Blog Post 4.4.15 Breastfeeding Sick YellowSo I’ve been scrambling my head trying to come up with a simple topic for this week’s post that didn’t involve lots of researching, since I lost a day this week from Jeff and my wedding anniversary. (He took Monday off so we could stay overnight at National Harbor to celebrate, so I kept thinking I had an extra day) I am also trying to keep track of my ideas for posts as they pop up into my head,  but most of the time that happens when I’m driving or at the grocery store; some place where it’s not that convenient to jot down my thoughts.

So, after being sick twice in 30 days (the first was that nagging and uncomfortable sinus cold-turned bronchitis spiel I had that lasted 10 days at the end of February and then my recent bout with the stomach virus that seems to be going around practically everywhere), I wanted to highlight what I’ve learned from being a breastfeeding mom + being sick.

So here goes… 

Things to Do:

  • Continue breastfeeding as much as you can, through the sickness.
    • Why? Your body is building antibodies to fight the infection and those antibodies are passed on through breastmilk, protecting your baby from whatever you caught. I did a lot of research on passive immunity through breastmilk in my college days and I wish I had my props to show you, but who saves projects from college? Some links to the scientific explanation at the bottom of the page. KellyMom and Medela’s tip sheet advise that through all normal illnesses (flu, colds, stomach viruses, food poisoning, fever, sore throat, mastitis), breastfeeding should continue.

      “The best thing to do for your baby when you’re sick is to continue to breastfeed… Withholding your breastmilk during an illness increases the possibility that baby will get sick and deprives baby of the comfort and superior nutrition of nursing.” KellyMom.com

      I know it’s hard. I get it. Through my first horrific cold – Sickness #1 – I was hacking up phlegm and feeling like an 18-wheeler rammed into my head. Thankfully I started getting sick on a Friday and Jeff covered Jia duty for the entire weekend as I lay in bed. I popped in to her room only to nurse her, then popped back into my isolation sick-room. I knew if I at least didn’t breathe on Jia or cough in her face, I was doing more good for her than bad, by continuing to nurse her.

