It is very difficult for a mother who is unwell, and she will benefit from as much support as possible from other caring adults.
As a general rule, mothers are able to breastfeed their baby or babies when they are unwell, provided that they are fully conscious and aware of what is going on, and do not have one of the small number of conditions or medications that would make breastfeeding unwise or dangerous.
Coughs, colds, ‘flu, Covid 19, tummy upsets and other illnesses are horrible for the mother. However, she will be making antibodies in her body to fight off her illness, and by continuing to breastfeed she will pass these on to protect her baby. This works the other way round too, when baby is sick the mother’s body works to protect her little one too.
Good hygiene is very sensible in these situations, for example washing hands thoroughly before handling the baby or baby kit, and not coughing or sneezing on little one. If at all possible, another well adult should look after baby in another room while the mother is sick, just bringing in her baby for breastfeeds. If it is possible for a mother to express her milk into a sterile container, and for another well adult to feed the baby expressed milk from a bottle, this could be a very sensible precautionary approach.
If the mother has an active cold sore (herpes simplex) this can be dangerous for her baby and it is vital that she does not kiss her baby and practices very good hand hygiene. She must not share anything that comes into contact with her cold sore including towels and cutlery.
When shouldn’t I breastfeed?
Some medications pass into breastmilk and can be dangerous for a baby. Please speak to your healthcare team before considering breastfeeding if you are taking:
- Antiretroviral medications (for HIV/AIDS treatment)
- Birth-control medications containing estrogen, the “combined pill”
- Cancer chemotherapy agents
- Illegal drugs
- Certain medications prescribed to treat migraines, such as ergot alkaloids
- Mood stabilizers, such as lithium and lamotrigine
- Sleep-aid medicines
In addition, women who are undergoing radiation therapy should not breastfeed, although some therapies may require only a brief interruption of breastfeeding.
The advice around breastfeeding after general anaesthetic and certain diagnostic procedures is a little mixed and confusing. Some medical professionals suggest that mothers pump and dump their breastmilk for a certain time after a procedure, others suggest that the mother can breastfeed when she feels well enough. Please talk to your health care providers about what they suggest in your particular case.
This section can only provide a rough guideline. Please speak to your healthcare provider about all medications you are taking, or planning to take, including prescription drugs, over the counter medicines, vitamins and herbal therapies. The Breastfeeding Network in the UK has fabulous online resources here.
If you are worried that your baby is having a reaction to something in your milk, or is generally unwell, please seek medical help immediately. This could include excessive crying, excessive sleepiness, skin reactions, allergic reactions and diarrhoea.
Women with certain illnesses and infections may be advised not to breastfeed because of the danger of passing the illness or infection to the breastfed infant.
If you have any of the following conditions, breastfeeding your infant is NOT advised.
- Infection with HIV
- Infection with human T-cell lymphotropic virus type I or type II
- Untreated, active tuberculosis
If you are sick with the flu, including the H1N1 flu (also called the swine flu), you should not stop feeding your infant expressed milk. You should avoid being near your infant, however, so that you do not infect him or her. To avoid infecting your infant, someone who is not sick should give your infant your expressed milk.
If you have Zika virus or live in areas where Zika virus is found, breastfeeding is still recommended. Although Zika virus has been detected in breast milk, there are no reports of transmission of the virus through breastfeeding, and the benefits of breastfeeding are thought to outweigh the risks.
Most developed countries advise mothers not to breastfeed if they are HIV positive, as the babies have an increased chance of acquiring HIV through breastmilk.