lactose intolerance NOT the only reason can't breastfeed? - Mothering Forums

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Old 07-29-2005, 05:15 PM - Thread Starter
 
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I've heard that lactoe intolerance is the only reason a woman wouldn't be able to breastfeed her baby...and repeated it. Well a woman on another message board said she couldn't breastfeed her child because she was rh-, child was rh+ and she had antibodies in her milk...is this true? She said she tried for 4 months and then they discovered that the anitbodies were the reason he wouldn't stay on the breast. Does this sound right? Seems wierd to me...but I know nothing about what happens if an rh- person does form antibodies (I'm rh- and my dh and kids are rh+, but I got the rogham shot and have never had problems...).

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Old 07-29-2005, 05:24 PM
 
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I've never heard about or read anything like this (the rh +/- reason). If it were legit, I'm sure it'd be in the literature somewhere.

As far as lactose intolerance, I don't think that's so much the issue as babies with galactosemia, who lack the enzymes to break down the milk sugars. That's not the same as lactose intolerance, or even milk protein allergy. If baby has a dairy sensitivity, mom can eliminate it from her diet. But babies with galactosemia/glycogen storage diseases cannot break down the sugars, so it's dangerous for them to ingest them, as far as I know.
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Old 07-29-2005, 05:29 PM - Thread Starter
 
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I thought lactose inloerance was just another name for galactosemia? LOL, I'm so confused! :LOL I'm gonna read a little on the rh thing...it just seems like it'd be in the literature, yk?

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Old 07-29-2005, 05:35 PM
 
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Lactose intolerance is the inability to break down the sugars. It's not a "sensitivity", really. Our milk does contain lactose and it is very rare for an infant to be lactose intolerant.
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Old 07-29-2005, 05:40 PM
 
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There's also a condition where the infant's body cannot utilize the particular kind of fatty acids contained in breastmilk, due to some insufficiency of the pancreas I think... there is a mom here whose son has this condition. I can't think of what it is called. But like real galactosemia, it is very rare. And apparently very difficult to diagnose as well.

I can't find anything about rh affecting breastfeeding. Not even at Kellymom, :LOL gosh if they don't have info about it there... hmmm

Apparently the antibodies develop in the mom in the first few days after birth but there is no mention as to it causing a problem for nursing in any of the articles about it that I looked at.
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Old 07-29-2005, 07:12 PM
 
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At least it's a differnet story than "I didn't have enough milk".

That is not a reason to not breastfeed, however there are more reasons than lactose intolerance.

I have antibodies to my daughter's blood (anti-B), and she's growing like a weed on my milk. They may have supplemented the baby with formula if the jaundice was severe at birth (according to our neonatologist, formula actually is better at clearing bilirubin - is this true?)
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Old 07-29-2005, 07:18 PM
 
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I've never heard the rh thing either. : I kinda doubt it, since there are lots of moms who have an rh incompatibility with their babies, but I don't hear them quoting that reason for not BFing.

Galactosemia is one reason, PKU disease is another reason (another metabolic disease). Both of these are incredibly rare, definitely NOT something you would need to worry about. True lactose intolerance is rare in babies as well, although a sensitivity to cow's milk proteins is more common. That can be handled though, without weaning. Our milk contains proteins and enzymes to digest those proteins in all the right amounts for a baby who does not have a very specific metabolic disorder. almost any sensitivity the baby has can be handled by the mother adjusting her diet, although most moms will not go through this. Thus, they "can't" BF.
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Old 07-29-2005, 07:43 PM
 
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Quote:
Originally Posted by wannabe
(according to our neonatologist, formula actually is better at clearing bilirubin - is this true?)
Here's a page with information on that.

http://www.kellymom.com/newman/07jaundice.html

I know they used to think that was true but now it is known that for "breastmilk jaundice" the best thing is to nurse. Increasing nursing frequency rather than giving formula is what they are supposed to advise now, but I don't think most hospitals have current info because I hear of moms being told to supplement w/ formula all the time, in fact we were pressured to give formula in the hospital too since our ds was very small and jaundiced. (we didn't, we nursed more often and he was fine).

sorry about the hijack!!
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Old 07-30-2005, 01:25 AM
 
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i have been active in the BF community for over 10 yrs and never heard the RH thing. sounds like bunk to me, but i could be misinformed.

as for LI, galactosemia is a form of lactose intolerance. but in your regular garden variety LI, it is just dairy in the mothers diet that is upsetting the baby. once it is removed all is well. in galactosemia, the baby lacks an enzyme called lactase, and such babies may only have soy abm. this is a life long, very serious medical condition. regular LI can be overcome if the mama is smart and withholds dairy for the first so many yrs of the dc's life. if not reversed by careful intro of solids, it can be managed by ingesting lactose free dairy products, by taking enzyme supp's, or the person can just choose to eat dairy and suffer gas. in galactosemia, if the db is not taken off of mothers milk or dairy formula stright away, the baby will generally die in the first weeks, or at the very least suffer irreversable brain damage. this has been on my mind b/c a mama i know irl has a 2mo ds who had rectal bleeding, and she called it GS so she could keep on eating her dairy foods sans guilt. i posted about it here.