  • Pump if you feel too crappy to nurse. My stomach virus – Sickness #2 – was a whole different story. I wished I could’ve nursed Jia throughout my entire sickness, but Day 1, I couldn’t. I just couldn’t. I wanted to, but I was losing fluids from both ends. Sorry, TMI. But I felt awful. I didn’t want to touch my clean uninfected healthy baby, for fear that she would get sick from me. Hospital policy was always “no returning to work until 24 hours AFTER vomiting/diarrhea stops.” So I figured as long as I was doing one or both of those things, I should at least pump, especially if I didn’t have the stomach capacity to leave the room for very long. But I couldn’t even do that. My body was in shut-down mode trying to retain as much fluids as possible; I wasn’t keeping anything down or in. I produced  a few drops in the morning after it all started (usually I get about 7-9 oz total). My body wasn’t making milk. So thankfully I had a bag of milk in the freezer (so I didn’t have to walk down to the basement, I probably would have collapsed) so I started the defrosting process in the hopes that by the time Jeff got Jia dressed and ready for breakfast, it would be ready. In the end, I couldn’t start nursing Jia until Day #2. This was due to 1) I was feeling better since I was keeping fluids down; 2) I missed her a lot; and 3) My body wasn’t responding to the breast pump. It had to be the baby or my body wasn’t having it.
  • Don’t substitute with formula or pumped milk and NOT try to empty your breasts. Remember in my post about Boobienomics: Nature’s Supply and Demand? Your body still needs that hormonal response to keep producing milk and if you’re not emptying your breasts, your body won’t think you need to keep producing milk. With Sickness #2, Jia had to drink previously pumped milk, because with all of the vomiting nonsense, my body couldn’t make any milk for that time being. I was scared that it would permanently affect my supply, but I couldn’t do anything about it at the time. 
  • Wash your hands OFTEN!
    • The most effective way to prevent the spread of infection is to wash hands thoroughly and frequently, when you are sick or when someone who lives with you is sick. Or heck – even if your coworkers are sick. Do I have to explain this one?
    • Make sure to clean your hands before and after touching their toys, food, utensils, bibs, etc.
    • Try to have your partner sleep in a “clean” room or space, while you are in an enclosed room so that germs are not spread easily. 
  • Limit Close Face-To-Face interaction
    • This means, limit when your face is in close proximity to your baby’s.
    • No kisses, don’t blow in their face, don’t kiss their eyes or nose, don’t kiss their hands. Don’t blow on their food to cool it.
    • If you’re bad at remembering this, maybe get a box of cheap face masks from the pharmacy or Target, to avoid droplets from aerosolizing when coughing and sneezing.
  • Medications to Avoid (because they may affect milk supply*)
    • Benadryl or medications with active ingredient diphenhydramine 
    • Pseudoephedrine (active ingredient in Sudafed and mediations with the letter “D” for “decongestant” in them). If you have a good supply this is unlikely to affect you, but long-term use (for more than 7-10 days) can permanently decrease milk supply.
    • Avoid excessive amounts of menthol products (like menthol throat lozenges), they can lower your supply
    • Try to take medications after nursing, so that the drug’s concentration in your blood (and milk) peaks well before baby nurses next. 
    • *there is not a lot of research on diphenhydramine’s affect on milk supply, mainly anecdotal reports. Use all medications with caution, and if you have questions about certain medications, call a lactation consultant or a local La Leche League representative for guidance. 
  • Instead, I felt a good balance for me was:
    • Mucinex (active ingredient guaifenesen) (Cold)
    • Vicks Sinex nose spray (Cold)
    • Neti Pot – nasal sinus flushing with bicarbonate mix to flush out the virus from the sinuses (Cold)
    • Tons of water and decaffeinated tea (Stomach Flu)
    • Humidifier (Cold), add a few drops of peppermint essential oil to help with congestion and inflammation! 
    • Drink lots of Vitamin C (I like Emergen-C powder) (Cold, Everyday)
    • Side Note: I actually was taking Sudafed (pseudo ephedrine) for a good 4 days before I realized it could affect my milk supply. I didn’t notice any change in supply with Sickness #1, but after knowing the information, I couldn’t in good conscience keep taking it. I’m very paranoid about anything threatening my ability to breastfeed, so I stopped it right away and found Mucinex + Sinex spray to work just as well, if not better. 
  • Outsource Some Help
    • Being sick takes the wind out of you. You’re zapped of energy, your head is spinning, and your body needs to rest and work on fighting whatever’s gotten you sick. The only way you can really get your much-needed rest is to have someone take over baby-duty.
    • Trust me, get the help if you can. DON’T TRY TO TOUGH IT OUT IF YOU DON’T HAVE TO. During Sickness #1 I was feeling better after only 2 weekend days of rest. But Jeff returned to work Monday and I took about 3 steps backward and felt so much worse after watching Jia by myself that one day. My symptoms got significantly worse, I felt sinusy x 1000, phlegm built up, I started to lose my voice, I got hot flashes, and I was dizzy. Had I gotten one more full day to rest, I am almost positive I wouldn’t have been so sick in Philly. 
    • Jeff and I were so fortunate that his mom was able to take over much of Jia’s care while I was sick. The first sickness came at the same time that I had to leave town for work (which was awful in and of itself), so we had already planned on her staying with us while I was out of town– so that part worked out. However, when I got this recent stomach virus, I don’t know what I would’ve done without her watching Jia. Jeff had to go to work even with me throwing up, but thankfully his mom and dad recently returned from a vacation just in the nick of my time of need! I felt awful to need her to watch Jia practically 12 hours after their plane landed, but I was in bad shape for those 2.5 days. (Thank you Joyce!!)
    • If you use daycare, keep using them. Get help from grandparents, babysitters, spouses, anyone if you can. Last thing you want is trading viral mutations through the household only to catch it again. 
  • DRINK A TON OF FLUIDS!!!
    • Most often, when a breastfeeding mom is sick, milk supply is affected.
      • With the cold-turned-bronchitis, I didn’t feel like it changed. I was still able to pump before bed as usual. However, the stomach virus is the one that took a hard hit at my supply. The vomiting and “such” drained me and my milk was so watery. As soon as I felt I could handle food, I was trying to fill up on high-fat foods so that my milk would become fatty again.
      • I really noticed a drastic response in the milk composition when calories and dietary intake went down, which is also the reason why you’re urged not to diet if you’re breastfeeding – the milk won’t be as nutritious for baby’s nutritional needs.
    • When you’re sick, you need more fluids.
      • Fluids help mobilize and thin-out chest congestion, as well as counteracting any fluids you are losing due to fever and illness.
      • Replacing fluids and maintaining a good intake of fluids will help your body use the fluid it needs to recover, as well as provide your body with fluids to maintain an adequate milk supply. 
      • It took about 5 days to get my nighttime supply back to normal.  
  • Eat GALACTAGOGUES!
    • Galactagogues are substances that support lactation in humans (and animals) and are found in plants, are synthesized (made in a lab), hormonal, or herbally sourced. 
    • Foods/Herbals include: 
      • Red raspberry leaf
      • Oatmeal (more on oatmeal and increasing supply here)
      • Marshmallow root
      • Fenugreek
      • Anise (licorice)
      • Alfalfa
      • Fennel
    • KellyMom talks Galactagogues here. She does state that the average nursing mother doesn’t need galactagogues, as long as she is nursing regularly. Also, she says that the most effective way for galactagogues to work is when combined with regular removal of milk (pumping or nursing). 
    • My post on The Best Lactation Cookies You’ll Ever Eat
  • Keep your Food Intake Up! 
    • As hard as it is to keep eating while you’re sick, your milk supply and the quality of your milk will thank you. Remember, good nutrition means good milk! 

 

Get well soon and happy breastfeeding!

Sources:

KellyMom: Should Breastfeeding Continue When Mom is Sick? http://kellymom.com/bf/can-i-breastfeed/illness-surgery/mom-illness/

Breastfeeding With a Cold or Flu – Medela US http://blog.medelabreastfeedingus.com/2012/03/breastfeeding-with-a-cold-or-flu/

National Library of Medicine – Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884328/pdf/bcp0056-0018.pdf

Institute of Biochemistry and Biophysics. Influenza Prevention and Treatment by Passive Immunization: http://www.actabp.pl/pdf/3_2014/573.pdf