Is it safe to breastfeed when I’m ill or feeling sick?

If you've got the flu, a fever, a stomach bug, a cold or an infection that needs antibiotics, is it OK to carry on breastfeeding? We get expert advice on what's safe and what's not

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In an nutshell

Yes, it is. There are very, very few illnesses that require you to stop breastfeeding1. Most common illnesses, such as a cold or the flu, a fever or a stomach bug with diarrhoea and vomiting, can’t be passed on on to your baby through your breastmilk.

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In fact, breastfeeding may help protect your baby from infection, as you’ll pass on, in your breastmilk, the antibodies your body is making.

What the experts say…

The only infectious diseases that are absolute contraindications to breastfeeding (in developed countries) are HIV and HTLV-1 [a rare T-cell leukaemia virus], according to Dr Ruth Lawrence, Medical Director of the Breastfeeding and Human Lactation Study Center in Rochester, New York1.

“Breastfeeding when you’re sick actually has a protective effect on your baby,” says our expert family GP Dr Philippa Kaye, “as the antibodies you are producing to fight your illness will be transferred to them through your breastmilk.

“Obviously, if you’re taking any medication for your illness,  you do need to check with your GP or a pharmacist that the medication is safe to take while breastfeeding.

“And you do have to look after yourself too. Feeding a baby when you are unwell can make you feel even more tired, so do rest and ensure you are eating properly and drinking enough to stay hydrated. And, if you feel very unwell, please seek medical advice.”

What medicines can I take if I’m ill when breastfeeding?

If it’s stomach bug or food poisoning…

“If you’re having diarrhoea and vomiting, potentially with stomach cramping or aches,” says Dr Philippa, “just make sure that you are drinking enough water to replace the fluids you’ve lost and ensure that you are hydrated enough to make milk.

“The most important thing is to keep up your fluid intake. Oral rehydration salts such as Dioralyte are safe to use. Don’t worry if you are unable to eat: your reserves should help you pull through a couple of days or so.

“If you need to take something for the vomiting, then always discuss this first with your pharmacist or doctor.” 

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If it’s a fever…

“It is safe to take paracetamol or ibuprofen to bring down the fever,” says Dr Philippa.

If you have a chesty cough and find milk hard to drink, do keep up your fluids with just water.

If I need antibiotics…

There may be times when your illness needs a prescription of antibiotics from your doctor to sort it out. “Don’t suffer nobly because you think antibiotics are bad for your milk,” says Dr Philippa. ‘They’re not and, by avoiding them, you could make yourself even sicker and less capable of looking after your new baby. Your GP will prescribe you antibiotics that are safe for breastfeeding.”

Medications you can safely take when breastfeeding

  • Ibuprofen 2
  • Paracetamol 3
  • Small doses of aspirin 4(check with your GP)
  • Some antibiotics (check with your GP)
  • Rehydration treatments, such as Dioralyte 

Medications to avoid when breastfeeding

  • Prescription painkillers such as codeine 5
  • Cold, flu and cough remedies that contain phenylephrine, phenylpropanolamine or guaifenesin
  • Medications that cause drowsiness

Premature and babies under 1 month old are the most likely to be affected by medications, according to La Leche League GB. If buying over the counter, always check packaging, seek advice from the pharmacist and read the label. 

Will being ill affect my milk supply?

It shouldn’t. “You will continue to make milk for your baby,” say experts at La Leche League GB, “although, if you feel very ill, it may seem as though you are producing less milk. Continuing to breastfeed whenever your baby is interested will help maintain your milk production while you are ill and increase it afterwards if needed.”

But if you feel too unwell to breastfeed, says Dr Philippa, “then the most important thing is that your baby is fed, whether it’s formula or breastmilk. If you’re already fully established breastfeeding, missing a feed or 2 is unlikely to affect your supply.”

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What if I have to have an anaesthetic or go into hospital?

If it’s a planned hospital visit, you may be able to express and store some breastmilk before you’re admitted. If your baby’s very little, you may be able to bring them in with you: ask the question – and also ask if there’s a hospital lactation consultant or breastfeeding specialist who can advise and support you while you’re an in-patient.

Anaesthetic (local or general) does not remain in your system or affect your breastmilk,so it’s safe to breastfeed as soon as you are alert enough to handle your baby – as new mum Laura D, posting on our MadeForMums Facebook page, discovered: “I had to go into hospital with an abscess on my breast caused by mastitis when my baby son was 4 weeks old. I had an operation under general anaesthetic. I carried on breastfeeding throughout… My son’s weight remained level instead of moving upwards for 1 week but, after that, he continued to put on weight happily.”

Pics: Getty

About our expert GP Philippa Kaye

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.

References:

1 Circumstances when breastfeeding is contraindicated. Lawrence RM Pediatr Clin North Am. 2013 Feb;60(1):295-318. dos: 10.1016/j.pcl.2012.09.012. Epub 2012 Oct 30.
2 Can breastfeeding mothers take paracetamol? Prepared by UK Medicines Information pharmacists for NHS healthcare professionals 20 February 2015
3 Can breastfeeding mothers take ibuprofen? Prepared by UK Medicines Information pharmacists for NHS healthcare professionals 24 July 2015
4 Transfer of low dose aspirin into human milk. Datta P et al. J Hum Lact. 2017;33(2):296-299.
5 Reece-Stremtan S et al. ABM Clinical Protocol# 15: Analgesia and anesthesia for the breastfeeding mother, Revised 2017. Breastfeed Med. 2017;12(9):500-506.

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