As a certified breastfeeding counselor (CBC) you will run into many lactation concerns. Breastfeeding and illness is a common concern new and even experienced breastfeeding moms have. Often parents wonder if it’s safe to breastfeed while ill. They also frequently have concerns about milk supply.
As a CBC, you cannot provide medical advice, but you can provide lactation education and support. When you know the evidence behind the safety of breastfeeding during illness you can use that to educate your clients. When you understand the process of supply and demand, you can help clients manage breastfeeding while under the weather.
Breastfeeding And Illness – Is It Safe To Breastfeed While Sick?
The simplest answer, is yes, it is very safe to breastfeed during illness. There are very few things which truly contradict breastfeeding. On the population level in the US, the AAP says the only true contradictions to breastfeeding are:
- “Infants with classic galactosemia (galactose 1-phosphate uridyltransferase deficiency)
- Mothers, in the US, who are infected with human immunodeficiency virus (HIV)”
Glactosemia is a congenital metabolic condition and is not related to an infant or mother’s illness. In the US, it’s advised women not breastfeed if they are infected with HIV. In some developing countries, the recommendations are different due to access to feeding substitutes and safe water sources.
Neither the AAP nor the World Health Organization recommend breastfeeding cessation for colds, influenza or even Covid-19. The following do not contradict breastfeeding per the AAP:
- “Infants born to mothers who are hepatitis B surface antigen-positive
- Mothers who are infected with hepatitis C virus (persons with hepatitis C virus antibody or hepatitis C virus-RNA-positive blood)
- Mothers who are febrile (unless cause is a contraindication outlined in the previous section)
- Mothers who have been exposed to low-level environmental chemical agents
- Mothers who are seropositive carriers of cytomegalovirus (CMV) (not recent converters if the infant is term)
- Mothers who smoke tobacco (though they should be encouraged to quit) or have an occasional celebratory drink
- The great majority of babies with jaundice or hyperbilirubinemia can continue to be breastfed without interruption”
As you can see, there are few circumstances where illness requires breastfeeding cessation. Often, it is complications from illness which lead to early weaning. As a CBC, you can help parents navigate these challenges and maintain breastfeeding.
What Breastfeeding Challenges Happen With Illness?
If a mother is ill, she may need extra support to rest. If she’s unable to be properly supported, fatigue can play a role in breastfeeding management.
Mothers who are sick are also prone to dehydration. While acute dehydration does not impact breastfeeding, prolonged dehydration could make breastfeeding more challenging. Occasionally due to supply drops, but often due to mom just being too unwell to feel confident in feeding.
There are also certain medications, herbs and essential oils mothers might use during common colds and illnesses which could influence milk supply. Some of these things include but are not limited to:
- Cold medicines with pseudoephedrine
- High dose steroids
- High doses of certain antihistamines such as diphenhydramine
- Consuming large amounts of menthol (via cough drops, cough syrup, etc.)
- Peppermint oils or tea
- Lemon balm
- Spearmint
- A lot of parsley (regular amounts in soup unlikely to be problematic, but large amounts might impact some women)
As a CBC, you cannot provide medication recommendations. However, you can provide information and sources to help them make informed decisions. Even if a mother consumes the above and has supply issues, on demand feeding can increase supply again. Milk supply dips are typically temporary as long as frequent feeds are reestablished.
While you cannot provide medication information, you can refer them to sources such as the Infant Risk Center.
How Do You Support A Mom Who Is Ill?
Every mother and illness is unique. Again, as a CBC you cannot provide medical or medication advice. However, you can reassure her of the safety of breastfeeding during common illnesses. You can help her understand the benefits of antibodies in breast milk and how that’s protective for her infant.
You can reassure parents that should their infant catch the illness, continued breastfeeding can help them fight it off. Helping parents to understand that any supply dips are temporary and feeding on demand more frequently will help.
It’s also important to acknowledge that the mother may not be feeling her best. Let her know extra rest is not only okay, it’s encouraged. Remind her that it’s okay for another to feed the baby expressed milk, or even formula if needed, if she is quite unwell and needs to sleep. If mother baby separation is needed due to hospitalization, remind her that she can breastfeed upon reunion and express as much as she’s able to. She needn’t worry about how much she gets but maintaining frequent stimulation.
As a CBC you are there to support mothers with evidenced based information, while also supporting them whatever their breastfeeding goals are. Any medical or medication concerns should be directed to their doctor, pharmacist, or other qualified medical professional.