Can I Breastfeed if I’m Sick?

The answer to this commonly asked question is usually yes! Except in certain circumstances, lactating parents can and should continue breastfeeding when sick. We talked with TLN IBCLC Demi Lucas about being sick and breastfeeding, including when to stop or pause breastfeeding, special cases like COVID-19 and monkeypox, and precautions to take to keep you and your baby safe and healthy. 

Breastfeeding While Sick

It’s a common misconception that breastfeeding while you’re sick will pass the illness through the milk to the baby. Almost the opposite is true. Lucas says, “The breastfeeding parent’s body will produce antibodies that will transfer through the milk and protect their infant from illness. In the case of many viral and bacterial infections, the baby is exposed days before the parent realizes they are ill. The parent’s body starts producing antibodies for their baby, providing them important protection in the early days of illness.” By breastfeeding your baby, they will benefit from the antibodies you develop, which will help prevent or fight off that sickness.

When to Stop or Pause Breastfeeding

Lucas says, “These are very rare and few cases in which breastfeeding or providing one’s milk would be contraindicated. In some cases, breastfeeding may need to be paused temporarily, or a parent can provide expressed milk.” You should NOT breastfeed or provide expressed breast milk if you are:

• HIV positive
• Infected with human T-cell lymphotropic virus (type l or type ll)
• Diagnosed with Ebola virus

In these few instances, breastfeeding can transmit the virus or disease to your baby through your breast milk. You should temporarily pause breastfeeding if you have:

• Untreated Brucellosis
• Untreated tuberculosis 
• Active lesions on the breast from herpes
• CMV and an extremely low birth weight preterm infant (less than 1500 grams)
• Chicken pox which developed within five days before delivery to two days following delivery
• Monkeypox (more on this a little later!)
• Or are taking certain medications or undergoing certain treatments

In some of these cases, such as tuberculosis and chicken pox, you can still feed your infant expressed breast milk while you pause breastfeeding. If you have herpes you can breastfeed from the unaffected breast if the lesions are completely covered. 

While temporarily not breastfeeding, lactation support can help you maintain milk production and continue to feed your baby. Consult with your doctor and IBCLC if you are unsure if you should breastfeed. They can also help you determine when it’s safe to resume breastfeeding.

Special Cases

COVID-19

According to a statement from the CDC, current evidence suggests that a parent with COVID-19 cannot spread the virus to their baby via breast milk. If you are diagnosed with COVID and plan to breastfeed, you should wash your hands and wear a mask while feeding (and whenever you are within six feet of your baby). You can also express breast milk to be bottle-fed to your baby by a healthy caregiver. You should still wash your hands first and wear a mask while pumping. 

The COVID-19 vaccine is safe for people who are pregnant, breastfeeding, or trying to get pregnant. 

Monkeypox

Because monkeypox is a relatively new virus, data on how it affects breastfeeding is still limited, and it is unknown if it can be transmitted through breast milk. Monkeypox is traditionally transmitted through direct contact and by touching objects used by the person with monkeypox. Due to the risk of neonatal transmission and the potential for severe disease in newborns, breastfeeding is not advised. 

If you have monkeypox, the CDC recommends isolating until all lesions have resolved, the scabs have fallen off, and a fresh layer of intact skin has formed. Continue to express breast milk to encourage your milk supply but discard any expressed milk until you are recovered. Working with an IBCLC can help you maintain milk production and avoid infection while healing.

Medications

Although many over-the-counter (OTC) medications do pass into breast milk; most do not have any known adverse effects on milk supply or the well-being of your baby. Certain OTC medications, like naproxen (Aleve), should not be taken. Lucas recommends using resources like the InfantRisk hotline and website and consulting with your doctor and IBCLC about the risks and benefits of different medications. Most drugs that might raise concerns are prescription-only, not OTC.

Things to Keep in Mind When You’re Sick

• If possible, have another caregiver help you take care of your child so that you can rest. 
• Be extra diligent about washing your hands frequently, disinfecting surfaces, and covering your mouth and nose when coughing or sneezing.
• Drink plenty of fluids and rest as much as you can.
• Take a break if you need to. Even though breastfeeding while sick is safe, if you’re feeling bad and need some respite, that’s okay.  Lucas says to express milk every two to three hours to avoid developing a clog or mastitis. 
• If you do breastfeed while sick, remember that you’re passing on amazing antibodies that will give your little one’s immune system a big boost.
• Get vaccinated!

Remember, if you’re sick, one of the best things you can do for your baby is to feel better soon. So rest, recover, and remember to lean on others during this time—including your IBCLC. In addition to in-person visits, TLN also provides telehealth consultations so you can virtually meet with your IBCLC, even when you’re feeling under the weather. As always, you deserve care.