Just thought of a few more cases to add:

*Multiple births - it is definitely possible to nurse twins, and I even
know of one woman who was breastfeeding triplets! It is especially
advantageous in these cases, as these babies are often low
birthweight or premature.

*Having only one breast (e.g. after mastectomy) - again it is possible
to breastfeed. Many women with two breasts find their babies prefer
one side and reject the other, so they are effectively breastfeeding
with only one breast (it is a supply and demand issue - the more
the baby nurses, the more milk you make). I saw a letter in Mothering
magazine from a woman who successfully breastfed after having
breast cancer (her breasts were not removed, but she wasn't sure
if it would be possible after the other treatments had been done).

*Being on medications. This one is tricky. Very often it is possible
to find a drug that is compatible with breastfeeding, but doctors
either don't bother to look or don't mention the possibilities. Or, if
you only have to take a drug once per day, you can time it for right
after the baby goes to sleep for the night (then, by the time the baby
next breastfeeds, most of the drug will have passed through the
mother's system). Chemotherapy is one instance in which
breastfeeding is definitely not a good idea.

*Breast size is irrelevant. What you see is fatty tissue - all women,
of all sizes, have the same milk ducts.

Laura
------
Laura Marple, SAH Mommy to Pippa (27 Nov 96)
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-----Original Message-----
From:
Sent:   Thursday, May 01, 1997 9:19 AM
To:     Milk/Casein/Lactose-free list
Subject:        RE: allergies and breastfeeding

>> Now, that many people on this list agree, that breastfeeding is the best
way to avoid or get rid of allergies for an infant, I wonder what a
mother is to do, when she for some reason can't breastfeed her baby? <<

Good question! Generally we should take the approach that not being
able to breastfeed at all represents the extreme exception to the rule.

*Some breastfeeding is better than none, so even if a woman has a too
low milk supply (which is *extremely* rare under normal circumstances -
in many countries breastfeeding rates approach 100%) it is better for
her to breastfeed her baby as much as possible and supplement with
formula. Many women who have had breast reduction surgery need to
supplement.

*In dire cases, where the baby absolutely needs breastmilk for health
reasons and the mother cannot provide it, insurance companies often
will cover the costs of getting milk from a breastmilk bank. (Naomi
Baumslag in _Milk, Money and Madness_ cites studies that show that
over 8,000 babies per year die in the US because they are formula fed,
and about 1.5 million worldwide). Breastmilk banks exist all over the
world and in some countries milk from them is routinely given to all
premies whose mothers won't breastfeed because it is so vitally
important - frequently a matter of life and death, even in first world
countries.

*Some women turn to wetnursing - asking a trusted friend or relative
to breastfeed the baby for them. Since it is possible to induce lactation
without ever being pregnant, this is a more viable option than one might
expect! Also very common all over the world, where grandmothers
often help breastfeed their grandchildren.

*Working out of the home or having inverted nipples do not prevent a
woman from breastfeeding. In the former case, it is easy to pump and
store breastmilk. In the latter case, there are ways to correct the problem.

*Some women do experience pain in the early weeks - often this is
because of poor latch-on or incorrect sucking on the part of the baby.
A good lactation consultant can help.

*Having AIDS or HIV positive status is another reason when it might be
better for the baby to be formula fed. It is a matter of weighing the overall
health benefits of breastfeeding against the risks of the baby acquiring
HIV (I think the exact risk is still unknown). In this case it mostly depends
on the environment in which the family lives - access to clean water,
the economic level of the family (poverty often leads mothers, even in the
US, to overdilute formula to "stretch" it - this can kill or severely damage
the baby).

Laura
------
Laura Marple, SAH Mommy to Pippa (27 Nov 96)
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http://www.seanet.com/~thisbe