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Breast-feeding: very few contra-indications

Situations where infant formula is preferable to breast-feeding are rare.

Breast-feeding protects against common infant infections, particularly diarrhoea and respiratory infections. But in some uncommon instances it presents a risk for the infant.

In rare cases, breast-feeding can transmit viral infections that are generally without repercussions for the infant’s health. Only infections with HIV (the AIDS virus) and HTLV-1 (which can lead to some forms of leukaemia) make breast-feeding harmful. However, in these cases, bottle-feeding is only preferable if the supply of drinking water or infant formula is guaranteed and affordable.

In very rare cases of metabolic diseases (especially congenital galactosemia), breastfeeding aggravates the infant’s condition.

In the event of general or localised breast infections, when it is advisable to restrict mother-baby contact, breast-feeding can be maintained with milk obtained using a breast pump and stored in good conditions (48 hours at below 4° or 4 months at -18°).

Drug treatment should be confined to the essential, taking into account the risk-benefit balance for the mother and the child, and giving preference to non-drug treatments.

Overall, cases where formula is preferable are rare.

©Prescrire September 2009

Source: "Promouvoir un allaitement maternel, Deuxième partie : Très peu de contre-indications à l'allaitement maternel" Rev Prescrire 2008 ; 28 (297) : 515-520.
"Very few contraindications to breast-feeding", Prescrire Int 2009; 18 (102): 178.

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