Is It Fine To Breastfeed While Sick?

Photo by Amanda Watters

It’s fall and soon flu season will be in full swing. Many new moms that are breastfeeding will end up coming down with the flu, colds and other viruses. The question is, is it safe to breastfeed while sick?

The short answer is: yes. In most cases, it is more beneficial for you to continue breastfeeding, even if you are sick. One notable exception is for mothers that have HIV or HTLV-1. If you are diagnosed with HIV, you should talk to a doctor immediately and not breastfeed. Another exception is if your baby is less than three weeks old. Very young babies can be especially prone to catching an illness, so if you are really sick, your pediatrician might recommend you discontinue breastfeeding until you are feeling better.

By the time your symptoms appear for a common cold or virus (runny nose, coughing, sore throat, upset stomach, etc.), you have already exposed your baby to your illness since you are most contagious before that. Once your symptoms are in full swing, you should be extra careful to wash your hands, avoid close facial contact and avert your head when you are sneezing or coughing. Skin contact and mucus or saliva are the most common ways of infecting others.

Breastfeeding can actually help protect your baby from your illness. When you are sick, your body develops antibodies to fight against your illness and those are passed to your baby through breastfeeding. Even if your baby does end up getting sick (and your baby might not get sick at all), usually he or she will develop a less severe case than you did.

When you are sick, it is important to drink lots of fluids, not only to help you avoid becoming dehydrated, but to keep your milk supply up. According to International Board Certified Lactation Consultant (IBCLC) Anne Smith, it may go down a bit while you are sick, but should come back up after you start to feel better.

Breastfeeding might feel like the last thing you want to do when you are ill, but sudden weaning can cause problems like mastitis and engorgement and can be upsetting for your child. If you can’t breastfeed (due to vomiting or other severe symptoms) or are still worried your baby will catch something from you, you can pump and have someone who is not sick feed your baby.

Dr. Alanna Levine advises that if you have a fever for more than three days, you should consult your doctor. If they recommend that you take an antibiotic, ask for one that is safe for breastfeeding. If that isn’t possible, Levine says you can pump your milk and dump it out while you are on the medication. However, a vast number of medications are safe to take while breastfeeding, so your doctor should help you find one that works.

If you absolutely must take a medication that isn’t safe for breastfeeding for some reason, you can give your baby breast milk that you have frozen ahead of time (if you have such a supply). If you must take this medication and you don’t have a supply of breast milk, talk to your doctor about the best course of action to bridge the gap while you are sick.

Many breastfeeding moms might be able to treat their illnesses with over the counter remedies. There is a wide variety of cold and flu medicines available that have different active ingredients, depending on the manufacturer. Before taking any of these, it’s best to consult your doctor.

For an excellent, comprehensive list of cold remedies, artificial sweeteners, antihistamines, weight control products, diagnostic tests, sexually transmitted diseases and chronic illnesses such as diabetes and epilepsy and their effects on breastfeeding, see Smith’s post from BreastfeedingBasics.com.

Here is the short version of her list, including the most commonly used remedies.

Generally, Aleve, Tylenol (acetaminophen) and Motrin or Advil (ibuprofen) are fine to use while breastfeeding – ibuprofen being preferred. Aspirin and Excedrin are not advisable because aspirin can cause Reye’s Syndrome. It’s a very small possibility, but Smith cautions against aspirin use, just in case.

Antacids and digestive aids are usually safe to take, including Lact-Aid, Tums, Mylanta, Mylicon, Maalox, Alka-Seltzer, Rolaids and Tagamet.

For a sore throat, don’t use lozenges or sprays that contain phenol or hexylresorcinols. So, no Cepastat, Listerine, Sucrets lozenges (unless they contain dyclonine instead) or Vicks Chloraseptic Sore Throat Spray. However, it’s ok to use Celestial Seasonings, Cepacol lozenges, NICE lozenges and Vicks lozenges.

Many sinus congestion medications contain pseudoephedrine, which is considered safe, but it could cause your milk supply to go down, so be careful when using them.

Most nasal sprays are also safe, but be sure to use ones that contain sodium chloride, oxymetazoline, or phenylephrine (Afrin, Breathe Free, or Dristan, or Neo-Synephrine). Don’t use any containing propyhlexedrine (Benedrex), desoxyephedrine (Vicks Vapor Inhaler), or Lemetamfetamine (Nuprin Cold Relief Inhalor).

Antihistamines for treating allergies are generally considered safe, especially ones that don’t make you drowsy like Claritin, Actifed, Zyrtec, and Allegra. Benadryl, which can make you sleepy, can also make your baby sleepy and have difficulty nursing, so be careful when using it.

Avoid cough suppressants that have an alcohol content over 20 percent. Robitussin, Mucinex, Triaminic Expectorant, and Vicks Nyquil are considered safe, but, as with Benadryl, watch out for your baby to become drowsy.

Unfortunately, flu season is coming and many new moms will catch it. The good news is that in nearly all instances you should be able to continue breastfeeding and hopefully feel better soon. 

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