Last update Dec. 27, 2021
Improvements in the treatment and management of this disease have increased life expectancy, allowing patients to reach the reproductive stage and in women, unlike men, fertility is not greatly affected. (Kroon 2018, McGuire 2016, Festini 2006)
Exclusive or partial breastfeeding should be encouraged, taking into account the health conditions of each mother (McGuire 2016, Edenborough 2008, Michel 1994, Kent 1993, Stead 1987). Partial breastfeeding of twins has been recorded. (McGuire 2016)
It requires a great deal of support, monitoring of the weight and health status of the mother with an extra daily intake of 500 calories, 11 g of protein, 500 mg of calcium, 400 IU of vitamin D and 2 litres of water. (Edenborough 2008, Michel 1994)
Respiratory physiotherapy must take into account changes in the breasts. (Edenborough 2008)
The concentration of sodium and other electrolytes and proteins in breastmilk are normal; linoleic acid, arachidonic acid and cholesterol levels are slightly decreased (McGuire 2016, Edenborough 2008, Kent 1993, Hamosh 1992, Shiffman 1989, Bitman 1987, Stead 1987, Alpert 1983, Welch 1981). Infants grow adequately with breastmilk. (Michel 1994, Smith 1992, Stead 1987, Alpert 1983, Welch 1981)
Virtually all medications used in the treatment of CF are compatible with breastfeeding (Kroon 2018): H2 antagonists (famotidine, nizatidine, ranitidine), metoclopramide, domperidone, laxatives (polyethylene glycol, senna, bisacodyl), all antibiotics except for chloramphenicol, antifungals such as fluconazole, antiviral agents such as acyclovir and valacyclovir, antidiabetics (insulin, glibenclamide, tolbutamide), pamidronate, ursodeoxycholic acid, systemic and inhaled corticosteroids, inhaled bronchodilators, pancreatic enzymes, dornase alfa, vitamins, immunosuppressants (azathioprine, cyclosporine and tacrolimus) and ibuprofen.
There is little data on the cystic fibrosis transmembrane conductance regulator (CFTR) protein enhancers, elexacaftor, ivacaftor, lumacaftor and tezacaftor, but limited data indicates that milk excretion is minimal (Terrell 2018, Trimble 2018) and no clinical or ophthalmologic problems have been observed in more than 30 infants whose mothers were taking elexacaftor, ivacaftor, lumacaftor, or tezacaftor (Taylor 2021 and 2020, Nash 2020, Middleton 2020). Several medical societies and expert authors consider that CFTR drugs are probably safe during breastfeeding. (LactMed, Hale, Jain 2021)
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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e-lactancia is a resource recommended by Asociación Pro Lactancia Materna (APROLAM) of Mexico
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