My daughter has Myasthenia Gravis(MG) and there is some good literature on
management of a mother with myasthenia during pregnancy and lactation. There
is no contraindication to breastfeeding! Most of the medications used for MG
are compatible with breastfeeding- the excaption would be some of the
chemotherapy drugs being used experimentally. Meastinon is not
contraindicated and one does not develop tolerance to very small doses which
might me transmitted through breastfeeding. What is important is the
literature that suggests breastfeeding may reduce the risk of autoimmune
diseases and most forms of MG are autoimmune.

There can be one complication of MG which can impact the early breastfeeding
relationship. If a mother who has MG delivers a baby who has high levels of
antibodies- the baby may develop a myasthenic crisis and have difficulties
with feeding and also breathing. This is transient and once the antibodies
are gone there is usually no additional problem. It is like a diabetic baby
having too much insulin after delivery and developing low blood sugar. Once
it is resolved the baby doesn't have further problems related to the
mother's illness.

There are also several types of congenital myasthenia (this is the type my
daughter has) which is related to a muscle-end-plate deformity and does not
have an autoimmune component. it is thought that some forms of congenital
myasthenia may be hereditary. It is so rare that there is very little data
and there is currently only one researcher investigating these syndromes.  A
baby who has a hereditary congenital form of MG may have some difficulties
feeding. My daughter tired very quickly at the breast but gained well.

I am with Jack on this one- add this to the list of "Stupid Reasons to
Wean!" Cathy Liles

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