Can You Pass an Infection Through Breast Milk?
Generally, most infections are not transmitted through breast milk and breastfeeding often continues during maternal illness, offering protection to the infant. However, some specific infections can be passed through breast milk, requiring careful evaluation and management.
Breastfeeding: A Foundation of Infant Health
Breastfeeding provides unparalleled benefits for both mothers and infants. Breast milk contains vital antibodies, nutrients, and enzymes that support infant growth, development, and immune function. The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend exclusive breastfeeding for the first six months of life, followed by continued breastfeeding alongside complementary foods for at least two years or longer. This recommendation stems from extensive research demonstrating the significant advantages of breastfeeding over formula feeding.
The Immunity Transfer Process
A key benefit of breastfeeding is the transfer of maternal immunity to the infant. This occurs through:
- Antibodies: Breast milk contains antibodies, primarily IgA, that coat the lining of the infant’s respiratory and gastrointestinal tracts, providing protection against pathogens.
- Living Cells: Breast milk also contains living cells, including leukocytes (white blood cells), which can help fight infection.
- Cytokines: These signaling proteins modulate the immune response and contribute to the overall protection.
This transfer of immunity is especially important during infancy, when the infant’s immune system is still developing.
Infections and Breastfeeding: A Complex Relationship
The relationship between maternal infections and breastfeeding is complex and depends on the specific infection. While many infections do not pass through breast milk and breastfeeding can continue safely, some infections pose a risk to the infant. It’s crucial to understand which infections fall into each category.
Infections Generally Safe for Breastfeeding
For most common infections, breastfeeding is considered safe and may even provide protective benefits to the infant. These include:
- Common Cold and Flu: Antibodies against cold and flu viruses are passed through breast milk, helping the infant fight off infection.
- Gastroenteritis: While the mother may experience vomiting and diarrhea, breastfeeding can provide the infant with antibodies to help prevent or lessen the severity of the illness.
- Mastitis: This breast infection, although painful for the mother, doesn’t pose a risk to the infant. Breastfeeding actually helps to clear the infection.
- COVID-19: Current evidence suggests that COVID-19 is unlikely to be transmitted through breast milk. The benefits of breastfeeding outweigh the potential risks, and mothers are encouraged to continue breastfeeding while taking precautions like wearing a mask.
Infections That May Require Caution or Temporary Cessation
Certain infections require special consideration and may necessitate temporary cessation of breastfeeding or the use of expressed breast milk. These include:
- Herpes Simplex Virus (HSV): If the mother has active herpes lesions on her breasts, direct breastfeeding should be avoided to prevent transmission to the infant. Expressed breast milk from unaffected breasts can be safely fed to the infant.
- Varicella-Zoster Virus (Chickenpox/Shingles): If the mother develops chickenpox shortly before or after delivery, the infant should receive varicella-zoster immune globulin (VZIG). Breastfeeding can usually continue after the infant receives VZIG.
- HIV: In developed countries, breastfeeding is generally not recommended for mothers with HIV due to the risk of transmission through breast milk. However, the WHO recommends breastfeeding for mothers with HIV in resource-limited settings where formula feeding is not safe, affordable, sustainable, or acceptable.
- Certain Medications: Some medications can pass into breast milk and may be harmful to the infant. Mothers should consult with their healthcare provider about the safety of medications while breastfeeding.
Rare, but Concerning Infections
Rarely, severe infections can pose a significant risk and require careful management. These can include:
- Active, untreated tuberculosis: Temporarily separating mother and baby and using expressed milk can be a necessary precaution while the mother undergoes treatment.
- Human T-cell Lymphotropic Virus Type I (HTLV-1): Found in specific populations, breast milk transmission is possible and often not recommended.
Medications and Breastfeeding
The compatibility of medications with breastfeeding is a crucial consideration. Many medications are safe to use while breastfeeding, but some can pose a risk to the infant.
- Consult a Healthcare Professional: Always consult with a healthcare provider or lactation consultant before taking any medication while breastfeeding.
- LactMed Database: The LactMed database is a valuable resource for information on the transfer of drugs into breast milk and their potential effects on infants.
- Timing of Medication: If possible, take medications immediately after breastfeeding to minimize the amount of medication in the breast milk at the next feeding.
Preventing Infection Transmission
Several measures can be taken to minimize the risk of infection transmission through breast milk:
- Good Hygiene: Frequent handwashing is essential to prevent the spread of infection.
