For babies with cystic fibrosis (CF)
Breast-feeding should be actively encouraged. Evidence suggests that prolonged exclusive breast-feeding is particularly beneficial, and may protect these babies against declining pulmonary function.1 Many infants with CF do not produce digestive enzymes, which therefore need to be given alongside the baby’s usual milk (e.g. in a small amount of expressed breast milk or a small amount of fruit purée, if the baby is receiving solids). Most infants with CF will thrive if given breast milk: if malabsorption is controlled, demand breast-feeding should support normal growth.
Breast milk is relatively low in protein and sodium, therefore infants with CF may have increased requirements for these nutrients. It is essential that all infants with CF are under the care of an experienced CF-specialist dietitian so they are individually monitored, assessed and their parents are advised. Breast milk is easily digestible, has a high calorific value, is immunoprotective and contains milk lipase, which helps to digest fat efficiently and improves absorption. This can aid weight gain. Very frequent feeding can be demanding on the mother, therefore expressing breast milk can help her to increase her milk supply and enable others to give supplementary breast-milk feeds.
For women with CF
Pregnancy and motherhood does not appear to have a detrimental effect on long-term health.2.3 Breast-feeding is not contraindicated in CF but each mother should be individually assessed and advised, taking her individual preferences, health, clinical condition and circumstances into consideration. Breast-feeding may be contraindicated if the mother’s CF treatment necessitates certain drugs, therefore her treatment regimen should be discussed with her specialist care team before she considers breast-feeding. The mother’s diet should be closely monitored by a CF specialist dietitian to ensure that she is receiving adequate calories, fluid and nutritional supplementation. This will help to minimize the risk of weight loss, distal intestinal obstruction syndrome and nutrient deficiencies in either the breast-feeding mother or baby.
1. Colombo C, et al. Benefits of breastfeeding in cystic fibrosis: a single-centre follow-up survey. Acta Paediatrica 2007; 96: 2007; 1228–1232.
2. Goddard J, et al. Cystic fibrosis and pregnancy. Obstetrician and Gynaecologist 2009; 11: 19–24.
3. Edenborough FP, et al. Guidelines for the management of pregnancy in women with cystic fibrosis. J Cystic Fibrosis 2008; 7 (Suppl 1): S2–S32.
ResourceCystic Fibrosis Trust. http://www.cftrust.org.uk. 12 Nov 2009.
From: Journal of Family Health Care Bulletin. Directory of Breast-Feeding Advice. December 2009. Published with JFHC 2009; 19(6). http://www.jfhc.co.uk/images/stories/breastfeeding.pdf