Can a Mother Breastfeed While Having RSV?
Yes, mothers with RSV should continue breastfeeding their infants, as there is no evidence that RSV is transmitted through breast milk, and breastfeeding provides critical protective benefits against respiratory infections including RSV itself.
Primary Recommendation
Breastfeeding should be encouraged and continued for all infants, including when the mother has RSV infection. 1 The American Academy of Pediatrics explicitly recommends breastfeeding to decrease a child's risk of lower respiratory tract disease, with evidence showing that breastfeeding provides immune factors against RSV including immunoglobulin G and A antibodies and interferon-α. 1
Evidence Supporting Continued Breastfeeding
Protective Effects Against RSV
Breast milk contains specific immune factors against RSV including neutralizing antibodies that provide direct protection to the infant. 1
Infants who are not breastfed have almost a threefold greater risk of hospitalization for lower respiratory tract disease compared to those exclusively breastfed for 4 months (risk ratio: 0.28). 1
Exclusive breastfeeding for >4-6 months significantly lowers hospitalization rates, length of hospital stay, supplemental oxygen demand, and ICU admission for infants with RSV infection. 2
The severity of RSV infection requiring oxygen therapy is significantly lower in exclusively breastfed infants (adjusted OR 3.807 for formula-fed vs breastfed infants requiring oxygen therapy). 3
Safety of Breast Milk During Maternal RSV Infection
There is no evidence that RSV is transmitted through breast milk. The virus causes respiratory infection and is spread through respiratory droplets, not through breast milk. 1
The benefits of breastfeeding substantially outweigh any theoretical risks during maternal RSV infection, with a strong preponderance of benefit over harm. 1
Practical Implementation
Infection Control Measures
Mothers with RSV should practice strict hand hygiene before breastfeeding to minimize transmission through respiratory secretions or direct contact, not because of concerns about breast milk itself. 1
Wash hands thoroughly with soap and water or use alcohol-based hand sanitizer before touching the infant or breastfeeding. 1
Consider wearing a mask during breastfeeding to reduce respiratory droplet transmission if the mother is actively symptomatic with cough or sneezing. 1
If Mother Is Too Ill to Breastfeed Directly
If the mother is severely ill and unable to breastfeed directly, expressed breast milk should be given to the infant. 4 This maintains the protective benefits of breast milk while allowing the mother to rest and recover.
Another caregiver can feed the expressed milk to the infant using appropriate feeding methods.
The mother should continue expressing milk to maintain supply and provide ongoing protection to the infant.
Clinical Context and Rationale
Why This Recommendation Matters for Outcomes
Continuing breastfeeding during maternal RSV infection directly impacts infant morbidity and mortality by providing passive immunity and reducing the severity of RSV disease if the infant becomes infected. 2, 3, 5
Breastfed infants who develop RSV have significantly lower rates of oxygen therapy requirement (4.3% vs 13.5% in formula-fed infants). 3
The duration of hospitalization and need for intensive care are reduced in breastfed infants with RSV. 2, 5
Common Pitfall to Avoid
Do not recommend stopping breastfeeding due to maternal RSV infection. This is a common misconception that can lead to unnecessary formula supplementation and loss of protective benefits. 1 The evidence consistently shows that while data on breastfeeding's specific protective effect against RSV acquisition may be conflicting, breastfeeding clearly reduces disease severity and should be encouraged. 1
Quality of Life Considerations
Maintaining breastfeeding during maternal illness preserves the maternal-infant bond and avoids the negative emotional and health consequences of unnecessary separation. 6 Breastfeeding provides comfort to the infant and can be continued safely with appropriate hygiene precautions, supporting both maternal and infant well-being during the illness period.