I have been lurking and have seen only one response from Jack about renal
disease and breastfeeding.  At the time the question was asked, I responded
by email directly.  I thought maybe tonight I would post my original
letter.  It is long, you may want to skip it.  The short version is - yes I
breastfed two children while in renal failure.

I am 38 yrs old and mother to Kate, soon to be 18 yrs (in Paris tonight on
a school trip) and Rachel, 14 yrs (who, I am proud to say, helped me
dialyse this evening).

My medical Hx is chronic pyelonephritis d/t bilateral reflux diagnosed at
about age 9.  I had a reimplantation of both orifices at that time but the
damage was done.  At nineteen, planning to marry, the advice of the
nephrologist was to not have children.  I cried.  My diagnosis at that
point was nephrotic syndrome and about 40% function.

Of course babies happen and my next visit I was pregnant with Kate.  She
changed my life.  Kate nursed until age 5, then we had a discussion about
how 5 year olds don't nurse.  Meds aside, (I was not taking any prescribed
meds), I can certainly discuss breastfeeding and ESRD.  I was very thankful
for being able to mother Katie with breastfeeding.  I must admit I was the
laziest mom on the face of the earth and prolactin and I got along very
well. As well, I took full advantage of nursing lying down. My blood
pressure stayed normal (BP had been a problem before Kate).  I ate very
carefully. I knew we would have no other children so Kate was enjoyed and
doted upon.  Once Kate was home from the hospital and we settled (1980 was
not a good year for breastfeeding and hospital protocols) breastfeeding was
fine.  No problem with supply, Kate thrived.  Kate has been checked out
and, thankfully, is healthy - no sign of renal disease.

When Kate was 3.5 yrs Rachel came home.  She was 2 months and 2 days.
Getting her to latch was a challenge.  She had been in foster care and
bottlefed.  We used a SNS and ABM.  Even though Kate was nursing daily, my
supply was low and hormone levels were probably at prepregnant levels.
After several weeks I noticed swelling of my breasts and some darkening of
my nipples, Rachel's stools changed, and my menstruation stopped.  We
tandem nursed for 1.5 years.  Rachel required the SNS (would not latch
without it) to age 10 months.  She, like her sister, agreed that 5 year
olds don't nurse and weaned around her 5th birthday.

Just before Rachel turned 3 I began to dialyse.  After several weeks
training, at age 25, I started dialysing at home.  That was 1985.  Thanks
be to God, I have been able to dialyse at home for these past 12 years.
The staff really tried to talk me into weaning Rachel when I began to
dialyse, "It will take too much out of you". Rachel was cutting molars, I'd
rather be sticking needles in my eyes than refuse her "nursies" in the
night.  We have some very cute pics of Rachel nursing while I dialysed.
Maybe I was "stuck in the chair" but I still had some control and could
mother my baby.  We adapted to the fact that my A/V fistula was in my left
arm.

Rachel did wean for a brief period from Nov.27/86 to Jan.5/97.  I had a
kidney transplant on Nov.27, I fought rejection, I finally wrestled the
kidney to the ground and a surgeon took it out on Jan. 12. (It weighed
about a pound and a half, big extension to the original incision to get it
out!!) Because of the meds I was on, I chose not to nurse her at that time.
We resumed nursing when the kidney was gone and I could stop the meds.  For
personal reasons, I have never gone back on The List.  That is a story for
another time.  (one little twist of irony - the daughter I was told to
abort, the gifted student in France tonight, is a the same blood type as
myself!! A potential kidney donor.  Isn't that a kick??)

Joy