Bring back the old MDC
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Old 07-30-2005, 01:45 AM
 
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Having been a bf educator for too many years to count and having bf 4 children ( one adopted) who are all RH +, I am surprised that someone would use this as a reason for bf failure. My RH- status never caused any supply problem, absorption problem or weight gain issues for any of the children. never heard of it as a reason either.
Even babies with PKU can often have some breast milk as they are allowed a little milk for growth depending on their blood levels of the undigestable protein molecule. We had a foster son with this challenge and his diet was very restricted for 5 years to prevent brain damage. He was allowed more human milk than cows milk when he could have some. Otherwise the main diet is an awful liquid composed of no natural ingredients and limited amounts of certain foods. I still find myself counting raisins or Corn Chex and loving apples as they could be eaten without restriction...
Poor Moms who need an excuse to justify their limited bf experiences. Often under-informed medical personel or well meaning relatives seem to conjur up far fetched reasons to stop... Just heard about a Mom who was living in the UK during a certain year and is not allowed to donate her milk to a Milk Bank but its fine to bf her own baby. Makes no sense to me either...
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Old 07-30-2005, 02:13 AM
 
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I'm RH- and DS2 is RH+ and I havn't had any prob.s FTM niether has he :LOL

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Old 07-30-2005, 03:37 AM
 
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I actaully know of two people who had pku and breastfed...one had pku but her child didn't and one had pku and her child did also. I know that they had to also give some sort of supplement (not artificial baby milk) though in addition to bf.
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Old 07-30-2005, 09:03 AM - Thread Starter
 
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the thing is thought this woman formed antibodies, does that make a difference? I'm guessing she didn't get that rogham shot or it didn't work...but the antibodies would be in the blood, and attack "alien" blood cell in her body, I just don't see any way that even if there were "in the milk" they could possibly cause a problem. I tried to suggest that she was misinformed...but she's very deffensive and now she's not sure that she's even going to try to bf future children.

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Old 07-30-2005, 11:09 AM
 
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(according to our neonatologist, formula actually is better at clearing bilirubin - is this true?)
I know someone addressed this, but our neonatologist just kept pushing nursing and pumping to me. My premie was in for 14 days with her main issue being Jaundice, she got less than 2 ounces of formula total and that was in small amounts added to my breastmilk in the begining (about 10cc at a time) For 2 days she didn't get anything by mouth, then days 3 & 4 she got that bit of formula, since then just momma's milk
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Old 07-30-2005, 02:46 PM
 
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Quote:
Originally Posted by mamabohl
the thing is thought this woman formed antibodies, does that make a difference? I'm guessing she didn't get that rogham shot or it didn't work...but the antibodies would be in the blood, and attack "alien" blood cell in her body, I just don't see any way that even if there were "in the milk" they could possibly cause a problem. I tried to suggest that she was misinformed...but she's very deffensive and now she's not sure that she's even going to try to bf future children.
I do not know if the woman is trying to mislead you, if her doctor is trying to mislead her, if she misunderstood her doctor or if her doctor is just completely ignorant (or bfeeding misinformed so trying to come up with *some* reason to have her stop nursing) but this story just does not jive.

Approximately 1% of women who are given the rogham shot will still form the antibodies. This should not effect breastfeeding in any way. The antibodies are formed when a Rh- mother gives birth to a Rh+ child. So, if the child was Rh- there would be no antibodies formed--- they would just not be there to cross the placenta. If the child was Rh+ and somehow the antibodies were getting in the milk it WOULDN'T MATTER--- the child is already Rh+ so the antibodies for + blood could not hurt the child.

I have to also add that galactosemia is a condition that is extimated to affect no more than 1/65,000 children and yet it is ALWAYS listed as a reason not to breastfeed. Meanwhile, 16% of the US population (I am assuming this woman is in the US, if not excuse my assumption) is Rh-.

