply is weak, you may want to stop nursing. “Some women try very hard to nurse but they have really bad milk supply, the baby is hungry all the time and is irritable, the mother is absolutely exhausted, and the whole process is stressful to the mother and baby, and it’s just not working out for anyone,” says Brodman.
If this is the case, it’s really a judgment call, and sometimes the best answer is to supplement breast milk with formula, instead, she says. Here, a lactation consultant would be helpful, as well as a pediatrician or OB, she adds.
You’ve had breast reduction surgery
If you’ve undergone a breast reduction, your milk supply might be compromised, says Brodman. “Breast reduction surgery may prevent good milk supply and may make it impossible to nurse effectively. Women are encouraged to try, if milk supply is not good, then they can stop,” she says.
Implants likely won’t cause the same problems. “Breast implants usually do not prevent nursing especially if they are placed behind the chest muscles, but on occasion any type of prior breast surgery may impede milk supply,” she says.
And if you’ve have breast infections, like Mastitis, you might also want to forgo breastfeeding, says Natalie Telyatnikov, a certified postpartum support specialist and physician and the founder of Better Postpartum.
“Clogged ducts and resulting infections, like Mastitis, may also cause some women to choose to forgo continued breastfeeding–although in this case–the best thing to resolve clogged ducts is to continue to move the milk–which can be facilitated using a breast pump,” she says.
You have an STD
Unfortunately, it is possible to transmit the infection to your baby through breastfeeding, so it’s advised not to breastfeed if you have HIV and to be very cautious if you have herpes, says Dr. Jennifer Landa, MD, a gynecologist and Chief Medical Officer at BodyLogicMD.
Women with present herpes lesions can transmit herpes to their baby, which is dangerous for infants, she says. You can breast feed if there are no active lesions on breasts, though, so unless you have an outbreak, you’re totally fine to breast feed if you like.
Yet “if a mom has herpes on her breast she should avoid breast feeding and consider ‘pumping and dumping’ instead which will keep her milk supply available until her herpes lesions resolve,” she says.
However, HIV is a different story. It is not safe for HIV positive mothers to breastfeed due to the concern about transmission to the infant regardless of the levels of the virus in the blood and her use of medications to keep it more dormant, Landa says. Unfortunately, there’s no getting around this one.
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