Breastfeeding in the flu season

Winter has arrived with a bang here in sunny South Africa, and it seems as if every second person I meet has a case of the sniffles. And alas, sometimes we and our babies also get sick. Consider this your guide to breastfeeding when either you or your baby have the flu.

Flu title

When mom has the flu

Is it safe to breastfeed?

If you get sick while breastfeeding, it’s only natural that you will worry about passing on the infection to your baby. But here’s the truth of it: your baby is already exposed to whatever virus you have (Since you only develop symptoms after you’ve been incubating the virus for a few days). Continuing to breastfeed is absolutely the best way to prevent your baby from getting ill too. Because of the wonderful way our bodies work, your breast milk is full of antibodies that are specifically designed to attach the exact virus or bacteria that is making you ill. In that sense, it’s kind of like a vaccine and medicine for your baby, all in one delicious package.

This reminds me of what happened to us when my youngest was still very small. Everyone in our house caught some ghastly flu bug – me, my husband, our eldest son, even the housekeeper! Except, of course, for the (exclusively breastfed) baby. He was the only one that came off without so much as a sniffle. It just goes to show how powerful breast milk is.


It’s important to make sure that the medicine you take is safe for baby. You can find a whole detailed post on medication use during breastfeeding here, but I’ll repeat the most important stuff regarding the treatment of colds and flu here:

  • Let’s start with antibiotics. Remember, the common cold and flu are both caused by viruses, so antibiotics will have no effect on them; but sometimes you can develop a secondary infection (e.g. pharyngitis or sinusitis) that may require antibiotics. Fortunately, the vast majority of antibiotics are safe to use while you breastfeed. Remember to take a probiotic to prevent thrush.
  • Pain and fever: paracetamol (acetaminophen) and ibuprofen are both good choices, with minimal amounts going to your breast milk. For more severe pain, you can consider using diclofenac (Cataflam/Voltaren). Avoid aspirin.
  • Congestion: AVIOD using any medication with pseudoephedrine; it is known to cause a drop in milk supply (and be warned: doctors and pharmacists don’t usually know this, so they may give it to you by mistake. Check the labels of everything they give you). Nasal sprays containing oxymetazoline or xylometazoline are effective and safe.
  • Runny nose and eyes: Antihistamines should be used with caution. There are some reports that it may decrease milk production, but it is not a consistent finding in the research. Newer, non-sedating antihistamines have a good track record so far.
  • Cortisone and prednisolone: these do not transfer well into breast milk, so a short course taken while you have flu is unlikely to do any harm.

Of course, remember all the non-medicinal measures that you can take: honey and lemon juice to soothe a sore throat and ease coughing, saline nasal spray to clear mucus, essential oils on a tissue to help ease breathing and, most importantly, lots of rest!

There’s also a variety of homeopathic remedies for colds and flu. I have no background in natural medicine, so I won’t recommend any fancy homeopathic preparations here, but it’s worth talking to someone who knows these things. I have found that Echinacea and Elderberry extracts help me to get over a bout of the sniffles faster.


I’ve already mentioned this, but let me say it again: you need to rest! If you overdo it now and keep breaking yourself down, you’ll not only stay sick for longer, you put yourself at higher risk of getting mastitis. Stay in bed if you can; leave all non-life-threatening work until you feel better and just rest as much as possible. Keep baby close to you for breastfeeding, and offer up a prayer of thanks that you don’t have to bother with sterilizing bottles and mixing formula now.

Drink a lot of fluids, especially if you’re feverish – you can easily become mildly dehydrated while ill, and that will have a negative effect on your milk supply.

Flu vaccines

Just a note about flu prevention: Women often ask whether it is safe to get a flu vaccine while breastfeeding. From a purely scientific standpoint, the answer is yes: your baby will not get any flu virus in your milk. The antibodies that you develop in response to the vaccine will be transferred through your milk, though, so baby will also get some protection from flu.

When baby has the flu

When it’s baby that’s sick with flu, it’s a whole other ball game. There can’t be a more helpless feeling than being the parent of a sick baby, and not knowing what you can do to make it better! But as usual, one of the best things you can do is simply to keep breastfeeding.

Breast milk is the best medicine!

We all know that breast milk is full of antibodies and other disease-fighting ingredients, but do you know just how amazing it is? When baby breastfeeds, little bits of his saliva are drawn up into the breast ducts. Your breasts detect the viruses and other germs in the saliva and immediately start pumping out antibodies that are targeted to attack that exact virus. And don’t worry if you’re an exclusive pumper – by kissing and breathing near your baby, the germs will still get into your body, and your milk will still contain those specific antibodies. So when baby is sick, your breast milk becomes a tailor-made medicine.

Some people worry that breast milk will cause an increase in mucus production, or that it will worsen symptoms like vomiting or diarrhoea. Nothing could be further from the truth – breast milk is not cow’s milk; breast milk is the perfect food for a human child.

Practical tips on how to keep breastfeeding

There’s just one big practical problem when you try to breastfeed a baby that has a cold or flu: the blocked nose. Usually babies suck and breathe at the same time, only pausing in their breathing to swallow. Obviously, this doesn’t work so well if baby’s nose is blocked. You can help baby by clearing the mucus out of his nose before feeding.

First off, you need to soften or loosen the mucus a bit. You can use plain saline nose drops for this, or just squirt a bit of breast milk in their (babies seem to prefer the milk option; I suspect it doesn’t sting as much). Next, you can use a bulb syringe (or something like a NoseFrida) to suck the mucus out of baby’s nose. Baby will not like this, so be prepared for a bit of a fight. Once baby’s nose is clear enough that he can breathe through it, you may want to put in some decongestant nose drops (speak to your pharmacist about these) – they are not essential, but I’ve found they can be really helpful to keep baby’s nose clear for a while. At night, putting on a humidifier with some eucalyptus oil or olbas oil can help to keep baby’s airways clear.


Do I need to say this? It’s important to observe good hygiene whenever anyone is sick – wash your hands well after touching anything snotty or anyone that’s sick, and make sure all dirty tissues go straight into the bin. And while you should definitely keep breastfeeding if you’re ill, it may be best to keep other ill people far away from baby.

In conclusion

To wrap this up, I will summarise everything I just said in two sentences: If you get sick, keep breastfeeding. If baby gets sick, keep breastfeeding. That’s the heart of the matter; everything else is common sense. I hope and pray that you will come through this winter without having to struggle with any illness; but if you do, at least you are now prepared to deal with it and keep breastfeeding!

I’m writing this just as I’m recovering from a terrible head cold that turned into a ghastly, can-I-please-amputate-my-head-now case of sinusitis, so it’s pretty fresh in my mind. How’s your winter going so far? Have you had any sniffles yet? Leave a comment and tell me about it!

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