Sometimes breastfeeding is not possible or recommended because of a medical condition of the breastfeeding woman or because of drugs or therapy. If you are undergoing chemotherapy, or if you are taking radioactive compounds (for example, gallium 67, iodine, or technetium-99m), lithium, ergotamine, or any recreational drugs, these harmful substances may be transmitted to your infant through your breast milk. If you have to receive a radioactive agent, you may want to take a brief "vacation" from breastfeeding until the substance clears from your body. Depending on the agent used, this may take anywhere from 1 day to several weeks, although most drugs may clear within a few days. To maintain milk production, express your milk and freeze it. This milk is safe to use because the radioactivity disappears from the milk within hours or days, depending on the treatment and dose.
If you have human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), breastfeeding is contraindicated. If you have chronic hepatitis C, you can probably breastfeed, but consult your doctor first. If you have hepatitis B, you can breastfeed if your infant has received the hepatitis B vaccine within the first few days after birth. Women with untreated tuberculosis should not breastfeed until they have started treatment.
Breastfeeding and minor illnesses
If you have a cold, flu, or bacterial infection, continue to breastfeed, because once you have symptoms of an illness, your baby has already been exposed. By allowing your infant to breastfeed, he or she will get the benefit of the antibodies your body produces to fight the illness. If you stop breastfeeding, you increase your infant's chances of getting sick.
Weaning and Breast Changes
When you stop breastfeeding, your hormone levels will return to pre-breast-feeding levels, and your body will go through many changes. If you wean your baby gradually, your milk production should steadily decrease, although it may take several months before it disappears completely. During that time, stimulation of the nipples, such as during sexual activity, may cause some milk to leak out. If you experience breast pain or discomfort during weaning because you are holding in too much milk, express small amounts by hand or allow your baby to feed for a minute or two. Avoid releasing too much milk, however, because this will stimulate more milk production. It may take several months for your breasts to return to their pre-pregnancy size. Some women's breasts become larger and firmer after breastfeeding; others become smaller. Much depends on how much weight you have gained or lost. Pregnancy and breastfeeding are two of the most natural phases of a woman's life, and they also involve many changes to the breasts.
