kirsten,

i have a few thoughts. this lady sounds pretty sick and may, in fact, be in
a precarious calcium balance. however, i would not think that bf was
absolutely contraindicated. if she is on dialysis daily then she could
easily be monitored for her levels. i am not really familiar w/ the ins and
outs of dialysis, but could calcium levels be adjusted (added if needed?)
per the dialysis process? the calcium requirements are not so much higher
for lactation. she is being managed in pregnancy, right?

it should also be taken into account, how mother will care for/mother her
infant in the face of such health problems and dialysis visits. surely, bf
is an easy to do (physically) process, allowing the mother much rest and
less trips to the market/grocery store and better health for her infant.
the pros and cons should be presented to mother (factual) and she decides
and then can be monitored. Good luck to this family.

<<History of chronic renal failure, metabolic bone disease, and
parathyroidectomy. She's been on dialysis for 4 years. ...she tells me the
ob, paed and renal physician have all told her NOT to
breastfeed because the calcium requirements for lactation are too much for
her - she tends to be hypocalcaemic..>>

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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