Information on Why Some are Unable to Breastfeed

Girls, we are so fortunate to live in a time when breastfeeding is encouraged. In my training in lactation I learned there have been times in American history where breastfeeding was shunned by the medical establishment. I remember hearing a woman say she talked with her Obstetrician about breastfeeding and he asked “Why on earth would you want to do that?” How discouraging!!!

Current scientific research is so supportive of breastfeeding it is difficult to imagine not considering it. The information available regarding hormones released in both mother and baby during the act of breastfeeding is staggering!!! Our bodies were designed to provide this precious food for our babies and it benefits both mother and child. These hormones embellish the emotional bond between mother and baby, they help mom’s body recover from labor, they stabilize baby’s body temperature and blood sugars, and the list goes on and on.

As a doula my greatest encouragement to you is to commit to breastfeeding and do it alone for three weeks. It takes that long for your milk supply to stabilize. Remember, your world has just turned upside down. You are no longer just you, you are now a mom. That is a huge adjustment. Allow yourself the time to absorb this. Feed your baby on demand, when ever he wakes to eat feed him. This reeks havoc on your sleep, but stabilizes soon. If, after three weeks things have not improved get some help. Ask the staff at your OB’s office. Contact your doula or midwife. There are many who wish to help.

I find very often moms believe they are not making enough milk. This is rarely the case, but it is a consistent concern. If your baby is putting on weight you are fine. The goal is that your baby returns to birth weight within two weeks. If you make this goal you are doing well. Baby’s tummy is about the size of a pea at birth. It takes time for it to stretch out. Colostrum is what your body provides baby the first few days of life. It is sparse but extremely nutritious. Around three days your milk will come in. As baby drinks more your body produces more. It is truly an amazing system. At three, six, and twelve weeks your baby will go through growth spurts and need more milk. Your body will produce it. You don’t even have to think about it.

Allow yourself the relaxed time to let this natural process take its course. It is the most healthy thing for both you and your baby. In the long term you will both benefit greatly emotionally and physically. It just takes time. Surround yourself with supportive friends, family, and medical staff. You will be amazed at your progress!



by Donna Murray, RN, BSN. Medically reviewed by Meredith Shur, MD. Updates April 11 2021

Please find excerpts from this article below. As always, further research on your own will answer more questions. Asking questions is always a good thing! Please let me know if I can help!!!

Breastfeeding is beneficial for both parents and babies, which is why experts recommend exclusive breastfeeding for the first six months of a baby’s life. However, while most birthing parents can breastfeed, there are sometimes contraindications.

There are a few reasons why someone should not or may not be able to breastfeed their baby. For example, some parents cannot produce a healthy breast milk supply, while others may take certain medications or need to undergo a medical treatment that isn’t breastfeeding safe. There are also a few medical conditions that aren’t compatible with breastfeeding. In some situations, the parent may be able to pump and provide their baby with breast milk in a bottle, or they may be able to stop breastfeeding temporarily then restart.

Contraindicated Medicines 

Many medications, including those that require a prescription, are compatible with breastfeeding, but some are not. Some medications can pose a risk to a breastfed babies when taken by the breastfeeding parent, such as:

  • Chemotherapy drugs2
  • Antiretroviral medications
  • Radioactive iodine
  • Some sedatives
  • Seizure medication
  • Medicines that may cause drowsiness
  • Medications that suppress breathing

Other medications can cause a decrease in the milk supply, making them a less favorable choice for breastfeeding parents. These include cold and sinus medications that contain pseudoephedrine, as well as certain types of hormonal birth control.

Discuss all medications with your doctor before breastfeeding—not just new ones. They can let you know if they’re safe to use while you’re breastfeeding.

