Yes, flu is dangerous for vulnerable young babies, so the agency's concern is understandable.  But the CDC advice is difficult on so many levels.  As Jeannette points out, many mothers don't have a team of helpers just standing by, waiting to care for her and for the baby separated from her.  The CDC's own information notes that someone is contagious for 24 hours *before* flu symptoms begin.  One could perhaps rationalize temporary separation at birth with a sick mother -- the mother hasn't already been breathing on the baby.  But in ordinary life, by the time the mother is feeling sick, the baby has already been exposed. as is everyone in the household. (And perhaps those instantly produced helpers are on their way to being sick themselves).  The symptoms of flu do overlap with other respiratory ailments -- the Web has lots of of "is it flu or a cold" checklists -- so would a mother be tempted to pause breastfeeding every time she feels under the weather?

And this so quickly assumes that everyone has a pump (more likely now in the US with insurance and mothers at work, but not in the world and throughout history) and is good at pumping and that the baby is happy to take a bottle -- pumping and keeping a pump sanitary are a lot of work -- and would require that the helpers are just as focused on preserving breastfeeding.  (We're led to believe that pumps are just miracle machines, and that pumped milk is exactly the same as fresh, but many mothers struggle with pumping at work.)  Expecting a sick mother to pump 6-8 times attempting to provide 30 oz. a day, possibly for weeks, seems like a set-up for milk stasis/plugged ducts/mastitis/down-regulated supply for the mother and formula for the baby, just when they need the normal immune support of breastmilk fresh from the source.  Putting breastfeeding at risk doesn't seem long-term benefit for the baby.

Yes, a sick mother needs lots of help, and perhaps perhaps could be encouraged toward plenty of hand-washing and perhaps minimizing other contact and using a mask during contacts (although it's likely too late).  As Jeanette said, a complicated issue…

Margaret Wills, IBCLC, Maryland USA




> Date:    Fri, 19 Jan 2018 10:54:00 -0800
> From:    Jeanette Panchula <[log in to unmask]>
> Subject: CDC and Flu
> 
> Got a message from a hospital RN/IBCLC that the CDC (https://www.cdc.gov/breastfeeding/disease/influenza.htm)  was forbidding mothers from breastfeeding if they have the flu...  
> 
> From what I can tell, this is the same information we have had from the CDC website for the H1N1 Virus a few years ago:
> 	No direct breastfeeding upon birth by a mom who has symptoms (fever, cough) and positive tests of Influenza
> 	Mom is encouraged/allowed to pump and provide her breast milk so that someone else can feed it to her baby
> 	Mom is not allowed to be with her baby (room sharing) until no fever and no coughing.
> 
> The references in the link above were not from this season, but from 2016.  Is there any change? 
> 
> In my experience, the complicated issue is the mom who has been home for days, weeks, months and has symptoms or positive diagnosis.  Assessment of the family situation, who cares for the baby and where, etc. can be very challenging for many mothers I see....
> 
> Thoughts?
> 
> Jeanette Panchula, BA-SW, RN, PHN, IBCLC
> Vacaville, CA

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