Mothers With H1N1 Should Breastfeed
American Academy of Pediatrics Says Breastfeeding is Safer
Oct 17, 2009
The death toll of the young and apparently healthy is rising from novel H1N1, a.k.a. swine flu, and the burden for pregnant and new mothers is increasing. H1N1 is not transmitted in breastmilk, but should a new mother, infected with H1N1, risk infecting her newborn by nursing? The answer from Dr. Ruth Lawrence, chair of the American Academy of Pediatrics Section on Breastfeeding Executive Committee, and Dr. John Bradley, a member of the AAP Committee on Infectious Diseases, is an unequivocal yes.
H1N1 is a Transmission Risk from Infected Mother to Infant
Infected mothers can transmit H1N1 virus to their baby, healthcare workers and visitors. It is obvious that mothers and anyone infected with H1N1 should minimize transmission by taking the same general precautions recommended by the CDC and other health organizations. These precautions must be particularly fastidious when the H1N1-infected new mother nurses, holds or even casually contacts her newborn. Extensive contact is needed and desirable, but must be skillfully protective of the infant, until the mother’s immune system is protecting her and the infant from the virus.
Mother’s Milk is Safe, but Infected Mother Needs to Take Precautions
Much is known about virus transmission from mothers to infants. Other epidemics provide encouraging knowledge that the flu virus is not transferred into the mother’s milk and that milk itself contains numerous cellular and natural chemical defenses against the flu virus. Milk is safe, but the mother can transmit H1N1 to her newborn in numerous ways.
Precautions to Avoid H1N1 Transmission From H1N1 Infected Mother to Newborn
- Handwashing with soap and water must be a ritual before any contact between mother and newborn.
- Mother must wear a surgical mask to avoid any airborne contamination.
- Mother’s breast must be washed with soap and water, and dried with a fresh towel, just prior to nursing.
- Mother must be changed into fresh clothing prior to coming in contact with her newborn.
- Use clean burp cloths, blankets, etc. during the nursing and replace them after contact between mother and infant.
Treatment of the Mother With Antiviral Drugs is Recommended
Therapy with antiviral drugs (Tamiflu or Relenz) is suggested and will reduce symptoms and infectivity. These drugs are now recommended to be started within the first two days of flu infection. These antiviral drugs are transferred into milk in extremely low concentrations.
Risks of Separation Worse than H1N1 Transmission Risk
The reason that separation between H1N1-infected mothers and their newborns is not recommended, is because early and continued breastfeeding is essential for the health of the baby and for normal development of infant/mother relationship. As the authors of the report state:
"Although the most effective way to prevent influenza transmission is complete separation from her infant when a mother is receiving antiviral treatment, separation may create more long-term problems in breastfeeding success and mother-infant bonding than any potential benefit achieved from avoiding infection in the newborn infant."
Until More Severe Risks Are Identified, Breastfeeding Is Still Best for Newborns
The 2009 H1N1 flu outbreak provides many new twists. The younger and healthier are more vulnerable and older individuals exhibit greater resistance than expected. The CDC has recommended breastfeeding as safest for newborns and as protection for infants. Representatives of the American Academy of Pediatrics recommend cautious, exclusive breastfeeding even for mothers infected with H1N1.
Reference:
Lawrence, Ruth A. and Bradley, John S. "Advice regarding breastfeeding for mothers with possible H1N1 infection." AAP News October 13, 2009, doi:aapnews.20091012-1.
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