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I am a maternity nurse and wants to know if a mother with a CF baby can do breastfeeding.

Dear questioner,

Thank you for your question which is a very relevant aspect of CF care with babies (Cystic Fibrosis).

There is little scientific data on what is the best nutrition for infants with CF (breastfeeding, bottle feeding or a combination) available to give a conclusive answer. However, a study in Wisconsin (Jadin et al, 2011) shows us that exclusive breastfeeding up to the age of 2 months, has respiratory advantages, namely a smaller incidence of Pseudomonas aeruginosa infection until the age of 2 years. On the other hand, exclusive breastfeeding after 2 months can have a negative effect on weight in order that additional feeding from that age is required.

However, each situation has to be evaluated individually, and the expertise of a dietitian of a CF center is useful. As the growth in the early years partly determines the evolution of lung disease in later life, a precise follow-up is necessary. When there is malnutrition or deflection of the weight curve, it is advisable to enrich the infant’s milk. For example, this can be done by adding maltose-dextrin and/or oil to the mother's or bottle’s milk. If pumping milk is too heavy for the mother, it can be switched to bottle milk, or in combination with breastfeeding. We advise a standard bottle milk formula and not a (thorough) hydrolyzate, unless there is an indication for it (like a cow's milk protein allergy).

Most infants with CF suffer from pancreatic insufficiency, for which a treatment with pancreatic enzymes and a supplement with fat-soluble vitamins is necessary. As Infants with CF lose more salt in their sweat and given that breast milk and humanized cow’s milk is low in salt, salt supplements should be given.
Conclusion: With close follow-up, supplementation of pancreatic enzymes and salt, exclusive breastfeeding is possible for babies with CF. From the age of 2 months, supplements should be given.

Best regards
Claes Ine