title: Got Milk? Breastfeeding and Milk Analysis of a Mother on Chronic Hemodialysis.
abstract: OBJECTIVE
  Women on dialysis rarely become pregnant. However, the overall rate of successful pregnancies is increasing in this patient population and breastfeeding becomes an option for mothers on dialysis. In this study we performed a systematic breast milk composition analysis of a mother on chronic hemodialysis (HD).
  
  
  METHODS
  Specimens of breast milk and blood were collected in regular intervals before and after HD from a 39-year old woman starting on day 10 postpartum. Samples were analyzed for electrolytes, retention solutes, nutrients and other laboratory measurements. Breast milk samples from low-risk mothers matched for postpartum age were used as controls.
  
  
  RESULTS
  Significantly higher levels of creatinine and urea were found in pre-HD breast milk when compared to post-HD. A similar post-dialytic decrease was only found for uric acid but not for any other investigated parameter. Conversely, sodium and chloride were significantly increased in post-HD samples. Compared to controls creatinine and urea were significantly higher in pre-HD samples while the difference remained only significant for post-HD creatinine. Phosphate was significantly lower in pre- and post-HD breast milk when compared to controls, whereas calcium showed no significant differences. In terms of nutrient components glucose levels showed a strong trend for a decrease, whereas protein, triglycerides and cholesterol did not differ. Similarly, no significant differences were found in iron, potassium and magnesium content.
  
  
  CONCLUSIONS
  To the best of our knowledge this is the first report on a breastfeeding mother on chronic dialysis. Although we found differences in creatinine, urea, sodium, chloride and phosphate, our general analysis showed high similarity of our patient's breast milk to samples from low-risk control mothers. Significant variations in breast milk composition between pre- and post-HD samples suggest that breastfeeding might be preferably performed after dialysis treatment. In summary, our findings indicate that breastfeeding can be considered a viable option for newborns of mothers on dialysis.
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Balzer
authors.affiliation: Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany.
authors.forename: Mechthild M
authors.initials: MM
authors.lastname: Gross
authors.affiliation: Institute of Clinical Chemistry, Hannover Medical School, Hannover, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Lichtinghagen
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Haller
authors.affiliation: Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Schmitt
mesh_terms: D000328:Adult; D001942:Breast Feeding; D003401:Creatine / Q000032:analysis / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology*; D008895:Milk, Human / Q000737:chemistry*; D009035:Mothers; D049590:Postpartum Period; D011188:Potassium / Q000032:analysis / Q000097:blood; D011247:Pregnancy; D006435:Renal Dialysis; D012964:Sodium / Q000032:analysis / Q000097:blood; D014527:Uric Acid / Q000032:analysis / Q000097:blood
chemical_list: D014527:Uric Acid; D012964:Sodium; D003401:Creatine; D011188:Potassium