Should I recommend vitamin D supplementation for my breastfeeding patients?

The AAP recommends that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth. Exclusively and partially breastfed babies should receive 400 IU of vitamin D each day starting in the first few days of life and continuing up until babies are weaned to at least 1 liter or 1 quart of vitamin D fortified formula or milk a day.

What if a mother is taking medication for a condition, can she still breastfeed or should I recommend that she stop breastfeeding or pump and dump?

Advising a breastfeeding mother on the compatibility of her medications and breastfeeding can often be a source of confusion. Clinicians must consider several factors: the benefit the medication will give to the mother; the risk of discontinuation of breastfeeding, even temporarily, to the baby; the risk of the medication to the baby and the risk of the medication to the maternal milk supply. The most accurate sources of information to aid clinicians about medications in breastfeeding mothers are:

  • The National Library of Medicine's Drugs and Lactation Database, LactMed, a searchable database of drugs and other chemicals to which breastfeeding mothers may be exposed

  • Dr. Thomas Hale's "Medications and Mother's Milk" and his website forums

  • Breastfeeding and Human Lactation Study Center at the University of Rochester Medical School Warm-Line for Health Professionals at (585) 275-0088. (This phone number is for the use of health professionals ONLY.)

Read the article, Medications and Breastfeeding: Tips for Giving Accurate Information to Mothers by Jennifer Thomas, MD, FAAP. Dr. Thomas further explains the thought process needed when caring for breastfeeding mothers who need medication.

If the mother of an infant is sick, does she need to discontinue or interrupt breastfeeding?

If a mother has a cold or the flu, it is not necessary to discontinue or interrupt breastfeeding. Through breastfeeding, the infant will receive the antibodies that the mother is producing to fight the illness. Most infectious diseases are also not a cause for weaning or interruption. Generally, by the time a disease has been diagnosed, the infant has been exposed and will probably benefit more from the protection he gets from his mother's breast milk than from weaning. However, each case must be evaluated individually.

Does a mother who has mastitis need to discontinue or interrupt breastfeeding?

Weaning should not be recommended during mastitis and may predispose the mother to developing a breast abscess. The milk is not harmful to the infant; instruct the mother to continue nursing. If the mother can tolerate feeding on the affected breast first, this is preferable. However, if this is too painful, the mother may begin on the unaffected breast until symptoms subside. The affected breast must be drained at each feeding by nursing and/or pumping.

The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. This content is for informational purpose only.

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