I am an LLL Leader and IBCLC, I also have a daughter with MG. I can tell you a little about it.There are actually 3 types of MG. The first and most common is an auto-immune type that is caused by antibodies acting against acetylcholine receptor sites prohbiting the nerve impulse from being uptaken by the muscle. As a result you get muscle weakness. This may be progressive and degenerative. The second type in called congenital myasthenia and is seen in newborns and may precipitate a crisis immediately after delivery. This is caused when a mothers antibodies accumulate in the baby causing his muscles (swallowing and breathing are the problems) to not work. Generally, the baby does not have continuing problems with MG after the crisis. The third type is also called congenital and is a deformity of the muscle end plates, we do not think it is progressive nor degenerative, but it too interferes with acetylcholine uptake. For breastfeeding, there are no contraindications with myasthenia gravis. Medication use may be a big issue depending on the drugs, mestinon or pyrostigmadine is not contraindicated in BF. There is need to help the mother find comfrotable positions for nursing- lying down seems to work the best, there also seems to be a need to change position frequently. If the baby has an MG crisis, BF will probably be contraindicated until s/he can take anything by mouth and is off respirator etc. If the mother has the autoimmune type she may be on some major steroids or immunosuppressants- these may be contra-indicated at the high doses used. Immuran is being used a lot lately. Plasmaphoresis is a technique that filters a mothers blood and returns it to her with reduced antibodies. This procedure is not contraindicated during breastfeeding. In terms of encouraging a mother with MG to breastfeed, we need to remember that this may be the one thing she can do for her baby. We also need to remember that contrary to popular belief- BF is not draining, would not worsen the MG by itself, and may allow a woman to rest and recharge and energize her. I like to make the analogy for my daughter of a cordless phone- when the battery is dead-you can't talk any more- return it tyoo its cradle for charging and it works again. For someone with MG resting or lying down may work well to recharge them. Another consideration for encouraging BF though is the mounting evidense that bf protects against autoimmune illness and may help protect the baby from MG- no studies, just my observation based on studies of other autoimmune diseases- MS and diabetes.