Should I Stop Breastfeeding with the Flu?

With the 2017-18 flu season being considered moderately severe, many people are staying home from work and school with fevers, muscle aches, fatigue, and chills[1]. Because this is my youngest’s very first winter, my family has been taking some extra steps to keep ourselves healthy this year. Sometimes though, you’re just going to get sick. And when one member of the house falls ill, one of the best ways to keep the rest of the family healthy is to isolate them to a separate room to recuperate. The only real exception to this case would be breastfeeding mothers, they should always have access to their infant.

In fact, according to the CDC, there are only select infections, like HIV and TB, where breastfeeding is not advised[2]. So, to see the CDC recommend that newborns be “temporarily” separated from “the mother who is ill with suspected or confirmed influenza” honestly comes as a complete surprise[3]. The sad thing is that “the optimal length of temporary separation has not been established” and separation can last anywhere from 24-48 hours, or until the mother is able to “control her cough and respiratory secretions.”

The Issues with Separation

While the CDC does recommend that the mother be encouraged to pump during the duration of the separation, it seems to be forgotten here that breast pumps are not the same as nursing an infant. Researchers from the University of Michigan determined that breast pumps were less effective than a suckling baby, and therefore put the mother at in increased risk of developing mastitis or supply issues[4]. And, according the NHS, lots of skin to skin contact in the early weeks can be extremely beneficial to creating a successful breastfeeding relationship[5]. Newborn separation from the mother not only stresses the baby[6], but can affect the child’s demeanor and aggression level well into childhood[7]. 

The Flu-Fighting Abilities of Breastmilk

Potentially the most dangerous aspect of this recommendation by the CDC is that it robs the baby of the most protective substance against the flu available to them. Because breast pumps don’t adequately empty the breast, many mothers have experienced the need to supplement with formula during a period of exclusive pumping. And, as many lives as formula may have saved, it simply doesn’t offer the antibodies and protective abilities that breastmilk does. It has actually been documented that breastmilk actively produces high levels of anti-influenza antibodies, and may provide protection for the infant[8]. And even if the baby was exclusively bottle-fed breastmilk during the isolation period, it’s still not quite as good as eating straight from the source. In one study, using ultrasound technology, scientists found that as the infant suckles from the breast, the ducts open and close, allowing some of the baby’s saliva to be sucked back into the breast[9]. This baby backwash is then analyzed by the mother’s body, and if the presence of harmful microorganisms is detected, her body begins producing more white blood cells – specifically tailored to fight the bad guys attacking the feeding baby.

The biggest issue a nursing mother might face while fighting the flu is a potential decrease in supply due to dehydration. Staying tucked away in bed, healing and nursing baby, with a bottle of water beside you, always is the best way to recover and prevent your baby from getting sick. Feel better soon, and nurse on.

Until next time,
Savannah

 

References:

1. The New York Times Already ‘Moderately Severe’, Flu Season in U.S. Could get Worse

2. CDC Maternal or Infant Illnesses or Conditions
https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/index.html
3. CDC Guidance for the Prevention and Control of Influenza in the Peri- and Postpartum Settings 
https://www.cdc.gov/flu/professionals/infectioncontrol/peri-post-settings.htm
4. University of Michigan School of Public Health Mastitis Among Lactating Women: Occurrence and Risk Factors
https://pdfs.semanticscholar.org/2039/e405efec235daaad65eaf2cb36d46006a976.pdf
5. National Institute for Health Research Skin-to-Skin Contact Improves Breastfeeding of Healthy Babies
https://discover.dc.nihr.ac.uk/content/signal-000400/skin-to-skin-contact-improves-breastfeeding-of-healthy-babies
6. Science Daily Maternal Separation Stresses the Baby, Research Finds
https://www.sciencedaily.com/releases/2011/11/111102124955.htm
7. NCBI Early Mother-Child Separation, Parenting, and Child Well-Being in Early Head Start Families 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3115616/
8. PLOS One IgA and Neutralizing Antibodies to Influenza A Virus in Human Milk: A Randomized Trial of Antenatal Influenza Immunization
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0070867
9. Science News Backwash from Nursing Babies May Trigger Infection Fighters
https://www.sciencenews.org/blog/growth-curve/backwash-nursing-babies-may-trigger-infection-fighters