Breastfeeding Flashcards
Is CMV a contraindication to breastfeeding
It does shed in breast milk but is not a contraindication
Except in VLBW
What are the contraindications to breast feeding?
HIV
human T-lymphotropic virus
Brucellosis
Can have EBM:
Active HSV
TB for the first two weeks of treatment
VZV five days before and two days after deliver
What do you advise for mom’s who have mastitis?
They can continue to breast feed unless there is obvious pus. If there is pus, then you advise to pump and dump from that breast and continue to feed from the other breast.
What do you do if mom has active TB?
If TB is active and untreated TB - cannot directly breast feed until two weeks of therapy is completed. Infant can have EBM in this time. Infant needs prophylaxis.
What do you do if mom has Hepatitis A?
Can continue to breast feed. Baby needs immunoglobulin
What do you do if mom has hepatitis B?
Can continue to breast feed
Hepatitis B Immunoglobulin and HBV vaccine at birth
What do you do if mom has hepatitis C?
Can continue to breath feed. No other precautions.
What do you do if there is HSV
- of mouth?
- on breast?
- wear a mask
- no breast feeding until lesions are crusted over. Can have EBM
Ensure not VZV
What do you do if mom has VZV?
Continue breastfeeding
For perinatal-give VZV
For postpartum-consider VZV
Is TB medication safe for breast feeding?
Do you need to give babies pyridoxine supplementation
Yes, compatible with breastfeeding.
No, you only need to give pyridoxine of the baby (not just mom) is on isoniazide
What do you do if mom has malaria and is in antimalaria medications?
You can continue to breast feed if the mom has malaria.
The anti-malaria mess are transferred in the breast milk, but are safe for all infants except those with G6PD. If the kid has G6PD, you cannot give quinine or primaquine
What do you do if mom is HIV positive, in Canada and in Ethiopia?
Canada: no breast feeding, provide formula and emotional support.
Ethiopia: breast feeding and infant+mom take antiretrovirals until 12 months
What do you advise for CMV positive moms? And why?
They can breast feed.
In the postpartum period, the virus reactivates in breast milk. But the risk to the neonate are minimal because they have received antibodies through the placenta if term. If preterm, breastfeeding outweighs the risk of severe CMV infection in breast milk acquired CMV.
Which antibiotics require discontinuation of breast feeding?
High dose metronidazole - discontinue X 12-24 hrs to allow excretion.
Chloramphenicol - can cause bone marrow depression.
Septra and dapson - can worsen jaundice especially with G6PD, stressed or premature.
What is the potentially adverse effects of amantadine?
Milk suppression