- Covering Coughs and Sneezes: Cover your mouth and nose when coughing or sneezing to prevent the spread of respiratory droplets.
- Cleaning and Disinfecting Surfaces: Regularly clean and disinfect surfaces that may be contaminated with pathogens.
- Proper Breast Pump Hygiene: If using a breast pump, follow the manufacturer’s instructions for cleaning and sterilizing pump parts.
When to Seek Medical Advice
Consult a healthcare provider if you have any concerns about your health or your infant’s health while breastfeeding. Specific situations include:
- High fever
- Severe symptoms of illness
- Unusual changes in your infant’s behavior or feeding patterns
- Known exposure to a contagious illness
Common Mistakes to Avoid
Several common mistakes can increase the risk of infection transmission or unnecessarily disrupt breastfeeding:
- Stopping Breastfeeding Without Consulting a Healthcare Provider: Abruptly stopping breastfeeding can deprive the infant of valuable antibodies and increase the risk of other health problems.
- Self-Treating Infections: Always seek medical advice for infections to ensure appropriate treatment and minimize the risk of complications.
- Ignoring Hygiene Practices: Poor hygiene practices can increase the risk of infection transmission.
- Using Unreliable Information: Rely on reputable sources of information, such as healthcare providers, lactation consultants, and established medical organizations.
Frequently Asked Questions (FAQs)
1. Can I breastfeed if I have a fever?
Yes, in most cases, you can continue breastfeeding even if you have a fever. Your breast milk will contain antibodies that can help protect your baby from the same illness you have. However, it’s important to consult your doctor to rule out any serious underlying conditions.
2. What if I have mastitis? Is it safe to breastfeed?
Yes, it is safe and recommended to continue breastfeeding if you have mastitis. Breastfeeding helps to clear the infection. Make sure to completely drain your breast during feedings.
3. Can I breastfeed if I have a cold or the flu?
Absolutely. Your breast milk will contain antibodies to the cold or flu virus, which will help protect your baby. Remember to practice good hygiene, like washing your hands frequently. Staying hydrated is also key.
4. What about diarrhea? Can I still breastfeed?
Yes, you can usually continue breastfeeding if you have diarrhea. The antibodies in your breast milk can help protect your baby from getting sick. Be sure to stay well-hydrated. Consider probiotics to help reduce your symptoms.
5. Is COVID-19 passed through breast milk?
The current consensus is that COVID-19 transmission through breast milk is unlikely. The benefits of breastfeeding typically outweigh the risks. Wear a mask while breastfeeding and follow recommended hygiene guidelines.
6. Can I breastfeed if I have herpes?
If you have herpes and active lesions on your breasts, you should avoid direct breastfeeding from the affected breast. However, you can safely express milk from unaffected breasts. Consult your doctor for treatment options.
7. What if I have chickenpox or shingles?
If you develop chickenpox shortly before or after delivery, your baby should receive VZIG. Breastfeeding can usually continue after the infant receives VZIG. If you have shingles, avoid breastfeeding from the affected area of the breast until the lesions have crusted over. Consult your physician promptly.
8. Is it safe to breastfeed if I have HIV?
In developed countries, breastfeeding is typically not recommended for mothers with HIV due to the risk of transmission through breast milk. In resource-limited settings, the WHO recommends breastfeeding if formula feeding is not safe, affordable, sustainable, or acceptable. Consult your healthcare provider.
9. What medications are safe to take while breastfeeding?
Many medications are safe to take while breastfeeding, but some are not. Always consult with your healthcare provider or a lactation consultant before taking any medication while breastfeeding. The LactMed database can provide reliable information.
10. How do I properly clean my breast pump to prevent infection?
Follow the manufacturer’s instructions for cleaning and sterilizing your breast pump parts. Generally, this involves washing the parts with soap and water after each use and then sterilizing them regularly.
11. I’m feeling sick. Should I pump and dump my breast milk?
Unless you are taking a medication that is contraindicated for breastfeeding or you are advised to by your doctor due to specific rare circumstances, there is typically no need to pump and dump. Your breast milk contains antibodies that can benefit your baby.
12. How can I boost my immune system while breastfeeding?
Focus on a healthy diet, stay well-hydrated, get enough sleep, and manage stress levels. Consider taking a prenatal vitamin and consulting with your doctor about other immune-boosting supplements that are safe for breastfeeding.