Viral gastroenteritis, commonly known as the stomach flu, is an inflammation of the stomach and intestines causing symptoms like vomiting, nausea, and diarrhea. When a nursing parent contracts this highly contagious illness, the primary concern is whether it is safe to continue breastfeeding and if the baby is at risk of infection. Guidance is needed to manage the mother’s acute symptoms while safely maintaining the feeding relationship.
Is Breastfeeding Safe During Stomach Flu?
Continuing to breastfeed during a bout of the stomach flu is safe and highly recommended by health experts. The viruses that cause gastroenteritis, such as norovirus and rotavirus, are not transmitted through breast milk itself. The mother’s immune response produces specific antibodies that pass directly into the milk, providing the infant with a specialized defense. Secretory Immunoglobulin A (sIgA) coats the baby’s intestinal lining, neutralizing the virus and preventing attachment to the gut wall. Breast milk also contains Human Milk Oligosaccharides (HMOs), which function as decoys, blocking viral particles from infecting the infant’s cells.
Protecting the Baby from Germs
While the milk remains safe, the primary risk of transmission is through the fecal-oral route via contaminated hands or surfaces. Rigorous personal hygiene is the most effective way to prevent the virus from spreading to the baby. Wash your hands thoroughly with soap and water for at least 20 seconds, especially after using the restroom, changing a diaper, or vomiting, and before touching the baby, feeding equipment, or pump parts. Regularly disinfect high-touch surfaces in your home, such as bathroom fixtures, doorknobs, and changing areas, using an effective virucidal cleaner. To minimize direct exposure, avoid coughing or sneezing directly onto the baby, turning your face away during feeds if necessary.
Protecting Milk Supply and Hydration
Hydration and Supply Maintenance
Acute gastroenteritis causes rapid fluid loss through vomiting and diarrhea, which threatens milk production. Since breast milk is nearly 90% water, fluid loss can quickly lead to a temporary decrease in supply. Focus on continuously replacing lost fluids and electrolytes by sipping small amounts of water or an oral rehydration solution (ORS) every few minutes. ORS contains balanced salts and sugars that are absorbed more effectively than plain water. Maintain a frequent nursing or pumping schedule, even if you feel unwell, as stimulation signals the body to continue producing milk.
Medication Safety
If you need relief from acute symptoms, exercise caution with over-the-counter medications. Antidiarrheal medications containing loperamide are compatible with breastfeeding for short-term use. Avoid products containing bismuth subsalicylate, as the salicylate component may transfer to the baby through the milk. For fever or pain relief, acetaminophen or ibuprofen are safe choices at standard dosages.
When to Call the Doctor
For the Parent
Contact a healthcare provider if you experience signs of severe dehydration. These include an inability to keep any fluids down for over 12 hours, a lack of urination, or profound dizziness upon standing. A fever that remains high (above 102.5°F) or symptoms that persist for more than 48 hours also warrant a call.
For the Infant
Monitor for clear indicators of dehydration or worsening illness. Seek immediate medical care if your baby is unusually lethargic or unresponsive, or shows signs of severe dehydration. Signs of severe dehydration include:
- A significantly decreased number of wet diapers (fewer than six in 24 hours for older infants).
- A sunken soft spot (fontanelle) on the head.
- A lack of tears when crying.
- Eyes that appear sunken into the sockets.