Parents often worry about passing an illness, such as a cold or the flu, to their infant through nursing. They question whether continuing to breastfeed is safe or might contaminate the milk. General guidance is highly reassuring: in the vast majority of typical illnesses, continuing to breastfeed is the recommended course of action. Stopping suddenly can introduce unnecessary complications for both the parent and the baby, and the unique biological components of the milk provide a natural protective mechanism.
Immune Protection During Maternal Illness
The body often responds to an infection before the parent experiences symptoms. This rapid response means the immune system begins producing specific defenses that are passed directly to the baby through the milk. These protective agents include specialized white blood cells, known as leukocytes, and high concentrations of a specific antibody called Secretory Immunoglobulin A (sIgA).
Maternal leukocytes migrate from the bloodstream into the milk, providing active immunity to the infant. The sIgA antibodies coat the baby’s gastrointestinal and respiratory tracts, preventing pathogens from attaching and causing illness. This targeted defense system gives the baby a tailored shield against the exact illness the parent is fighting.
Maintaining Milk Supply and Comfort
Illness often brings physical challenges for the nursing parent, including fatigue, fever, and dehydration, all of which can affect milk production. Since the body prioritizes healing, this increased energy expenditure can temporarily slow down milk synthesis. To counteract this, aggressive hydration is necessary, including drinking water, broths, and electrolyte-rich beverages to replenish fluids lost through fever or sweating.
Finding time for rest is also important to support recovery and milk production. A “nurse-cation” involves resting in bed with the baby and allowing them to nurse frequently and on demand. This maximizes skin-to-skin contact, which naturally stimulates milk production hormones while providing the parent with rest. If the parent is too weak to hold the baby for direct feeding, using an electric pump to express milk is an effective alternative. Frequent milk removal, whether by baby or by pump, is the single most important factor for maintaining the established supply.
Navigating Medication Safety
A primary concern when ill is whether common medications can be taken safely while nursing. Only a small amount of most medications transfers into the milk, often less than one percent of the maternal dose. For pain and fever relief, over-the-counter options like acetaminophen and ibuprofen are generally compatible with nursing. Ibuprofen is a preferred choice because it is nearly undetectable in milk, with infants receiving an average of only 0.2 to 0.3 percent of the maternal dose.
When choosing cold and flu remedies, caution is needed regarding certain ingredients, especially oral decongestants. Medications containing pseudoephedrine or phenylephrine can actively reduce milk supply by interfering with prolactin, the primary milk-making hormone. Studies show a single dose of pseudoephedrine can decrease milk production by up to 25 percent. Safer alternatives for congestion include saline nasal sprays or steam inhalation, as these localized treatments do not enter the bloodstream or milk supply significantly.
To minimize infant exposure, the best practice is to take necessary medication immediately following a nursing session. This timing allows the drug’s concentration in the parent’s bloodstream and milk to peak and decline before the baby feeds again. For any medication, including herbal remedies or combination cold products, the parent should consult a healthcare provider or a trusted resource like the Drugs and Lactation Database (LactMed). This resource provides data on medication transfer into breast milk, potential infant side effects, and safer alternatives.
Conditions Requiring Temporary Cessation
While continuing to nurse is safe for the vast majority of common illnesses, a few rare circumstances require temporary cessation or specific precautions. One such situation involves an untreated, active infection with tuberculosis, where the primary risk is airborne transmission. In these cases, the parent should temporarily separate from the baby, but they should continue to pump and discard their milk until they have been on appropriate treatment for at least two weeks.
Temporary cessation is also necessary for certain medical procedures involving radioactive agents or specific chemotherapy treatments, as these substances can be incompatible with nursing. Additionally, if the parent develops active, contagious lesions, such as those from herpes simplex or impetigo, directly on the breast or nipple, nursing on the affected side must stop until the lesion has completely cleared. These specific instances are uncommon, and any parent facing such a situation should immediately consult their healthcare team for a plan to maintain their milk supply and safely resume nursing.