So, further assuming that attraction has nothing to do with Rh compatibility (so, Rh factor has no influence on who people mate with) the children born would be in the following ratios:

1) + Father + Mother = 70.56% of babies born
2) + Father - Mother = 13.44% of babies born
3) - Father + Mother = 13.44% of babies born
4) - Father - Mother = 2.56% of babies born

Now, situations 1, 3, & 4 pose no threat of Rh incompatibility. Situation 2, which applies to 13.44% of babies.

Now, lets take this further. 1% of the mothers who have those 13.44% of babies (with +father and -mother) will form antibodies. That means that .1344% of babies, or over 1 out of every 1000 babies would be unable to breastfeed due to this issue.

Given that galactosemia is listed, with a *high* estimated occurance of 1/65000 babies and PKU is listed with an estimated occurance of 1/14000- 1/20000 I have a hard time believing that something that would prevent 14-65 TIMES MORE babies from being breastfed would be mentioned *no where* in any lactation information.

Lastly, as a Rh- mother yourself, you probably understand the unfortunatley common outcome of drastically high antibodies in the mother's blood--- the inability to have future biological children. As the woman has mentioned *not bfeeding future children* I assume she plans on having future biological children--- something the doctor definatley would have brought up the risks of.

 

 

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Old 07-30-2005, 04:32 PM
 
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I am also a breastfeeding educator and have breastfeed three, I am RH- and all three RH+. I have not had any problems with breastfeeding (as far as the RH incompablity is concerned) or the medical community saying it maybe hard to breastfeed. I did not find any literature that said anything about the inablity to breastfeed and blood incompablity. I would encourage you to talk to the mom a little more and find out what the problem is with breastfeeding that she feels the blood incompablity is causing. We sometimes especially as new moms don't realize that the medical community is not educated on breastfeeding, they are not taught about it in school and the only info they have are what they decide to find out about and educate themselves on. It could be possible that this doctor may be giving miss info. Because even milk senstivity in babies is many times told to moms as reason for them to absolutely have to stop breastfeeding. It is the antibodies in the form of proteins in the cows milk that causes problems, and if baby is allegeric to these proteins which do pass through moms milk then there can be a problem. But as long as mom elimanates milk products from her diet she could still nurse, for some moms these is difficult especially when milk products in everything from hot dogs to bread. Galactosemia is completely different and is a rare inherited metabolic disorder in which the liver enzyme that breaks down galatose is absent, leaving the baby unable to metabolize lactose, or milk sugar.
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Old 07-30-2005, 11:14 PM
 
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Hi,
I majored in biology and I also worked in cardiology for some time. Last I checked, the rh factor was attached to red blood cells. While breastmilk is very much like the plasma in our blood, with some kinds of white blood cells thrown in, the red blood cells are NOT in there, so I can't see that there is any issue about the mom being rh-.

Found this webpage, it explains blood types and Rh really well:

http://nobelprize.org/medicine/educa.../readmore.html

This is easier to understand than any of my texts. Enjoy
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Old 07-31-2005, 08:57 AM - Thread Starter
 
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thanks so much everybody!

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Old 07-31-2005, 12:09 PM
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As far as reasons not to breastfeed. There are a few physical abnormalities that can prevent direct nursing. I had to pump exclusively (my daughter was breastfed), but she was unable to nurse because she had a cleft palate. As far as I know, galactosemia is the only reason that a baby could not tolerate breastmilk at all.


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Old 07-31-2005, 05:05 PM
 
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I think the point about being sensitised is a very good one - it's so rare to be sensitised these days - as someone said - 1.6% without prophylactic rhogam, less tham 1% with it. The antibodies could harm the baby, provided they got into the milk, and into the baby's blood. But this was never mentioned to me, and I have antibodies to my daughter's blood. Maybe it depends on your titre?

Quote:
If the child was Rh+ and somehow the antibodies were getting in the milk it WOULDN'T MATTER--- the child is already Rh+ so the antibodies for + blood could not hurt the child.
It's actually the other way round - the antibodies don't hurt the mother, because she's got no Rh protein, but the antibodies will attack the Rh on the baby's red blood cells.

