Sorry for the lull!
I celebrated a milestone birthday with my family last weekend, and almost immediately after, all three of my kids came down with colds and cough. My 21-month-old toddler also developed a high-grade fever, and since she doesn’t know to expectorate her phlegm, it would pool in her throat and cause her to gag and vomit. There was a time when we thought that we would have to confine her, so we brought her to our pediatrician, and aside from the respiratory tract infection (probably viral), he also diagnosed her with bilateral otitis media (middle ear infection of both ears). She’s been on an antibiotic since yesterday, and I’m happy to say that her fever is finally going down. I’ve been especially paranoid since not only am I worried for her health and that of her brothers; I’m also worried for my own because the household jars to a halt when I am sick.
Nebulizing our sick toddler.
These ongoing health issues brought to mind one of the questions that I often encounter in Mommy groups: Should we continue breastfeeding if the baby is ill? Conversely, should we continue breastfeeding even if we are sick?
For the first question, the answer is a resounding YES. For one thing, babies who are unwell are likely to lose their appetite and get dehydrated. I experienced this firsthand with my toddler; although she can already eat finely chopped/osterized versions of table food, she refused anything savory for the past two days. We had to resort to oatmeal, taho (soft tofu with sweet sauce), and yogurt. She also did not drink a lot of water, so her urine output decreased. She compensated by nursing more often; waking me up several times throughout the night, when before she’d only wake me up once. Once she started doing this, her urine output went back to normal. (My supply also went up, since she was demanding more milk than usual.)
Also, babies are less likely to vomit up or have difficulty digesting breastmilk compared to any other drink or food, and it is much more nourishing. A mother’s milk constantly adjusts based on her baby’s ongoing needs, particularly if he/she is sick. It also contains antibodies, white blood cells, and protective enzymes that the mother produces against the germs to which both she and the baby have been exposed to, thus helping her little one fight the illness. In fact, studies have shown that sick infants who are breastfed get well faster and have fewer hospital visits.
Nursing is also very comforting for a baby or toddler, and sometimes, they may want to latch just to soothe themselves, even if they are not actually hungry or thirsty. I am used to my toddler using me as a pacifier when she is feeling unwell.
The second question is more complicated, although in most cases, the answer is also YES. (I will discuss the exceptions in a future post.) We can continue breastfeeding even if we have common respiratory tract infections such as colds, cough or flu; gastrointestinal problems such as vomiting and diarrhea; or even mastitis. In fact, the breastfed baby would be less likely to catch the infection of the mother for the same reason as elucidated above–antibodies, white blood cells, etc. It’s just a matter of balancing the effort and increased caloric/water intake necessary for continued breastfeeding, and the rest and self-pampering that one needs when sick.
A problem is that one tends to produce less milk when ill, which we can try to offset by drinking more fluids and taking some galactogogues. Personally, I drink as much water and broth as I can, and ask my housekeeper to make lots of soup incorporating malunggay (Moringa). I also increase my intake of fenugreek, malunggay tea, and lactation chocolate or coffee (more about these in a future post).
In general, one just has to make some sensible precautions when breastfeeding while sick (either Mom or baby), such as the following:
- Wear a mask, especially if you are suffering from a respiratory infection with lots of coughing, sneezing, and nose-blowing. This also makes sense even if it is your baby who is sick; there is no sense in getting sick along with him.
- Try not to kiss or smell your baby for now. I know this is hard. I am very physically affectionate with my toddler and often kiss her on the lips or face or hands, so yes, the struggle is real.
- Keep a bottle of alcohol or hand sanitizer beside you and use it often. Wash your hands whenever you can.
- Sneeze or cough into tissues or the crook of your arm (not into your hands). Use tissues or wipes to clean the nose and face of your sick baby and bin them immediately. Then wash your hands as soon as possible.
- You can take some mild OTC medications such as paracetamol, ibuprofen, or second-generation (non-drowse) antihistamines such as loratadine and cetirizine, but try to steer clear of strong pain-relievers (ex. Tramadol, Dolcet); first-generation antihistamines that can make you and your baby drowsy (ex. diphenhydramine-Benadryl, hydroxyzine-Iterax), decongestants such as phenylephrine or phenylpropanolamine that can decrease your supply (ex. Decolgen, Neozep, etc.); and some expectorants (ex. guaifenesin).
- Sanitize the surfaces that the sick person has touched before someone else touches them. This is especially important with toys and gadgets.
- When everyone is well, deep-clean the house. Change all the bedsheets and pillowcases, and spray everything with a disinfectant such as Lysol.
What do you do when either you or your baby gets sick while you are breastfeeding?