With cold and flu season in full swing, you may be worried about passing an illness to your baby through your breast milk. No need to panic: you won’t need to stop breastfeeding or waste your milk because you’re sick. Here is why breastfeeding while sick is good for your baby, which cold and flu medicines are safe while breastfeeding, how to protect your baby and your milk supply, and when to call your doctor.
Can you keep breastfeeding while sick?
Yes. For the common cold, the flu, COVID-19, and most stomach bugs, the CDC says to keep breastfeeding. Breast milk is still the recommended food for your baby when you’re sick.
- The virus doesn’t travel in your milk. Flu and COVID-19 are not spread to babies through breast milk. They spread from person to person through droplets when people cough, sneeze, or talk, which is why hand washing and a mask matter more than what’s in the bottle.
- Your milk helps protect your baby. Breast milk carries antibodies and other immune factors that help protect your baby from the flu and other infections.
- Feeding keeps a sick baby hydrated. If your baby catches the bug too, keep feeding to give them nutrition and keep them hydrated.
So yes, you can breastfeed with a cold, and if you have the flu you can still breastfeed your baby. The goal is to keep the milk flowing while you cut down on the germs your baby gets from close contact.
Breastfeeding with a cold, the flu, COVID or a stomach bug
The answer to “can I keep breastfeeding?” is yes for all four of the most common illnesses. The advice is almost the same for each: keep breastfeeding, rest, drink more fluids, and wash your hands. What changes is how sick you feel and what treatment helps. A cold usually builds over a couple of days, while flu tends to hit suddenly.
| Illness | Typical signs | Good to know |
|---|---|---|
| Common cold | Stuffy nose, sneezing, sore throat, mild fever. Peaks in 2 to 3 days | Usually gone within a week |
| Flu | Sudden fever or chills, body aches, cough, tiredness | Call your doctor early about Tamiflu |
| COVID-19 | Can look like a cold or the flu | Ask your doctor about testing |
| Stomach bug | Vomiting, diarrhea, cramps | Drink extra fluids; skip Pepto-Bismol |
Breastfeeding with a stomach bug
With vomiting or diarrhea, the CDC says you can keep breastfeeding and should drink more to avoid dehydration. Sip fluids all day and use an oral rehydration drink if you’re losing a lot. Avoid bismuth subsalicylate (Pepto-Bismol, Kaopectate), which can pass salicylate to your baby through breast milk. Norovirus, the usual stomach bug, spreads easily, and hand sanitizer doesn’t work well against it, so wash with soap and water after the bathroom and before feeds.
Breastfeeding with a fever
A fever from a cold or the flu is not a reason to stop. Acetaminophen and ibuprofen both bring a fever down and are good choices while nursing. A fever that gets better and then comes back is a reason to call your doctor.
What cold medicine can I take while breastfeeding?
Most common cold and flu medicines are considered safe while breastfeeding, because only small amounts reach your milk. The ones to watch are the few that can lower your milk supply. There is no single best cold medicine while breastfeeding: the best choice is a single-ingredient medicine for the symptom that’s bothering you most, at the lowest dose that helps. This guide is based on LactMed, the National Institutes of Health database on medicines and breastfeeding.
| Symptom | Generally fine while breastfeeding | Use with care |
|---|---|---|
| Fever, aches, sore throat | Acetaminophen (Tylenol), ibuprofen (Advil, Motrin) | Aspirin: choose another pain reliever |
| Stuffy nose | Saline spray or rinse; oxymetazoline nasal spray (Afrin) for a few days | Pseudoephedrine (Sudafed) and oral phenylephrine (Sudafed PE) can lower supply |
| Cough | Dextromethorphan (Robitussin, Delsym); guaifenesin (Mucinex) to loosen mucus; honey for you | Liquids with a lot of alcohol |
| Runny nose, sneezing | Loratadine (Claritin), cetirizine (Zyrtec), fexofenadine (Allegra) | Diphenhydramine (Benadryl), chlorpheniramine: small, occasional doses only |
| Flu | Oseltamivir (Tamiflu), by prescription | Start within 2 days of symptoms if you can |
Pain and fever: acetaminophen and ibuprofen
Generally speaking, over-the-counter pain relievers like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) are considered safe while breastfeeding. LactMed calls ibuprofen a preferred choice for nursing mothers because so little gets into milk, and acetaminophen a good choice for pain and fever. Aspirin is best skipped for colds: LactMed prefers other pain relievers over regular high doses of aspirin, which passes into milk, and aspirin given to babies with viral infections is linked to Reye’s syndrome.
