Breastfeeding is Safe and Strongly Recommended When Mother Has Influenza
Breastfeeding should be encouraged even if the mother or infant has influenza, as breast milk provides protective antibodies and there is no evidence of viral transmission through milk. 1
Key Protective Mechanisms
Breastfeeding actively protects infants against influenza through multiple mechanisms:
- Activates innate antiviral defenses, specifically type 1 interferons that provide direct antiviral protection 1
- Delivers influenza-specific immunoglobulin A in higher concentrations, especially when mothers were vaccinated during the third trimester 1
- Reduces respiratory illness episodes with fever in the first 6 months of life when breastfeeding is more exclusive 1
Practical Management During Maternal Influenza
Direct Breastfeeding Protocol
When the mother has active influenza infection, implement these precautions:
- Hand hygiene before every feeding to prevent transmission via respiratory secretions 1
- Wear a surgical mask while breastfeeding to minimize droplet exposure 1
- Continue direct breastfeeding unless mother or infant is too ill 1
Alternative Feeding Method
- Pump and feed expressed breast milk if either mother or infant cannot breastfeed directly due to illness severity 1
- The virus is not transmitted through breast milk itself 2, 3
Evidence from Clinical Practice
A prospective study of 42 mothers with peripartum influenza who practiced hand hygiene, wore masks, and continued breastfeeding showed zero infant infections during one-month follow-up, demonstrating the safety of this approach 2, 3
Maternal Antiviral Treatment Compatibility
Oseltamivir (75 mg twice daily for 5 days) is the preferred antiviral for breastfeeding mothers and does not contraindicate breastfeeding 1, 4
- Baloxavir is not recommended for breastfeeding mothers due to lack of safety data on presence in breast milk 1
Critical Distinction: Influenza is NOT a Contraindication
The absolute contraindications to breastfeeding are limited to:
- HIV infection
- Human T-cell lymphotropic virus type I or II
- Untreated brucellosis
- Suspected or confirmed Ebola virus disease
- Classic galactosemia in the infant 1
Influenza is explicitly excluded from this list and most maternal infections are compatible with continued breastfeeding 1, 5
Common Pitfall to Avoid
Do not unnecessarily separate mother and infant or stop breastfeeding when influenza is diagnosed—this only deprives the infant of nutritional and immunologic benefits while the exposure has likely already occurred through respiratory contact before diagnosis 5, 6