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I’ve been asked some questions about gastroenteritis and breastfeeding, and here are my answers.
1. I am breastfeeding and have gastroenteritis, what should I do?
Sign off as sick!
Sorry to hear! It’s hard enough to take care of a baby without having to deal with gastroenteritis. The first thing to do (for your own sake!) is to make sure that you have someone else (the father / your own mother / your own father / mother-in-law / father-in-law) take care of the baby and all the house duties. Let the nanny come and place the baby on you when the baby wants to eat, and let the nanny take care of the baby afterwards.
Get some fluids in you!
My post about fluid replacement for children is applicable to adults as well. Keep in mind that you need a lot of fluids. You’ll need to compensate for your daily intake (about 2 liters); plus all the fluid loss from gastroenteritis (diarrhea and vomiting); plus the fluid required to produce milk (about 1 liter) plus compensate for the fluid that evaporates when you have a fever. That is a lot of fluid to replace! Provided that your heart and kidneys are healthy, your body will fix itself if you drink too much fluid. So don’t be afraid of drinking a lot. Do not hesitate to seek medical care if you are unable to keep up with the fluids. Sometimes you may need a drip, even as an adult. Then make sure you are hospitalized with the child. You and the child are entitled to it!
A basic concept about breastfeeding is that milk production is determined by how often the baby sucks with any 24-hour delay. This means that if you abruptly stop breastfeeding, your breasts will still produce milk. Your breasts will fill and you run the risk of sleeping with both milk congestion and gastroenteritis at the same time. We don’t want that! If you are now clear of the milk congestion (or fought your way through it) and took a few days’ break from breastfeeding, your breasts will produce much less milk than your baby needs afterwards. It’s possible to get milk production back up by intensive breastfeeding for a day or two, but it becomes unnecessarily more complicated.
It feels like the milk has dried up
It may have done so, especially if you haven’t had enough fluids. Then let the baby suck as often as they usually do, as long as they usually do, to tell your body that you want it to continue producing as much milk as before, when it can cope. Allow the person taking care of the child to supplement with formula until the child is full and satisfied after each lactation. Milk production will get back up and running once you’re healthy, provided you keep letting your baby suck.
Breast-feeding protects your baby from your stomach virus
Your immune system is in full swing to fight the stomach virus. Kindly enough, it shares some of the protection via the breast milk to the baby. The baby’s risk of contracting your gastroenteritis is therefore reduced if you continue to breastfeed. And if your child becomes infected, they are less seriously ill.
I’m nursing a baby who’s become sick, what am I going to do?
First question is, does the baby really have gastroenteritis? The vast majority of babies vomit, often after meals, some a little and others a lot. A fully breastfed baby always poops loose, yellow or greenish poop with some grainy lumps in it.
If there is gastroenteritis in the environment and the baby vomits much more than usual, or gets really watery stools, the baby has probably suffered from it. Otherwise, if the baby has occasional major diarrhea or vomiting, no fever and eats a good as usual, you can calmly continue to breastfeed and look after the baby at home.
Babies under 6 months of age with profuse watery stools several times daily and/or copious vomiting, should see a pediatrician on the same day. Young children are both fragile and difficult to interpret. They may well be diagnosed with gastroenteritis and recommended to go home, continue breastfeeding and perhaps supplement with fluid replacement. But with younger children, it is usually safer that a pediatrician takes a look.
I’m partly breastfeeding a child who has gastroenteritis, what should I do?
Continue with partial breastfeeding at the same frequency as before. If the child wants to lie on your chest for longer, that is ok. Supplement with liquid replacement according to the principles of this post. Your milk production will be the same as before the gastroenteritis, but it does not cover the child’s extra need for fluids. Therefore, you need to supplement with fluid replacement therapy if the child has abundant diarrhea and vomiting.
Many children tolerate breast milk well while having gastroenteritis. Some, however, vomit as soon as they suck on the mother’s milk. If your baby does, take a break from breastfeeding for a few hours (pump if necessary) leave the baby on your chest and let them suck on your finger or pacifier if they wish and provide only fluid replacement. Then try short breastfeeding sessions, so the baby only gets a little milk at a time. Increase breastfeeding times when you notice that the baby is able to keep the milk down.