Breastfeeding While Sick: Colds, Flu, Stomach Bugs and COVID-19

Getting sick with a baby to care for is hard enough without worrying whether you’re making your baby sick too. The good news: for most everyday illnesses, the best thing you can do is keep breastfeeding.

By the time you notice symptoms, your baby has usually already been exposed. Your body has also started making antibodies, and some of those reach your baby through your milk. Stopping suddenly can leave your baby without that protection and leave you at risk of painful engorgement.

Is breastfeeding while sick safe?

For most illnesses, yes. The CDC says flu is not transmitted through breast milk, and current evidence suggests the virus that causes COVID-19 isn’t spread to babies through breast milk either. Common colds and stomach bugs spread through close contact, droplets and unwashed hands, not through milk.

What matters most is limiting how germs spread from you to your baby while you feed and cuddle.

Hygiene tips that protect your baby

• Wash your hands with soap and water before touching your baby, before handling pump parts or bottles, and after coughing, sneezing, blowing your nose or using the bathroom. If soap isn’t available, the CDC suggests a hand sanitizer with at least 60% alcohol.
• Consider a mask while you feed or hold your baby close if you have flu or COVID-19, as the CDC suggests.
• Cough or sneeze into a tissue or your elbow, away from your baby, and throw tissues away right away.
• Clean pump parts and bottles carefully after every use.
• Let a healthy caregiver help. If you’re expressing milk, the CDC suggests that a healthy person feed it to your baby when possible.
• Clean high-touch surfaces and let fresh air in when you can.

Never put a mask on a baby or a child under 2. The CDC warns this is a suffocation risk.

Breastfeeding with specific illnesses

Illness	Can you breastfeed?	Key tips
Common cold	Yes	Hand hygiene, tissues, rest and fluids
Flu	Yes	Handwashing, consider a mask; ask about antivirals
COVID-19	Yes	Handwashing, consider a mask, clean pump parts
Stomach bug (vomiting, diarrhea)	Yes	Drink extra fluids; wash hands well after the bathroom
Fever	Usually yes	Find and treat the cause; check for mastitis

Colds

A cold is no reason to stop breastfeeding. Focus on handwashing, rest and fluids. If you want something for symptoms, our guide to cold medicine while breastfeeding explains which ingredients are usually considered compatible.

Flu

The CDC recommends that mothers with flu keep breastfeeding, or express milk if they’re too sick to nurse. Breast milk contains antibodies that can help protect your baby. If you’re diagnosed with flu, ask your doctor about antiviral treatment. The CDC notes that oral oseltamivir is the preferred antiviral for breastfeeding mothers because very little passes into milk. Antiviral treatment is especially recommended if you’re within 2 weeks of giving birth.

COVID-19

The CDC advises continuing to breastfeed with precautions, whatever your vaccination status. Wash your hands before touching your baby or pump parts, consider wearing a mask during feeds and clean your pump well. If you’re too sick to nurse, keep expressing milk so your baby still gets it and your supply holds up.

Stomach bugs: vomiting and diarrhea

You can keep breastfeeding through a stomach bug. For diarrhea caused by food or water, the CDC says breastfeeding can continue, and the germs that cause travelers’ diarrhea don’t pass through breast milk.

The bigger risk is dehydration for you. Sip fluids often, even small amounts. The CDC says oral rehydration salts are safe while breastfeeding if prepared correctly. Wash your hands thoroughly after using the bathroom and before feeding.

If you want an anti-diarrhea medicine, read labels carefully. The CDC advises avoiding bismuth subsalicylate (the active ingredient in some upset-stomach remedies), because salicylate can pass into breast milk. Ask a pharmacist about alternatives.

Fever

A fever on its own is not a reason to stop breastfeeding. It’s a sign that your body is fighting an infection, so it’s worth finding out what’s causing it. If you have a fever along with a painful, red or swollen area on your breast, it may be mastitis. Keep breastfeeding as usual and contact your doctor, as you may need treatment.

Medicines while breastfeeding

Most medicines for common illnesses are compatible with breastfeeding, but some are better choices than others:

• Pain and fever relievers: Acetaminophen and ibuprofen are generally considered compatible with breastfeeding. See our guide to ibuprofen and Tylenol while breastfeeding for details.
• Decongestants: LactMed reports that pseudoephedrine can lower milk production, and that people with a newborn or a low supply should avoid it.
• Combination products: Multi-symptom cold and flu products often contain several active ingredients. Check each one, and avoid doubling up on the same ingredient.
• Antibiotics: Many are compatible with breastfeeding. Tell your doctor you’re breastfeeding so they can choose one that fits.

Use the standard adult dose on the label unless your doctor tells you otherwise. Always check with your doctor, pharmacist or a lactation consultant (IBCLC) before taking a new medicine, especially if your baby is a newborn, premature or has health conditions. You can also look up individual medicines in the NIH’s free LactMed database.

Taking care of yourself (and your supply)

Being sick can make breastfeeding feel exhausting. A few things help:

• Feed lying down if it’s safe for you, so you can rest. Move your baby to their own safe sleep space if you start to feel drowsy.
• Keep fluids and easy snacks within reach. Our breastfeeding snacks guide has ideas that are easy on a low appetite.
• Accept help with diapers, laundry and meals.
• Express milk if you’re too ill to nurse, to keep up your supply and avoid engorgement.

When breastfeeding is not advised

Only a few situations mean you shouldn’t breastfeed or give your expressed milk. According to the CDC, these include:

• Your baby has classic galactosemia
• You have HIV and aren’t on treatment or don’t have a suppressed viral load (talk to your provider about your options)
• You have HTLV-1 or HTLV-2
• You use illicit drugs such as opioids, PCP or cocaine
• You have suspected or confirmed Ebola virus disease

Breastfeeding is temporarily not advised if you have untreated brucellosis, take certain medicines, have certain imaging tests with radioactive materials, have herpes sores on your breast (you can feed from the other breast if the sores are fully covered) or have mpox until you meet isolation criteria. With untreated active tuberculosis, or chickenpox that started between 5 days before and 2 days after birth, you shouldn’t breastfeed directly for a time, but your expressed milk can usually be given to your baby. Your doctor will guide you on when you can restart.

When to call a doctor

Call your doctor if you:

• Have a high fever, a fever that lasts more than a couple of days or symptoms that keep getting worse
• Can’t keep fluids down or have signs of dehydration, such as dizziness or very dark urine
• Have trouble breathing or chest pain (seek emergency care)
• Have a red, painful area on your breast with fever or chills

Call your baby’s doctor right away if your baby:

• Is under 3 months old and has a fever
• Is feeding much less than usual or has fewer wet diapers (our baby poop color chart lists normal diaper counts)
• Seems very sleepy, floppy or hard to wake, or is breathing fast or with effort

For more health topics, browse our nutrition and health guides.