Breast Feeding When Mom Feels Sick (or has COVID!)

Between sleep deprivation and putting the needs of others before their own, it’s pretty common for moms to get sick. And it’s common for me to get questions about breast feeding when mom feels sick. I’m not surprised by these concerns. There’s not one answer for everyone, but here are my thoughts:

Should I breast feed the baby if I’m sick?

Personalized precision medicine: If you have a minor illness, such as the cold or flu, not only is breast feeding still okay, but it can also be one of the best things you can do to help protect your baby. Your baby has probably already been exposed to the virus. As you make antibodies to the specific strain of virus, the antibodies come through your milk and might protect your baby from getting sick or help him get better faster if he does. In addition to this, there are powerful molecules in breast milk, such as lactoferrin and lysozyme, that help protect babies from getting sick.

Should I breast feed the baby if I have COVID?

How hard to have COVID and a nursing baby! Current evidence suggests that it would be very unlikely for COVID to be transmitted through breast milk. It’s wise to wash or sanitize your hands before nursing or pumping, and to wear a high-quality mask whenever close to your baby or pumping. You may want to consider having someone else feed your baby pumped breast milk during the time of your isolation, if feasible. But as with minor respiratory infections, the breast milk itself is likely to help protect and nourish your baby through this time.

With a serious illness blood-borne illness such as hepatitis or HIV, though, it may be better not to breast feed. This is something you’ll want to talk about with your doctor.

Whether the illness is big or small, if you take any medications – prescription or over-the-counter – be sure to check how they might affect your baby.

What do I do for mastitis and should I continue breastfeeding if it hurts? 

Ouch! Mastitis is quite common. Often it will go away within 48 hours with moist heat and taking care to empty the breast – but women who have a fever, flu-like symptoms and a reddened breast should talk with their doctor about antibiotics.

I recommend nursing frequently during mastitis to speed healing (starting on the infected side every two hours if possible). It should be safe unless the baby is sick or a hospitalized premie. The infection is in the breast tissue, not the milk. If nursing hurts too much, pump — and pump often.

I’m a fan of increasing rest (sleep when the baby sleeps!), increasing fluids (to the extent you notice you’re peeing more), and losing the bra if it might be compressing the breast. Moist heat to the breast for 15 or 20 minutes before nursing or pumping and as desired can be helpful whether or not you are taking antibiotics.

What medications can I take while I am breast feeding?

Almost any medicine or supplement you take will end up in the breast milk in at least some amount. Some of these can affect breast feeding; some can affect your baby. Most of the time the baby would get 10% or less of the mother’s dose. Often it’s only 1% or less. But with a few medications the baby can get the same dose as the mother through the milk.

Whenever a nursing mother takes a drug or supplement, I recommend checking the constantly-updated National Library of Medicine database called LactMed. It’s easy to enter what you’re taking on their website or in their app.

And above all else, take good care of yourself — sleep as much as you can, drink lots of water and let other people take care of baby whenever possible.