Compiled by Jenny Buck
Leader with Hong Kong English Group
Magic Ingredients has previously reported that breastfeeding protects babies against influenza and other viruses (see article). But respect for the importance of breastfeeding in providing immunological protection to babies was undermined by guidance issued by the US Centers for Disease Control (CDC) during the 2009 H1N1 pandemic and updated in 2011. The CDC suggested that breastfeeding should be temporarily discontinued, and breastfeeding mothers and babies separated, when mothers exhibit flu symptoms. The CDC is a resource which is often referred to by physicians, and their guidance caused confusion during this year’s flu season in the Northern Hemisphere. Many were left wondering, “Who else is supposed to look after the baby if our whole family has already been exposed to the virus?”
In response, on 22 January 2018, La Leche League International (LLLI) issued a media release, and here are some highlights:
“Most often, babies who are being nursed remain healthy even when their parents or other family members fall ill with an infectious illness, because they benefit from the antibodies provided in the lactating parent’s milk. Lactating parents who are infected or immunized with an appropriate vaccine during the antenatal period will produce sufficient quantities of specific secretory IgA antibodies in their milk to protect their nursing infants against infection from the influenza virus. Following good hygiene practices will also help reduce transfer of the virus ...
Beyond the newborn stage, nursing babies or toddlers and nursing parents are generally living together in the same environment; they are exposed to the same germs ... Once the lactating parent has been exposed, so have the baby and the rest of the family. In addition, not every respiratory infection, even accompanied by fever, is the flu; winter is the season of many viral upper respiratory infections. Even colds may be accompanied by a fever at times.
Separating the baby from the lactating parent may have serious consequences. Being refused the breast can be emotionally traumatic for nursing babies and toddlers and may not prevent the baby or toddler from developing the illness. The stress of separation may actually increase the risk of illness in the infant or toddler. In addition, it is important not to interrupt the immunological protection that nursing provides or to risk early weaning.
In normal circumstances, there is no need to interrupt direct breastfeeding. Instead, parents who believe they may have the flu are encouraged to follow good hygiene practices, such as thoroughly washing their hands and wearing a protective mask to prevent spread of the virus. In unusual circumstances, when an interruption of nursing is deemed medically necessary, pumping or hand expression is encouraged. In such cases, the expressed milk, which contains antibodies specifically produced against the influenza virus, may be fed to the baby to help prevent the infection in the baby or to help reduce the severity and duration of the infection.”
We are delighted to report that on 12 February 2018, the CDC issued revised guidance regarding breastfeeding and influenza. Given the proximity of the revision to LLLI’s media release, we are confident that pressure from LLLI and members of LLLI’s Health Advisory Council contributed to the CDC's decision to revise their guidance. A victory for parents and babies worldwide!
Close to the Heart Vol. 19 No. 1 (Early-Year 2018)
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