When a mother who is breastfeeding contracts the flu, the immediate concern is managing symptoms effectively without exposing the infant to potentially harmful medications. The flu often presents with fever, body aches, congestion, and cough, requiring prompt symptom relief for the mother’s recovery. While many over-the-counter flu remedies are available, nursing status requires careful consideration of each medication’s safety profile and its potential transfer into breast milk. This information serves as a general guide, and any decision regarding medication use while nursing should always be made in consultation with a healthcare provider.
Continuing to Breastfeed While Sick
A mother who contracts the flu should continue to breastfeed, as the illness is generally transmitted through respiratory droplets, not through the milk itself. Continuing to nurse during a viral illness is beneficial because the mother’s body rapidly produces specific antibodies in response to the infection. These protective antibodies are transferred directly to the baby through the milk.
Secretory IgA antibodies coat the mucous membranes in the infant’s respiratory and gastrointestinal tracts, providing passive immunity and neutralizing the virus before it can cause infection. This transferred immunity offers a protective layer against the strain of flu the mother has. To minimize the risk of direct transmission, the mother should practice simple hygiene, such as thorough hand washing before touching the baby or feeding equipment. Wearing a face mask while nursing or holding the infant can also significantly reduce the spread of respiratory droplets.
Safe Over-the-Counter Medications for Flu Symptoms
Managing flu symptoms safely involves selecting single-ingredient medications that have minimal transfer into breast milk and a low risk of adverse effects for the nursing infant. For generalized aches, pains, and fever, Acetaminophen is considered a good choice for nursing mothers. This pain reliever transfers into breast milk in very small amounts, and adverse effects in breastfed infants are rare.
Another effective option for pain and inflammation relief is Ibuprofen, which is also found in breast milk at very low levels. Studies show that the amount of Ibuprofen passed through milk is significantly lower than the doses typically given directly to infants. Nursing mothers should always use the lowest effective dose of either pain reliever and avoid long-acting formulas, which can lead to rapid accumulation in the baby’s system.
For cough and chest congestion symptoms, single-ingredient products are preferred. An expectorant like Guaifenesin helps thin mucus secretions, making coughs more productive, and is compatible with breastfeeding. For a dry cough, the suppressant Dextromethorphan can be used, as it is minimally present in breast milk and is not expected to affect the infant. For a sore throat, local treatments such as lozenges and throat sprays are generally safe because the active ingredients are absorbed locally, minimizing systemic exposure.
Medications to Avoid or Use With Extreme Caution
Certain ingredients commonly found in flu and cold preparations should be avoided or used with great caution by nursing mothers due to the risk to the infant or to the mother’s milk supply. Oral decongestants containing Pseudoephedrine pose a notable risk to milk production. A single 60-milligram dose of Pseudoephedrine has been shown in studies to reduce breast milk production by an average of 24% over a 24-hour period.
Phenylephrine, another common oral decongestant, is also generally not advised for breastfeeding women, though its effect on milk supply is less studied than Pseudoephedrine. Both decongestants can also cause irritability in the infant. Instead of oral decongestants, mothers should consider topical nasal sprays, which act locally in the nasal passages and do not affect the milk supply.
Sedating or first-generation antihistamines, such as Diphenhydramine, should only be used occasionally and for a short period. These medications can cause drowsiness in the mother and potentially in the baby, leading to poor feeding or excessive sleepiness, and they may also reduce milk supply. Aspirin, or any product containing salicylates, should be avoided for flu symptoms due to the risk of Reye’s syndrome in infants during a viral infection.
Non-Medication Comfort Measures and Home Care
Beyond medication, several supportive measures can help manage flu symptoms and promote recovery without risk to the infant. Staying well-hydrated is important, as fever and increased mucus production can lead to fluid loss, which may negatively impact milk supply. Consuming water, clear broths, and electrolyte-containing drinks helps maintain fluid balance.
Rest is also important for recovery, and mothers should try to delegate non-essential duties to allow the body time to heal. Other non-medication methods offer relief:
- Prioritize rest and delegate non-essential duties to allow the body time to heal.
- Use a humidifier or inhale steam from a hot shower to help loosen mucus.
- Use saline nasal rinses or sprays to safely clear the nasal passages.
- If too weak to nurse directly, express milk with a pump to maintain milk supply until recovery.
Warning Signs and When to Call a Doctor
While most cases of flu resolve without complications, certain symptoms in both the mother and the infant require immediate medical attention. A mother should contact her doctor if she experiences difficulty breathing or shortness of breath, persistent chest pain or pressure, or sudden dizziness or confusion. A fever that persists beyond three days or returns after initially improving also requires professional evaluation.
For the infant, watch for signs that suggest the illness is worsening or that they are not tolerating a medication. These signs include decreased wet diapers, lethargy, poor feeding, or a high fever. If the mother’s symptoms are severe, a doctor may prescribe an antiviral medication such as Oseltamivir, which is considered safe for breastfeeding mothers as only minimal amounts are transferred into breast milk.