Marie,

You can find the answers to your questions in Breastfeeding Answers Made Simple (2010), pp. 758-59.  See below

Nancy Mohrbacher, IBCLC, FILCA, LLLL, BfUSA BC
Chicago suburbs
http://www.nancymohrbacher.com/

I  met briefly with a young woman who is expecting her first child in 4 weeks. She herself has cystic fibrosis. She had questions for me that I could not answer. She has GI malabsorbtion issues and is wondering what this would do to her breastmilk. For instance, her body does not absorb many vitamins.

Does anyone have experience with CF? Share your info please.

*Mothers with cystic fibrosis produce normal milk.   *According to several studies and case reports, mothers with cystic fibrosis with full milk production produce milk of normal composition and their babies grow normally(Kent&  Farquharson, 1993; Michel&  Mueller, 1994; Shiffman, Seale, Flux, Rennert,&   Swender, 1989; Welch, Phelps,&  Osher, 1981).,,,***

The mother’s weight and nutrition.   *If a mother with cystic fibrosis has issues with incomplete digestion of food (called “pancreatic insufficiency”), the nutrients in her food may not be well-absorbed and she may find it challenging to maintain a healthy weight.   A mother like this is probably taking digestive enzymes to help break down her food more completely and may also be taking vitamin and mineral supplements.  If so, this mother needs to carefully monitor her weight and nutritional needs while pregnant and breastfeeding(Edenborough et al., 2008).   As long as she can maintain a healthy weight, breastfeeding can continue.

*Cystic fibrosis and the breastfeeding baby. ..* babies born with cystic 
fibrosis who do not breastfeed have been found to have poorer health 
outcomes and earlier and more severe symptoms (Colombo et al., 2007; 
Parker, O'Sullivan, Shea, Regan, & Freedman, 2004).Also, mother’s milk 
provides the baby with protection from the bacterial infections, such as 
/Staphylococcus aureus /and /Pseudomonas/, many mothers with cystic 
fibrosis regularly battle.

*Treatments for cystic fibrosis and breastfeeding.…* most drugs 
prescribed for these mothers are compatible with breastfeeding (Gilljam 
et al., 2000).One Italian case report documented a severe /Pseudomonas 
/lung infection in a breastfeeding mother with cystic fibrosis, which 
was treated with the IV antibiotic tobramycin (Festini et al., 
2006).This medication was undetectable in her milk.

Alpert, S. E., & Cormier, A. D. (1983). Normal electrolyte and protein 
content in milk from mothers with cystic fibrosis: an explanation for 
the initial report of elevated milk sodium concentration. /J Pediatr, 
102/(1), 77-80.


Colombo, C., Costantini, D., Zazzeron, L., Faelli, N., Russo, M. C., Ghisleni, D., et al. (2007). Benefits of breastfeeding in cystic fibrosis: a single-centre follow-up survey./Acta Paediatr, 96/(8), 1228-1232.

Edenborough, F. P., Borgo, G., Knoop, C., Lannefors, L., Mackenzie, W. 
E., Madge, S., et al. (2008). Guidelines for the management of pregnancy 
in women with cystic fibrosis. /Journal of Cystic Fibrosis, 7 Suppl 1/, 
S2-32.


Festini, F., Ciuti, R., Taccetti, G., Repetto, T., Campana, S., & De 
Martino, M. (2006). Breast-feeding in a woman with cystic fibrosis 
undergoing antibiotic intravenous treatment. /Journal of Maternal and 
Fetal Neonatal Medicine, 19/(6), 375-376.


Gilljam, M., Antoniou, M., Shin, J., Dupuis, A., Corey, M., & Tullis, D. 
E. (2000). Pregnancy in cystic fibrosis. Fetal and maternal outcome. 
/Chest, 118/(1), 85-91.

Kent, N. E., & Farquharson, D. F. (1993). Cystic fibrosis in pregnancy. 
/Canadian Medical Association Journal, 149/(6), 809-813.


Michel, S. H., & Mueller, D. H. (1994). Impact of lactation on women 
with cystic fibrosis and their infants: a review of five cases. /J Am 
Diet Assoc, 94/(2), 159-165.


Parker, E. M., O'Sullivan, B. P., Shea, J. C., Regan, M. M., & Freedman, 
S. D. (2004). Survey of breast-feeding practices and outcomes in the 
cystic fibrosis population. /Pediatr Pulmonol, 37/(4), 362-367.


Shiffman, M. L., Seale, T. W., Flux, M., Rennert, O. R.,&  Swender, P. T. (1989). Breast-milk composition in women with cystic fibrosis: report of two cases and a review of the literature./Am J Clin Nutr, 49/(4), 612-617.

Welch, M. J., Phelps, D. L., & Osher, A. B. (1981). Breast-feeding by a 
mother with cystic fibrosis. /Pediatrics, 67/(5), 664-666.







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