When a mother falls ill, continuing to breastfeed is safe and highly recommended. The mother’s body creates a biological defense tailored to the illness, and this protective mechanism is immediately shared with the infant. Stopping nursing suddenly is rarely necessary and can introduce complications for both the mother and the baby.
The Immunity Advantage: Why Nursing While Sick Protects the Baby
The mother’s body begins producing antibodies against a pathogen before she feels the first symptom of sickness. By the time a cough or fever appears, the baby has almost certainly been exposed through shared air and close contact. Stopping nursing at this point would prevent the transfer of protective factors.
The immune system creates antibodies that pass directly into the breast milk to support the baby’s developing immunity. The primary antibody transferred is secretory Immunoglobulin A (sIgA), which is not absorbed into the baby’s bloodstream. Instead, sIgA coats the mucous membranes of the infant’s gastrointestinal and respiratory tracts. This coating acts as a protective barrier, preventing the invading bacteria or virus from attaching to the mucosal surface and blocking its entry into the body’s tissues.
This process provides the baby with “passive immunity” customized to the specific germs both mother and child are encountering. As a result, the baby is less likely to contract the illness, and if they do, the severity of their symptoms is often reduced.
Navigating Common Illnesses and Absolute Contraindications
For most common ailments—including colds, influenza, stomach viruses, and even mastitis—breastfeeding should continue without interruption. These illnesses are generally spread through respiratory droplets or contact, not through the milk itself. Mothers should focus on strict hygiene practices, such as washing hands frequently before handling the baby and nursing, and covering coughs and sneezes.
However, there are a few rare, absolute contraindications where direct nursing is not recommended. These include mothers who have an untreated, active infection with the human immunodeficiency virus (HIV), though current guidance is evolving based on viral load. Breastfeeding is also contraindicated for mothers infected with Human T-lymphotropic virus types 1 or 2 (HTLV-1/2), and those undergoing specific cancer treatments like chemotherapy or using diagnostic radioactive substances.
Another temporary contraindication is active, untreated tuberculosis, requiring separation to prevent airborne transmission. In such cases, the mother can pump her milk to be fed to the baby by another caregiver, as the bacteria is not transmitted through the milk itself. Mothers with active herpes simplex lesions on the breast should cover the lesions and only nurse from the unaffected breast.
Safe Symptom Management and Supply Maintenance
When managing symptoms, most over-the-counter pain and fever reducers are compatible with nursing. Medications such as acetaminophen and ibuprofen are preferred options because only minimal amounts pass into the milk. For any other medication, including herbal supplements or prescription drugs, consult a reliable source like the LactMed database or a physician to confirm safety for the infant.
Certain cold and flu medications should be approached with caution, particularly oral decongestants that contain pseudoephedrine or phenylephrine. These ingredients are known to potentially decrease the milk supply. Non-sedating antihistamines are generally safe for the baby, but some may also reduce milk production.
Maintaining milk supply while ill requires frequent milk removal. Illnesses, especially those involving fever, vomiting, or diarrhea, can quickly lead to dehydration, which temporarily affects milk volume. Staying well-hydrated with water and electrolyte drinks is paramount. Continue emptying the breasts on a regular schedule, either by direct nursing or by pumping, even if the baby is temporarily nursing less due to the mother’s fatigue. Resting in bed with the baby and allowing frequent nursing helps both recovery and supply.