Stuffy nose: decongestants and your milk supply
Decongestants are the one group that can really affect breastfeeding. Pseudoephedrine (Sudafed) passes into milk in small amounts, but it can cut your supply: in a small study, one 60 mg dose lowered milk production by an average of 24% over the next day, and repeated doses seem to interfere with milk making. LactMed advises against it for moms of newborns whose supply isn’t settled yet and for anyone already struggling with supply. Oral phenylephrine (Sudafed PE) might lower supply too, so LactMed suggests another option, especially with a newborn.
If you are already struggling with your supply, skip the decongestant pills and clear your nose with saline instead:
- Saline spray or a neti pot. Salt water loosens mucus and is a gentle first step. If you use a neti pot or rinse bottle, the FDA says to use only distilled, sterile, or boiled and cooled water, never straight from the tap.
- A nasal spray decongestant. Very little oxymetazoline (Afrin) reaches your bloodstream, so it is recommended over decongestant pills while breastfeeding. Follow the label’s limit on how many days to use it.
Cough and sore throat
Dextromethorphan, the cough suppressant in many cough syrups, shows up in very low amounts in milk and isn’t expected to affect your baby. Guaifenesin, which thins mucus, hasn’t been studied in breastfeeding, but usual doses are unlikely to harm a nursing baby, especially one over 2 months old. Choose products without a lot of alcohol. Plain cough drops are a common choice for a sore throat; check the label for added medicines.
Hot lemon and honey is an old favorite that may soothe a cough, though the evidence is limited. Honey is fine for you. Never give honey to a baby under 1 year old, because it can cause infant botulism.
Runny nose and sneezing: antihistamines
Non-sedating antihistamines like loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra) are the preferred choices while nursing. Sedating ones like diphenhydramine (Benadryl) are fine in small, occasional doses (25 mg or less), but larger or regular doses may affect your baby or lower your supply, especially combined with pseudoephedrine. If you need one to sleep, take it after the last feeding of the night.
What to avoid or limit
- Pseudoephedrine and oral phenylephrine, especially with a newborn or a low supply.
- Multi-symptom “cold and flu” products (day and night formulas). Many pair a decongestant with a sedating antihistamine, which is the combination most likely to affect supply, and they treat symptoms you may not have. Single-ingredient medicines make it easier to take only what you need.
- High or frequent doses of sedating antihistamines.
- Aspirin and bismuth subsalicylate (Pepto-Bismol).
- Liquid medicines high in alcohol.
Most medicines are considered safe with breastfeeding, but it’s always a good idea to check with your pharmacist, your doctor, or your baby’s pediatrician that the medicine you plan to take won’t interfere with breastfeeding, especially if your baby is a newborn or was born early. Tell them you’re nursing. The MommyMeds app can also be a great resource.
The flu shot and Tamiflu while breastfeeding
Flu shot
The flu shot is safe while breastfeeding, for you and for your baby. When you get vaccinated, your body makes antibodies against the flu and shares them with your baby through your breast milk. That matters because babies younger than 6 months are too young for their own flu vaccine. The CDC recommends a yearly flu shot for everyone in the house 6 months and older, so other caregivers should get one too.
The CDC’s breastfeeding guidance also says there is no evidence that COVID-19 vaccines harm breastfeeding moms or their babies, and moms who get an mRNA vaccine have antibodies in their milk. Ask your doctor which vaccines make sense for you this season.
Tamiflu and other flu antivirals
If you think you have the flu, call your doctor early. Antiviral medicine can make the flu milder and shorter, and it works best when started within 2 days of the first symptoms. Oseltamivir (Tamiflu) is the CDC’s preferred antiviral for breastfeeding moms: very little gets into breast milk, and it isn’t expected to cause problems for your baby. The CDC recommends antiviral treatment for moms who get the flu within 2 weeks of giving birth. Antivirals need a prescription.
How to protect your baby when you’re sick
Staying clean and washing your hands for 20 seconds with soap and water before breastfeeding or pumping is a good rule of thumb even when you’re well. When you’re sick:
- Wash your hands often: before you touch your baby or anything your baby will touch, before every feed or pumping session, and again anytime you sneeze, cough, or blow your nose.
- Think about a mask while you nurse and hold your baby, to keep droplets off them. Never put a mask on your baby; masks aren’t safe for children under 2.
