Monday, February 24, 2014

When a nursing mom is sick

This Martin Luther King Day long weekend was no fun for us. I caught stomach flu and spent the whole Saturday night in the emergency room. The very next day my hubby was down by the very same disease.

Breastfeeding in emergency room.
It turned out our little one was the only one who didn't get sick in the house. According to my doctor, it's breast milk that protect the baby from the flu.

So, to thank breastfeeding and in light of flu season, I wrote the following post for San Diego County Breastfeeding Colition's blog.

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Breastfeeding should continue when mother is sick, experts say

It’s flu season. Many women believe that they have to stop breastfeeding when they catch flu, but according to experts, breastfeeding should continue even when mother is sick.

In his article “Breastfeeding and Illness,” Dr. Jack Newman, founder of the first breastfeeding clinic in Canada, wrote, “Very few maternal illnesses require the mother to stop breastfeeding. This is particularly true for infections the mother might have, and infections are the most common type of illness for which mothers are told they must stop.”

According to Dr. Newman, viruses cause most infections, and most infections due to viruses are most infectious before the mother even has an idea she is sick. By the time the mother has fever, running nose, or diarrhea, she has probably already passed on the infection to the baby. However, breastfeeding protects the baby against infection, and the mother should continue breastfeeding, in order to protect the baby. If the baby does get sick, which is possible, he is likely to get less sick than if breastfeeding had stopped. But often mothers are pleasantly surprised that their babies do not get sick at all. The baby was protected by the mother’s continuing breastfeeding. Bacterial infections, such as strep throat, are also not of concern for the very same reasons.

Kelly Bonyata, IBCLC and owner of KellyMom.com, agreed with Dr. Newman. “It is very, very rare for a mom to need to stop breastfeeding for any illness,” she wrote on her website. “There are only a few very serious illnesses that might require a mom stop breastfeeding for a period of time or permanently.”

Per Bonyata, during any ordinary” illness such as cold, sore throat, flu, tummy bug, mastitis, etc, a mother should continue to breastfeed, just remind her doctor that she is nursing so that if medications are needed the doctor can prescribe something that is compatible with breastfeeding. She also pointed out that most medications are safe to take while breastfeeding, and for those that are not recommended there is almost always an alternative medication that is safe.

As for the decision about continuing breastfeeding when the mother takes a drug, “it is far more involved than whether the baby will get any in the milk. It also involves taking into consideration the risks of not breastfeeding, for the mother, the baby, and the family, as well as the society.” wrote Dr. Newman. He questioned, “Does the addition of a small amount of medication to the mother’s milk make breastfeeding more hazardous than formula feeding? The answer is almost never,” and he considers that breastfeeding with a little drug in the milk is almost always safer than formula feeding.

So experts agree that instead of stop breastfeeding, the best thing a mother can do for her baby when she is sick is to continue breastfeed. In fact, Dr. Newman warned, “remember that stop breastfeeding for a week or even days may result in permanent weaning as the baby may then not take the breast again.” Bonyata also reminded mothers, “withholding your breast milk during an illness deprives baby of the comfort and superior nutrition of nursing.”

There is, though, an exception to the above, which is HIV infection in the mother. “HIV and HTLV-1 are the only infectious diseases that are considered absolute contraindications to breastfeeding in developed countries,” explained Dr. Ruth Laurence, a pioneer in the field of human lactation. “Until we have further information, it is generally felt that the mother who is HIV positive not breastfeed,” Dr. Newman added. “At least in the situation where the risks of artificial feeding are considered acceptable.”

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Update on July 18, 2016: Now HIV therapy for breastfeeding mothers can virtually eliminate transmission to babies.

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