Substance Use 

It is not safe to use recreational drugs while breastfeeding because these substances can get into your breast milk and pass to the baby, which can cause irritability, sleepiness, poor feeding, growth problems, neurological damage, or even death. If you’re struggling with addiction, help is available.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

If you are sober or in treatment, you may be able to breastfeed safely.3If you have a history of drug use but no longer use substances and want to nurse your baby, consult your healthcare provider for guidance

Infectious Diseases 

Many common infections are easily treated and do not interfere with breastfeeding or harm the baby. However, there are a few infectious diseases that can pass to a baby through breast milk, and in some cases, the risk of transmission outweighs the benefits of breastfeeding.


The human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). A mother who has HIV can pass the virus to her child through breastfeeding and her breast milk.

Since AIDS does not have a cure, a mother who is HIV positive should not breastfeed if she lives in an area of the world where a safe alternative such as infant formula is available. However, in countries where a safe replacement is not possible, exclusive breastfeeding may be recommended.4


The human T-cell lymphotropic virus 1 (HTLV-1) is a virus that can lead to leukemia and lymphoma. Human T-cell lymphotropic virus 2 (HTLV-2) can cause brain and lung issues. These viruses may not cause any symptoms at all, but they are lifelong conditions for which there is no cure. Since HTLV-1 and HTLV-2 can pass to a baby through breast milk, babies born to parents who are positive for HTLV should not breastfeed.

However, studies show that HTLV-1 cells can be destroyed by the freezing and thawing of expressed breast milk if the milk is frozen at a temperature of -4 degrees F (-20 C) or below for more than 12 hours.5

Active Tuberculosis Infection 

Tuberculosis (TB) is a bacterial infection in the lungs. It is passed through respiratory droplets, not by breastfeeding or breast milk. However, a parent can give active tuberculosis to a child through coughing, sneezing, and touching. When a parent has active TB, but their baby does not, the parent should not be in close contact with the baby and therefore should not breastfeed.

Since tuberculosis is not transmitted through breast milk, a baby can receive pumped breast milk until breastfeeding can begin after about two weeks of treatment. When both breastfeeding parent and baby have TB, they can stay together during treatment, and the baby can breastfeed.

Herpes on the Breast 

Herpes is not passed through breast milk, so as long as the lesions are not on the breast, any lesions on other body parts are covered, and thorough hand washing is performed, it is safe to breastfeed.6However, when there are active lesions on the breast, breastfeeding is dangerous as the herpes virus can be deadly to a baby.

Baby’s Medical Needs 

Most babies can breastfeed. Even infants born with conditions such as prematurity, cleft lip and palate, or Down syndrome who may not be able to take the breast right away can still take pumped breast milk in a bottle. With patience, time, and help, these babies may go on to breastfeed successfully.

It’s only when a baby is born with one of a few rare genetic metabolic conditions that breastfeeding may not be possible. But, even then, sometimes a baby can still partially breastfeed.

Classic Galactosemia 

Galactosemia is the body’s inability to break down galactose. Galactose is a part of the milk sugar lactose, and lactose is the main sugar in breast milk. So, if a baby tests positive for classic galactosemia, they cannot breastfeed or take breast milk in a bottle.7

 The child will need a special infant formula and a galactose-free diet to prevent severe complications such as jaundice, vomiting, diarrhea, long-term developmental problems, and death.

A less severe form of galactosemia is called Duarte’s galactosemia. Children with Duarte’s galactosemia can break down some galactose. Under the direct care of a doctor specializing in metabolic disorders, it may be possible to breastfeed babies with Duarte’s galactosemia while supplementing with the galactose-free formula. The doctor will have to monitor the baby’s galactose levels frequently to make sure that they stay under control.

Phenylketonuria (PKU) 

A baby with PKU can’t break down phenylalanine, an amino acid. If phenylalanine builds up in the baby’s body, it can cause brain damage. Therefore, babies with PKU need a diet low in phenylalanine.

There is a special infant formula for infants with PKU. But, since breast milk is low in phenylalanine, a baby with PKU may be able to combine breastfeeding and formula feeding with a special formula. The amount of breastfeeding needs to be controlled, and the baby has to have regular blood work and careful monitoring.

