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Breastfeeding
Questions Answered:
A Guide for Providers
From INFO's Toolbox
This guide answers questions that women often ask about breastfeeding.
March 2006
Issue No. 5
The INFO Project • Johns Hopkins Bloomberg School of Public Health • Center for Communication Programs • 111 Market Place, Suite 310 Baltimore, Maryland 21202, USA • 410-659-6300 • www.infoforhealth.org

Population Reports; Series L, Number 14, Better Breastfeeding, Healthier Lives

Illness or Infection

Can a woman breastfeed when she is sick?

During any minor illness such as a cold, sore throat, mild flu, stomach problem, or minimal fever a woman can and should continue to breastfeed. A woman with any of these conditions does not pass the germs to her infant through her milk. In fact, the antibodies a woman creates to combat her own illness will be passed to her baby through her breastmilk, helping to prevent the baby from becoming sick.

In most cases, women who are malnourished can and should breastfeed their babies following the same recommendations as breastfeeding women who are adequately nourished?that is, breastfeed exclusively for six months followed by complementary feeding through two years of age and beyond. Almost all malnourished women will produce enough breastmilk for their babies. Malnutrition may, however, reduce the nutritional quality of milk or affect the mother?s own health by reducing her energy and nutrient reserves.

In rare cases, such as cancer treatment or infectious sores on the breast, a woman may have to stop breastfeeding briefly. She may be able to continue breastfeeding if she can obtain treatment that is compatible with breastfeeding.

Should a woman breastfeed when her baby is sick?

When a baby is sick, the mother should breastfeed more often. Breastmilk replaces fluids and nutrients lost through frequent loose stools. For most babies, nursing is comforting when they are sick. If a baby refuses to nurse when sick, a woman can try different nursing positions?particularly positions that allow the baby to be upright?and continue to offer the baby her breast every hour or so. A woman can also try expressing her milk by hand or by pump to feed the baby breastmilk from a cup, dropper, or spoon.

Can a woman breastfeed if she is taking medications?

Nearly all (but not all) prescription drugs and over-the-counter (nonprescription) medications are considered safe to use when breastfeeding. A few are risky, including mood-altering drugs, reserpine, ergotamine, anti-metabolites, cyclosporine, high doses of corticosteroids, bromocriptine, radioactive drugs, lithium, and certain anticoagulants (for acomplete list see the Breastfeeding and Maternal Medication Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs). For women who take these drugs, breastfeeding is not recommended.

Can a woman with viral hepatitis breastfeed her baby?

Yes. A woman with viral hepatitis can breastfeed, because breastfeeding does not increase the risk of passing hepatitis to a child. The hepatitis B virus (HBV) and hepatitis C virus (HCV) are passed through blood. A breastfeeding woman with HBV or HCV should take good care of her nipples, ensuring proper latch-on and allowing the nipples to dry before covering to avoid cracking or bleeding. These healthy practices will help prevent the woman?s baby from being exposed to the virus through breastfeeding. A woman with HBV or HCV can pass the virus to her baby during childbirth, however.

If a woman is diagnosed with HBV, her infant should receive the first dose of hepatitis B vaccine within 48 hours of birth, when feasible, or as soon as possible thereafter. Subsequent doses of the vaccine should be given with routine childhood immunization at one month and six months of age. There is no vaccine for the prevention of HCV infection.

Can a woman breastfeed if she is infected with HIV?

If a woman is infected with HIV, there is a chance that her baby also will become infected with HIV during pregnancy, delivery, or breastfeeding. In general, about 16% of babies breastfed by untreated HIV-positive mothers over a two-year period acquire HIV through breastfeeding. The risk is less if the woman?s nipples are not cracked and if she breastfeeds exclusively for the first few months of her baby?s life and then makes an abrupt transition to full replacement feeding?that is, feeds the baby exclusively with commercial formula or modified animal milk, not breastmilk. HIV transmission through breastmilk is more likely among mothers with advanced disease, reflected in low CD4+ cell counts.

Avoiding breastfeeding altogether will prevent HIV from passing from mother to baby through breastmilk. If replacement foods cannot be adequately and safely prepared, however, avoiding breastfeeding may expose a baby to greater risk of other serious infectious diseases, such as diarrheal and respiratory diseases.

The relative risks and benefits of breastfeeding and replacement feeding vary considerably according to an HIV-positive woman?s circumstance. If an HIV-positive woman wishes to breastfeed, she should discuss her options with a health care provider. The options that may be appropriate to consider include expressing and heat-treating her breastmilk or using safe replacement foods. If a mother wants to use replacement foods to feed her baby, she can use commercial formula or fresh or powdered modified animal milk.

Can a woman breastfeed if she is infected with HIV?

Disclaimer: The information provided on this web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development, the U.S. Government or The Johns Hopkins University.