This document updates previously posted information for parents about infant feeding and novel H1N1 flu (swine flu). It now more clearly addresses parents who are formula feeding as well as breastfeeding, suggests that parents sick with novel H1N1 flu (swine flu) find someone who is not sick to feed the baby, and provides more detailed strategies for breastfeeding mothers to maintain breastfeeding throughout the course of infection. This document is based on current knowledge of the novel H1N1 flu outbreak in the United States, and may be revised as more information becomes available.
What is this new flu virus?
This novel H1N1 flu virus (sometimes called “swine flu”) was first detected in people in April 2009 in the United States. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.
Take everyday precautions such as washing your hands with plain soap and water or using an alcohol-based hand rub before feeding your baby. More tips on good health habits for preventing sickness from the flu virus can be found at this website: http://www.cdc.gov/flu/protect/habits.htm. In addition, try not to cough or sneeze in the baby’s face while feeding your baby, or any other time you and your baby are close. If possible, only family members who are not sick should care for infants. If you are sick and there is no one else to care for your baby, wear a facemask, if available and tolerable, and cover your mouth and nose with a tissue when coughing or sneezing. For more information, see the Interim Recommendations for Facemask and Respirator Use.
Infants are thought to be at higher risk for severe illness from novel influenza A (H1N1) infection and very little is known about prevention of novel H1N1 flu infection in infants. If you are breastfeeding or giving your baby infant formula, a cautious approach would be to protect your baby from exposure to the flu virus in the following ways:
- Ask for help from someone who is not sick to feed and care for your baby, if possible.
- If there is no one else who can take care of your baby while you are sick, try to wear a face mask at all times when you are feeding or caring for your baby. You should also be very careful about washing your hands and taking everyday precautions to prevent your baby from getting flu (http://www.cdc.gov/flu/protect/habits.htm). Using a cloth blanket between you and your baby during feedings might also help.
- If you are breastfeeding, someone who is not sick can give your baby your expressed milk. Ideally babies less than about 6 months of age should get their feedings from breast milk. It is OK to take medicines to treat the flu while you are breastfeeding.
There are many ways that breastfeeding and breast milk protect babies’ health. Flu can be very serious in young babies. Babies who are not breastfed get sick from infections like the flu more often and more severely than babies who are breastfed.
Since this is a new virus, we don’t know yet about specific protection against it. Mothers pass on protective antibodies to their baby during breastfeeding. Antibodies are a type of protein made by the immune system in the body. Antibodies help fight off infection.
If you are sick with flu and are breastfeeding, someone who is not sick can give your baby your expressed milk.
No. Because mothers make antibodies to fight diseases they come in contact with, their milk is custom-made to fight the diseases their babies are exposed to as well. This is really important in young babies when their immune system is still developing. It is OK to take medicines to prevent the flu while you are breastfeeding. You should make sure you wash your hands often and take everyday precautions (http://www.cdc.gov/flu/protect/habits.htm). However, if you develop symptoms of the flu such as fever, cough, or sore throat, you should ask someone who is not sick to care for your baby. If you become sick, someone who is not sick can give your baby your expressed milk.
Yes. Mothers who are breastfeeding and taking medicine to treat flu because they are sick should express their breast milk for bottle feedings, which can be given to your baby by someone who is not sick. Mothers who are breastfeeding and are taking medicines to prevent the flu because they have been exposed to the virus should continue to feed their baby at the breast as long as they do not have symptoms of the flu such as fever, cough, or sore throat.
Yes. One of the best things you can do for your sick baby is keep breastfeeding.
- Do not stop breastfeeding if your baby is sick. Give your baby many chances to breastfeed throughout the illness. Babies who are sick need more fluids than when they are well. The fluid babies get from breast milk is better than anything else, even better than water, juice, or Pedialyte® because it also helps protect your baby’s immune system.
- If your baby is too sick to breastfeed, he or she can drink your milk from a cup, bottle, syringe, or eye-dropper.
Please check back to the CDC H1N1 website often for the most recent updates.