Quote:
Originally Posted by velcromom

I know they used to think that was true but now it is known that for "breastmilk jaundice" the best thing is to nurse. Increasing nursing frequency rather than giving formula is what they are supposed to advise now
Sorry too for the hijack, but thankyou! next time I'll know (I have antibodies so my next baby will also have jaundice)

Quote:
Just heard about a Mom who was living in the UK during a certain year and is not allowed to donate her milk to a Milk Bank but its fine to bf her own baby. Makes no sense to me either.
That's becasue her baby has already ben exposed to the prions, if she had contracted mad cow. No-one who lived in the UK for a year in the 80's and early 90's is allowed to donate anything - cord blood, blood, organs. All blood products in the UK are imported, I beleive. Of course, it shouldn't matter in the US, since BSE is in the population anyway.
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Old 08-01-2005, 12:17 AM
 
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Quote:
Originally Posted by wannabe
It's actually the other way round - the antibodies don't hurt the mother, because she's got no Rh protein, but the antibodies will attack the Rh on the baby's red blood cells.
Thanks for the clarification! I thought that the issue was only with future pregnancies.

But, as another poster already pointed out red blood cells are not passed in bmilk.

 

 

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Old 08-01-2005, 04:15 PM
 
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My son has eosinophilic esophagitis (EE) and can not BF. He is unable to digest and absorb proteins of any type in my BM, regular food, or regular abm. He has a gastrostomy tube and is fed an elemental formula called EleCare that is made up of only amino acids. He does not have to digest it-- just absorb it. the only thing he can have by mouth is water and ice. He was exclusively BF with me on a strict diet of 12 foods until he was 12.5 months old. He had stopped growing at 9 months old and was literally starving to death on my BM. We put him on the EleCare and he is thriving! At almost 2 years old he is extremely smart, funny, gentle, and a complete joy. He is still small but only has a speech delay (no other delays) because he does not know how to chew. He has never eaten anything but BM and now EleCare. Giving up BF him was the hardest thing I've ever had to do. I was tandeming him and his sister (who at almost 6.5 years old is still BFing) and had TONS of milk. But after seeing him grow and thrive on the EleCare, I know we did the right thing. You can read more about eosinophilic disease at www.apfed.org. So yes, there is another reason why you can't BF....
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Old 08-01-2005, 04:29 PM
 
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Quote:
Originally Posted by velcromom
There's also a condition where the infant's body cannot utilize the particular kind of fatty acids contained in breastmilk, due to some insufficiency of the pancreas I think... there is a mom here whose son has this condition. I can't think of what it is called. But like real galactosemia, it is very rare. And apparently very difficult to diagnose as well.
That's my son! His condition is called Severe Exocrine Pancreatic Insufficiency. His pancreas produced none of the 4 enzymes necessary for fat digestion. We still don't know what caused this, and have yet to recieve a full diagnosis for him. It took months to figure out why he was losing 3 oz a day. Usually children w/this condition have CF, but he doesn't. And usually enzyme supplements will help w/fat digestion, but for him they didn't. So he had to be on a higly specialized formula w/medium chain fats instead of long chain fats (he still had difficulty digesting even the medium chain fats which are considered to be already broken down, but at least he started gaining a little bit).

But even with Severe Exocrine Pancreatic Insufficiency there is often a way to BF successfully if the enzyme supplements work. I wish they would have in our case, but they didn't. However, the enzyme supplements not working is very rare. They dr.s at Stanford decided that our son is "baffling". He started producing some enzymes at 8 months & I tried relactating (he wouldn't latch but I pumped & gave it to him) & then got pg w/DD & am now BFing her. Now at 22 months he is producing adequate enzymes, but still doesn't gain weight very well, so obviously something else is going on too. Sorry for such a long post. As velcromom said my son's condition in rare, but it does happen.

.

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Old 08-01-2005, 06:03 PM
 
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Quote:
Originally Posted by TiredX2
But, as another poster already pointed out red blood cells are not passed in bmilk.
It's the baby's red blood cells that are attacked by the antibodies the mother produces.
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Old 08-01-2005, 08:47 PM
 
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I just want to make sure everyone is clear that lactose intolerance in the MOTHER wouldn't be a factor at all. I am lactose intolerant, haven't had ANY milk products or derivitives for 15 years and have easily produced breastmilk for two kids over the last four years. (My own mom couldn't understand how I could make milk if I didn't drink any cow's milk :-) )

Also, re: jaundice, the hospital pediatrician told me to give formula too. I resisted and finally took the samples he gave me. As soon as he left the room I threw them away. From talking to people later I got the sense that doctors recommend the formula b/c then they can measure how much intake the baby has. So typical. Just b/c it's much harder to calculate how much bm goes in, they don't recommend it.
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Old 08-02-2005, 12:30 AM - Thread Starter
 
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wow thanks so much for all the info, I love getting educated. and wow calliemommy and nursiemom - you guys have been through some tough dstuff!

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Old 08-02-2005, 06:38 PM
 
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