• Naiomi Catron RNC, IBCLC

Breastfeeding with the Flu or Cold

It’s that time of year again … no, not pumpkin spice lattes … cold and flu season. Last year’s influenza season in Travis County was mild, but it was an active flu season nationally. If you have a baby and are breastfeeding, you may have plenty of questions about flu season and we’re here to answer the most common ones.


Can I get a flu shot if I’m breastfeeding?

The best way to protect yourself and your family is to get a flu shot every year. If your baby is younger than 6 months, they can’t be immunized. So, preventing the flu in other family members is key, and the best way to do this is for everyone who has contact with your baby to get immunized. Pregnant or breastfeeding mothers who get the flu shot provide immune protection to their infants through breast milk until baby can be immunized themselves.


What if I get the flu?

Being sick when you’re the mom is always challenging. If you’re pregnant or breastfeeding, illness can be even more burdensome. Symptoms of influenza include:

  • Sore throat

  • Nasal congestion

  • Dry cough

  • Fatigue

  • Muscle aches and weakness

  • Headache

  • Fever greater than 100.4 F (38 C), chills

  • People with influenza are contagious 1 day before getting sick until up to 5 to 7 days after symptoms appear.

Because flu complications are so dangerous to newborns, a mother presenting with flu symptoms during labor may be separated from their baby briefly. If she plans on breastfeeding, she should begin pumping early and often, and this milk can be given to her baby.

The flu cannot be transmitted to your baby through your breastmilk.

If you get the flu while breastfeeding, the best course of action is to continue breastfeeding while using precautions to prevent the spread of the virus. These safeguards include frequent hand washing, disinfecting surfaces, and always covering your mouth and nose when you cough or sneeze (and throwing away the tissues right away).


Continuing to breastfeed provides your baby with flu-fighting immunities. This is especially important if your baby is younger than 6 months old as they cannot get a flu shot. If you are too ill to breastfeed directly, then pumping regularly so someone else can feed your baby expressed breast milk is the next best thing.


Most of the time the flu just needs to run its course. Most of the time comfort measures are all that will be prescribed. If you are at risk of complications, your healthcare provider may suggest an antiviral drug. Experts recommend oseltamivir (Tamiflu) over zanamivir (Relenza) for breastfeeding mothers. If you have been prescribed any medications to treat the flu, you can check LactMed to see if they are compatible with breastfeeding.


Maternal illness can sometimes lead to low milk supply - either from dehydration and low calorie intake or simply being too ill to feed or pump. Resuming breastfeeding as soon as she feels up to it will help to re-establish her milk supply, though baby may need supplements (previously saved expressed breastmilk or formula) in the meantime if mom’s milk is considerably less than baby needs.


What if my baby gets the flu?

Sometimes everyone in the family gets sick except for the breastfeeding baby. But if your baby does get the flu, continuing to breastfeed can be the best way to keep your baby hydrated while they’re recovering. Breastmilk is easily digested and gentle on your baby’s stomach, and provides immune factors that will help with recovery. If your baby refuses the breast, provide breastmilk by cup, spoon, dropper or bottle and pump often enough to keep up your supply for when baby feels up to nursing again.


Complications of the flu for young children can include sinus and ear infections, bronchitis, and pneumonia. The younger the baby, the more dangerous the complications can be.

The best protection for your baby is to breastfeed, get the flu shot yourself, and get your baby immunized as soon as they are old enough. Keep your little one away from anyone who is sick, and be persistent about hand washing during cold and flu season.


Is it the flu or a cold?

Whether it’s a cold or the flu, you can continue to breastfeed your baby, protecting them with the antibodies you’re delivering through your breastmilk.

Can I take any over-the-counter medications?

While many over-the-counter medications are compatible with breastfeeding, try treating your symptoms with some basic remedies first. Get plenty of rest, allowing others to provide all of the baby care other than feeding. Stay hydrated – water, juice or warm tea are good choices. Use a humidifier as needed. Try salt water rinses for a sore throat or saline drops or spray for nasal congestion. Eat foods high in vitamin C and consider zinc for cold symptoms.

If you still need something more, keep these guidelines in mind:

  • Choose a medication that treats only the symptoms you are having

  • Opt for shorter duration of coverage (such as every 4-6 hours rather than a 12-hour or 24-hour formulation)

  • Nurse your baby first, then take the medication (which will lessen your baby’s exposure most of the time)

  • While pseudoephedrine is safe to use, it may decrease milk supply. So you may want to choose something without this ingredient if you have had milk supply issues in the past.

If you are concerned about a specific medication, check LactMed or call a lactation consultant for more information.


If you have more specific questions and would like expert advice from an IBCLC for your individual breastfeeding questions, check us out!

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Resources::

https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/influenza.html

https://www.cdc.gov/flu/highrisk/children.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fflu%2Fprotect%2Fchildren.htm

https://www.cdc.gov/flu/professionals/infectioncontrol/peri-post-settings.htm

https://www.infantrisk.com/content/influenza-season-recommendations-pregnant-and-breastfeeding-mothers

https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Recommendations-for-Prevention-and-Control-of-Influenza-in-Children-2019-2020.aspx

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