Two days ago a mother asked me if she could continue to breastfeed. The mother was on Tamiflu as her older child had tested positive for the influenza A virus. My answer was “You must continue to breastfeed”. The affirmative answer was based on recommendations of ACASH (Association for Consumers Action on Safety and Health), BPNI (Breastfeeding Promotion Network of India), WABA (World Alliance for Breastfeeding Action) and ABM (Academy of Breastfeeding Medicine).
Breastfeeding limits the severity of respiratory infections in infants and is particularly important for minimising the risk and effects of infection during an influenza outbreak. The immune substances in mother’s milk help protect the infant even when a mother does not have pre-existing immunity to a particular illness.
The ABM has clearcut guidelines on this issue. The guidelines are based on scientific evidence and urge physicians to support continued breastfeeding even if the mother is suspected of having the H1N1 influenza virus, since the infant would likely have been exposed to the virus before the mother’s symptoms appeared.
Breastfeeding should continue if the infant is suspected of having H1N1 flu. If breast milk is only part of an infant’s diet, it would be wise to increase the amount of breast milk the infant receives during an influenza outbreak, perhaps even supplement breastfeeding with pumped milk.
Good hygiene around the baby, including regular hand washing can help minimise the exposure to respiratory droplets that may carry the flu virus. Limiting close contact by non-caretakers, use of a mask if a caretaker has flu-like or other respiratory symptoms, and avoiding crowds are other recommended actions to reduce risk of infant exposure.
Dr Anand is a paediatrician and founder president of ACASH, advisor to BPNI and co-chairperson of WABA