Can breastfeeding be continued in mothers with dengue (Dengue Fever)?

Breastfeeding During Dengue Fever

Mothers with dengue fever should continue breastfeeding their infants, as there is no evidence that dengue virus is transmitted through breast milk. 1

Benefits of Continuing Breastfeeding During Dengue

• Most maternal infections, including dengue fever, are compatible with breastfeeding. Breast milk typically provides antibodies and protection against infections 1
• Continued breastfeeding is particularly important in dengue-endemic areas, as it provides essential nutrition and immune protection for the infant 1
• Regular feeding or expression of milk during maternal illness is an important adjunct to other treatments, similar to recommendations for other conditions like mastitis 2
• Breastfeeding reduces the risk of severe or persistent diarrhea by 30% when continued exclusively for 6 months, which is particularly relevant in areas where dengue is endemic and other infectious diseases are common 1

Maternal Considerations During Dengue Fever

• Dengue infection during pregnancy increases maternal morbidity and mortality risk, with pregnant women having higher risk (15%) of developing dengue shock syndrome compared to the non-pregnant population (5%) 1
• Maternal hydration is critical during dengue fever, and mothers should be encouraged to drink adequate fluids while continuing to breastfeed 1
• Mothers with dengue should practice good hand hygiene before breastfeeding to minimize risk of transmission through respiratory secretions or direct contact 1

Safety of Breast Milk During Dengue Infection

• While dengue virus has been detected in breast milk samples from infected mothers, there is no conclusive evidence of disease transmission through breastfeeding 3
• In a study of mother-newborn pairs, 75% of breast milk samples from dengue-infected mothers tested positive for dengue virus, but transmission through breast milk remains theoretical rather than proven 3
• The WHO recommends that mothers with infectious diseases should generally continue breastfeeding, as the benefits outweigh potential risks 1

Vertical Transmission Considerations

• The primary concern with dengue is vertical transmission during pregnancy and peripartum period, not through breast milk 4
• Studies have shown high rates (90%) of vertical transmission when mothers are viremic at delivery, but this occurs through the peripartum route rather than through breastfeeding 3
• Maternal dengue-specific antibodies acquired by infants during breastfeeding may actually provide protection against homologous dengue infection 5

Clinical Management

• Mothers with dengue should be monitored for signs of dehydration and hemorrhagic complications while continuing to breastfeed 4
• If a mother is too ill to breastfeed directly, expressed breast milk can be given to the infant 1
• In cases of severe maternal illness, temporary support for breastfeeding may be needed, but discontinuation is not recommended 6

Conclusion

Breastfeeding should be continued during maternal dengue infection, as there is no evidence that the virus is transmitted through breast milk. The nutritional and immunological benefits of breastfeeding outweigh any theoretical risks, especially in dengue-endemic regions where other infectious diseases are common.