Women with the flu can and should continue to breastfeed, according to the U.S. Centers for Disease Control and Prevention (CDC).
In fact, the CDC says one of the best things you can do to protect your baby from contracting the flu is to breastfeed. Breast milk contains antibodies—special proteins that fight infection. Because a baby’s immune system is still developing, they rely on their mothers for protection in the form of antibodies passed through breast milk.
The American Academy of Pediatrics (AAP) also urges women to breastfeed even if they have a cold or the flu. Infectious diseases seldom require weaning or interruption of breastfeeding. Generally, by the time a mother gets sick, her baby has already been exposed to the virus.
Adults with an infectious disease can infect others up to 24 hours before they develop symptoms and up to a week after becoming sick, the CDC explains. Because breast milk contains protective ingredients that formula lacks, the AAP encourages mothers who are ill to continue to breastfeed, but urges them to contact their child’s pediatrician, so that each case can be individually assessed.
During the H1N1 outbreak in 2009, the Academy of Breastfeeding Medicine (ABM) also issued guidance for breastfeeding mothers stating: “Breastfeeding can limit the severity of respiratory infections in infants and is particularly important for minimizing the risk and effects of infection during an influenza outbreak… Continued breastfeeding may help limit the severity of respiratory symptoms in infants that become infected.”
Even though breastfeeding is protective, there are limits to its effectiveness. Parents are cautioned, therefore, to take steps to avoid exposing their babies to the flu.
Since the virus is spread primarily through droplets from the mouths and noses of infected people, the National Institutes of Health (NIH) reports that breastfeeding mothers can take the following precautions to protect their babies:
- Get vaccinated. The annual flu vaccine reflects the CDC’s ‘best guess’ as to the strains that will be prevalent that year—sometimes their forecasts are accurate, but occasionally the virus mutates, or different strains become more prevalent, and the vaccine isn’t as effective as expected (read this to learn more). Nonetheless, the vaccine is still recommended since some protection is better than none. For best protection, get a flu shot as soon as it becomes available, usually around the end of September or beginning of October. If the flu shot is unavailable, get a nasal spray vaccine. The CDC believes the nasal spray provides less protection than the shot, but finds that any protection is better than none. The nasal spray vaccine may not be suitable for everyone; check with your doctor when selecting your vaccine.
- Consult a doctor if you suspect “flu.” While antiviral medications are no substitute for vaccination—your first line of defense against this illness—the drugs can ease symptoms, help you feel better sooner, and reduce your risk of complications. (By easing and shortening your illness, you can reduce the risk of transmitting the flu to your child.) Drugs such as Tamiflu® or Relenza® are generally safe to take while breastfeeding, but they work best when started within the first two days of becoming ill. If you have symptoms of the flu, don’t delay in consulting with your physician. Not all antiviral drugs are safe to take while breastfeeding, so check with your doctor before taking any antiviral drugs.
- Wash your hands thoroughly with soap and water before feeding your baby. If soap and water are not available, use an alcohol-based hand sanitizer.
- Limit close contact between your baby and other non-essential people, and avoid crowds.
- Wear a mask when caring for an infant if you suspect you are sick.
Breastfeeding women who develop symptoms of the flu (including fever, cough, or sore throat) can take these additional steps to avoid exposing their baby to the virus:
- Wear a face mask and cover your mouth and nose when coughing or sneezing.
- Place a cloth blanket between you and your baby during feedings.
- Pump or express your milk and have another person who is not sick give it to your baby in a bottle or a cup.
Since the NIH warns that children younger than 2 years of age have a higher risk of developing complications if they get the flu, parents should contact their child’s pediatrician immediately if they notice any of the following symptoms in their baby:
- acting tired or irritable
- not feeding well
- coughing
- diarrhea and vomiting
- fever
- runny nose
Parents should never give their infants or toddlers any over-the-counter medications without first consulting their child’s health care provider.
More information for breastfeeding mothers concerned about the flu is available from the U.S. Department of Health and Human Services’ Flu.gov and the NIH website.