Maple Syrup Urine Disease 

A baby born with maple syrup urine disease cannot break down the amino acids leucine, isoleucine, and valine. When these amino acids accumulate in the baby’s blood, they give off a sweet maple syrup scent that is noticeable in the urine, ear wax, and sweat. The build-up of these amino acids can cause sleepiness, poor feeding, vomiting, seizures, coma, and death.

To fulfill the baby’s nutritional needs, your baby’s doctor will order a special infant formula that does not contain the three amino acids leucine, isoleucine, valine. The doctor may also recommend partial breastfeeding if the amount of breast milk is carefully measured and the baby is monitored closely.

1. Galactosemia. If the infant is born with this rare genetic metabolic disease, breastfeeding is impossible. Many states test for this disorder, but early diagnosis is important. It is imperative that those with the condition avoid all milk products throughout life. The rate among white infants is 1 in 60,000, according to the US National Library of Medicine.

2. Mothers who have HIV. The disease can be transferred easily to the infant through breast milk.

3. Mothers with active and untreated tuberculosis. This is highly contagious, but for mothers who have been treated and no longer infectious, it is safe to nurse their babies.

4. Mothers have cancer and are taking chemotherapy drugs or other drugs toxic to baby. These medications can cross into the breast milk to the baby.

5. Mother is undergoing radiation treatment. This is a temporary situation, so moms can breastfeed once the radiation treatments have ended.

6. Mother has a severe illness such as sepsis that may be carried to the baby. 

7. Mother is infected with hepatitis B or C. If it’s hepatitis B, the baby should be vaccinated within 48 hours of birth. If it’s hepatitis C, according to the Children’s Health Network, avoid nursing if nipples are cracked or bleeding.

8. If mother has herpes virus and has related sores on her nipples. However, breastfeeding may resume once the sores have healed.

9. Mother is infected with human T-cell lymphotropic virus type I or II. 

10. Mother uses illicit drugs such as cocaine, other hard drugs, or uses marijuana, drinks alcohol or smokes cigarettes and is unable to stop. In such cases, mothers should seek treatment whether or not she is nursing for her own health and her child’s welfare however.

5 Reasons Why Women Don’t Breastfeed

1. The biggest reason: 31 percent of women stated, “My baby had difficulty nursing.” Most new moms do have some initial difficulties in the early weeks, and if they don’t know it will get better, or know how to get help, they are likely to give up due to latch on problems, nipple pain or concerns about whether they are doing it correctly. According to a national survey, up to 47 percent of women were not told of breastfeeding resources available to them while in the hospital after giving birth.

2. Bottle feeding is perceived as easier, is the second most common reason. For those who have breastfed successfully, this one seems highly arguable. Breastfeeding requires no bottles, no midnight runs to the store, certainly less prep time and no cash outlay. This again would seem tied to how prepared and informed new mothers are about breastfeeding options.

3. It was tough to get started nursing the baby, is tied as the second reason women give for not breastfeeding. First timers must admit, the early weeks are indeed the hardest weeks. Your nipples may seem to be ready to fall off, depending on your particular sensitivity, and your milk supply isn’t established yet so you may experience painful swelling or engorgement at times. Once more, better information and preparation as well as support seems the answer to this common problem.

4. I didn’t get the support I needed. This next most common reason cited seems to combine all the earlier responses. These women just realized this as the root of the problem with nursing their babies. Hospitals make it far easier to bottle feed, handing out free formula, coupons for formula, supplementing with formula or water, offering newborns pacifiers before baby has learned to deal with mama’s nipples adequately, and don’t as a rule actively support breastfeeding or provide new moms with instruction on the nitty-gritty how to’s.

5. I knew I wouldn’t breastfeed long anyway, as I have to go back to work soon. Working and breastfeeding are definitely more challenging than staying home and nursing. However, should women be given more tips, as easy access to breast pumps and other supplies as they are formula, the numbers would likely change

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