There are few contraindications to breastfeeding because of the infant's medical condition.
Congenital lactose intolerance
High flow therapy - may be possible for stable patients. May require SALT review first, for example in the setting of prematurity
Other metabolic disorders - The American Academy of Pediatrics advises that "alternating breastfeeding with special protein-free or modified formulas can be used in feeding infants with other metabolic diseases (such as phenylketonuria), provided that appropriate blood monitoring is available". One case series reports predominantly success with a variety of metabolic disorders, another showed variable success. Partial breastfeeding in phenyloketonuria is well established, and breastfeeding may be linked to lower phenylalanine levels and higher weight gain for the infant
Problems with oral intake:
If lack of oral feeding is the only problem, babies can be fed expressed milk. Mothers will need expert advice on establishing or maintaining milk supply with exclusive expressing, which follows the same principles as for mothers of very preterm babies outlined here.
If supplementary feeds are necessary but oral feeding is not contraindicated, remember breastfeeding is a source of comfort for mother and child, and is particularly useful for analgesia during painful procedures. Babies who are mixed fed can receive infant formula while suckling at the breast with a supplementary nursing system.
Breastfeeding is not all or nothing
There are many ways to retain some of the valuable breastfeeding experience even if oral feeds are not possible or need to be supplemented with other feeding modes or types of milk