By Anne Smith, IBCLC
When you are sick, you and your baby will almost always benefit from continuing to breastfeed. There are very few illnesses that require a mother to stop nursing. Since most illnesses are caused by viruses, that are most infectious before you even realize you are sick, your baby has already been exposed before you even develop symptoms (such as fever, diarrhea, vomiting, rash, runny nose, cough, etc). Continuing to breastfeed will help protect your baby from the infection, because your body produces antibodies to the specific bug that is causing the infection, and you pass them on to the baby in your milk. Often, a breastfed baby will be the only member of the family who doesn't get sick. If he does get sick, he will usually have a much milder case than the older members of the family.
Illnesses are most often transmitted through skin contact and secretions from the mouth and nose. Be sure to wash your hands often, and try to avoid face-to-face contact (and sneezing directly on the baby).
Nursing your baby while you are sick makes it easier for you to rest. Tuck him into bed with you to nurse, then have someone take him away when you're done. I remember being so sick that my older kids would bring the baby in to nurse every couple of hours, and I was so out of it that I didn't even know when she nursed.
Weaning abruptly is never a good idea, especially when you are sick. You put yourself at risk for engorgement and mastitis, as well as the emotional trauma of sudden weaning for both you and the baby.
You do need to make sure that you get plenty of fluids when you're sick, because you don't want to become dehydrated. Often your milk supply will decrease during and immediately after your illness, but your supply will build back up when you feel better.
Here is some general information about OTC (over the counter) drugs and breastfeeding -- remember, though, that drug manufacturers often change their active ingredients, so always read the label carefully and/or consult your health care provider before taking any drug when you are nursing.
• Analgesics: avoid extra-strength formulas -- Aleve, Anacin-3 Regular Strength, Tempra, Tylenol (Acetaminophen), and Excedrin are generally safe. Motrin and Advil (Ibuprofen) are ok if the dose is 400mg or less.
• Antacids and digestive aids which are usually ok to take: Lact-Aid, Lactobacillus acidophilus, Tums and Tums E-X or Ultra, Mylanta or Mylanta extra-strength, Mylicon, Maalox, DiGel, Gaviscon, Alka-Seltzer, Phazyme, Rolaids, and Pepto-Bismol Original or Extra Strength.
• Antidiarrheal Medications: preparations containing "attapulgite" (such as Donnagel, Diasorb, Kaopectate, and Rheaban), as well as those containing "loperamide" (such as Imodium A-D, Kaopectate 1-D, and Pepto-Bismol) are usually not harmful.
• Artificial Sweeteners: Avoid saccharin (Sweet'n'Low) because we just don't know. Aspartame (Equal or NutraSweet) are ok unless your baby has PKU ( a very rare metabolic disorder which every baby should be screened for soon after birth -- ask your doctor if you're not sure).
• Cough, Cold, and Allergy Preparations: Try to use single ingredient, short acting forms of the drug.
• For sore throats, avoid lozenges and sprays which contain phenol, or hexylresorcinols. (These include Cepastat, Listerine, and Sucrets lozenges, and Vicks Chloraseptic Sore Throat Spray). Instead, choose Celestial Seasonings, Cepacol Lozenges, NICE Lozenges, and Vicks Lozenges (these contain menthol/and/or benzocaine rather than phenol. You can also use Sucrets Lozenges if they contain dyclonine rather than hexylresorcinols.
• For allergies and sinus congestion: Actifed, Benadryl, Benylin, Chlor-Trimeton, Dimetapp, Drixoral, Gualifed, Sinutab Non-Drying, Sudafed, Tavist-D, Triaminic, and Vicks Dayquil Sinus Pressure and Pain Relief are usually ok.