Cough, urp, achoo: common conditions like colds, stomach bugs, fevers and seasonal allergies are not fun at the best of times. Add breastfeeding to the mix and many moms find themselves wondering, is it safe to breastfeed when you’re sick? After all, it would be terrible, and potentially dangerous, to have your little one feel as crummy as you do. Experts agree that you should continue nursing when you’re sick, to both protect your baby from that exact illness, and to preserve your breastfeeding relationship. Here’s what you need to know about breastfeeding while you’re sick.
How’s this for a cool superpower: Minutes after you’re exposed to viruses and other microbes, your body starts making breast milk that contains antibodies to fight those specific germs. “Your milk is custom-designed to protect your baby,” explains Jennifer Ritchie, an International Board Certified Lactation Consultant (IBCLC), who helps moms through her company Milkalicious, in Laguna Niguel, California. “There are many stories of the entire family getting sick with something, but not the baby, and that’s because of the antibodies in the breast milk.”
Of course, use common sense when you’re sick by washing your hands frequently. Get as much rest as you possibly can, which will hopefully mean another family member can care for your little one and just bring him to you for feedings for a day or two. And, you may have to just improvise. “When my first baby was a few months old, my husband and I were both badly sick with the flu at the same time,” remembers Shari Criso, MSN, RN, CNM, IBCLC and owner of My Baby Experts in New Jersey. “The baby just lay in bed between the two of us, happily breastfed continuously, and never got sick.”
A common misconception for many breastfeeding moms is that all medication will negatively affect their baby, and so they therefore can’t take any medicine while breastfeeding, says Criso. “This is simply untrue. In fact, most medications are completely safe to take while breastfeeding, including most antibiotics,” she says. “If your doctor does prescribe a medication that is contraindicated, there is almost always a substitute that is safe and mom should ask for it.”
Over-the-counter pain relievers like ibuprofen (eg Advil) and acetaminophen (eg Tylenol) for fevers and aches are fine, as well as antihistamines such as loratadine and fexofenadine (eg Claritin or Allegra) for seasonal allergies. If your baby is very young, a preemie or has a medical condition, doublecheck with your health care provider.
In addition to your health care provider’s advice, you can check LactMed, an online drugs and lactation database by the U. S. National Library of Medicine. Ask your health care provider if she has access to an online or hard copy of the book Medications and Mother’s Milk by pharmacologists Thomas W. Hale and Hilary Rowe, which reviews the latest scientific literature.
Avoid long-acting or multiple-action medicines, and take the minimum dose when possible. Opt for non-drug alternatives when you can, such as using a saline rinse on a stuffy nose rather than a decongestant, gargling with salt water for a sore throat or sipping ginger tea for an upset stomach. “As for timing, take the medication while you’re nursing or just afterwards,” says Criso, because the medication will then be at a lower volume in your body and your milk, when you next breastfeed in a few hours’ time.
A lot of decongestants contain pseudoephedrine (eg Mucinex D, Claritin-D, Sudafed Triple Action), which has been shown to decrease milk supply in some women, so read labels with an eagle eye. Taking a lot of menthol cough drops is also not a good idea, as menthol may also cause your milk production to dip.
The main culprit of not enough milk when you’re sick, however, is usually dehydration, so if you’re breastfeeding and have a stomach bug or food poisoning, or are breastfeeding and have a fever, take frequent small sips of water. “Drinking a lot of water won’t necessarily increase milk supply, but not drinking enough can lead to dehydration and may decrease your milk supply,” says Criso. “Rest, fluids and frequent feedings at the breast are most important in keeping up your milk supply.”
When Jeni Taylor of Washington, DC, who blogs at Little Sproutings came down with a bad stomach flu, her husband fed her daughter with breast milk she had previously pumped and stashed in the freezer, because she was too dehydrated to make milk. She still attempted to nurse and pump though. “Your body needs that hormonal response and if you’re not emptying your breasts, your body won’t think you need to keep producing milk,” she says. “I was scared that [not being able to nurse while ill] would permanently affect my supply, but I couldn’t do anything about it at the time.” (And fortunately after a day she was able to breastfeed again.)
Mastitis is a bacterial infection of the breast tissue, generally caused when the breast isn’t fully emptied of milk, often due to plugged milk ducts from a poorly fitting bra, or when you and your babe are still getting the hang of correct breastfeeding techniques. The result is a sore, swollen red breast, painful breastfeeding and sometimes a fever with chills and aches. “You will feel lousy, but it’s extremely important to keep breastfeeding, because keeping the breast empty will help to reduce the inflammation and clear up the infection. You can also pump, but keep in mind that the baby always does a better job of emptying the breast than a pump,” says Criso.
Your milk is totally fine for your baby to drink. The typical treatment is to get lots of rest, massage your breast in a hot shower, apply warm compresses and breastfeed frequently, and that’s often enough to clear things up, says Ritchie. If your sore boob doesn’t improve in a day or two, your doctor will likely prescribe antibiotics to zap the infection and again, the meds will be safe for the baby.
Bottom line: you can breastfeed while you’re sick. Remember that it takes energy to make breast milk and energy to get better. “Rest as much as you can,” says Jennifer Brenan of Washington, DC, a mom of two (soon to be three) who blogs at Breastfeeding Needs and who has breastfed through colds, stomach viruses, mastitis and various other illnesses. “I know this is easier said than done when taking care of kids. It feels so hard when you are going through it though, so hang in there!