- Clean your pump parts and bottles after every use.
- Hand off the extras if you can. A healthy partner or helper can do diaper changes, rocking, and bottle feeds of your pumped milk while you rest.
- Keep your distance from others and cover coughs and sneezes. Everyday steps like these help you and your baby stay healthy.
These precautions are especially important for babies younger than 6 months, who can’t get a flu shot yet.
Pumping while sick, or when you’re too sick to nurse
Some days you’ll feel too sick to hold your baby for a full feed, or your baby will be too congested to nurse well. On those days, a breast pump keeps your baby on breast milk and keeps your supply from dipping. The CDC says moms who are too sick to breastfeed should be supported to express their milk regularly.
- Pump about as often as your baby usually eats, so your body keeps getting the signal to make milk.
- Wash your hands first and clean the pump parts after each session.
- Let a healthy caregiver give the bottle if possible, so your baby gets your milk without the close contact.
- No need to throw it out. Being sick isn’t a reason to pump and dump, and your milk is still full of those antibodies. Store it the usual way: see how to store breast milk.
- If your baby is the one who’s sick, keep offering the breast or bottles of pumped milk to keep them fed and hydrated, and ask your pediatrician about a stuffy nose.
Keeping your milk supply up while you’re sick
The CDC notes that milk supply can drop for some moms while they’re sick. Less fluid, less food, missed feeds, and some medicines all play a part. Always remember the best prescription to get well and keep a good milk supply:
- Stay well hydrated and nourished. Keep water, broth, or an electrolyte drink next to you while you nurse, and eat what you can.
- Keep your feeding or pumping schedule. Feed or pump on a similar schedule as before, even if a session is short, to protect your supply.
- Skip the supply-lowering medicines above, especially decongestant pills.
- Rest whenever you can, and let others take over everything that isn’t feeding.
If your supply hasn’t bounced back a few days after you feel better, try a few extra pumping sessions and see our tips on how to increase milk supply.
When to call your doctor or your baby’s doctor
Most colds and stomach bugs pass on their own. Always contact your medical provider with any questions or concerns, and call sooner for any of the signs below. You can also talk to us virtually for breastfeeding support through our virtual lactation support.
Questions moms ask about breastfeeding while sick
Can I breastfeed with a cold?
Yes. The common cold isn’t passed through breast milk, and your milk carries antibodies that help protect your baby. Wash your hands before feeds and think about a mask while you nurse.
If I have the flu, can I still breastfeed my baby?
Yes. The CDC says moms with the flu can keep breastfeeding. Flu isn’t spread through breast milk. Wash your hands, consider a mask, and if you feel too sick to nurse, pump and let a healthy caregiver give the bottle.
What is the best cold medicine while breastfeeding?
There isn’t one product for everyone. Pick a single-ingredient medicine for your worst symptom: acetaminophen or ibuprofen for aches and fever, saline or a short course of a nasal spray for congestion, dextromethorphan for cough, or loratadine for a runny nose. Avoid pseudoephedrine if you’re worried about supply, and check with your pharmacist.
Can being sick lower my milk supply?
It can for a few days, mostly from dehydration, missed feeds, and some medicines like pseudoephedrine. Keep drinking fluids and keep feeding or pumping on schedule to protect it. If it’s still low after you feel better, extra pumping sessions can help build it back.
Will my baby get sick from my breast milk?
No. Cold, flu, and COVID-19 viruses spread through droplets and close contact, not breast milk. Your baby may still catch the bug from being near you, but breastfeeding gives them antibodies that can help them fight it.
Can I take Tamiflu while breastfeeding?
Yes. Very little oseltamivir (Tamiflu) gets into breast milk, and the CDC lists it as the preferred flu antiviral for breastfeeding moms. It needs a prescription and works best started within 2 days of symptoms.
Sources
- CDC: Influenza (flu) and breastfeeding
- CDC: COVID-19 and breastfeeding
- CDC: Foodborne and waterborne illness and breastfeeding
- NIH LactMed: Drugs and Lactation Database (pseudoephedrine, acetaminophen, ibuprofen, antihistamines, dextromethorphan, guaifenesin, oseltamivir, aspirin)
- CDC: Signs and symptoms of flu
- CDC: About the common cold
- CDC: Treatment of flu
- CDC: How to prevent norovirus
- CDC: Botulism prevention (no honey before age 1)
- NHS: Cough
- FDA: Is rinsing your sinuses with neti pots safe?
