HOW TO PROTECT YOUR BREASTFEEDING RELATIONSHIP EVEN WHEN YOUR BABY IS NOT FEELING WELL | SERIES TWO

SICKNESS BLOG SERIES: #2 RESPIRATORY INFECTIONS

RESPIRATORY INFECTIONS

This is an umbrella word for a ton of different illnesses, anything from your basic cold to croup to bronchiolitis and pneumonia a lot in between. Upper respiratory symptoms can include coughing, sneezing, draining from the nose and/or eyes. Lower respiratory symptoms can be chest congestion, coughing, wheezing, belly pain, and fever. They can be scary and labor intensive for parents. 

Hey there! My name is Kelly Maher Carvell, CLC, CLE.
I offer effective telehealth lactation support and education to modern families.  
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​There’s not much worse than holding your baby while they cough and cry. But when is it “just a virus” and when might they need medical attention? Here are some basics for every baby.

• Babies, especially newborns, are nose breathers by nature. If their nose is blocked, they will feed and sleep poorly. 
• Normal respirations (how many breaths in a minute) are between 30-60 breaths per minute while awake at rest and slower when sleeping. Counting respirations is valuable. If you call your doctor on call and you’ve already counted their respirations, that will help them make the decision on how to care for your baby. If a baby is breathing rapidly, either at the high end of normal or faster than the normal range, their body is struggling to move air and they need help. HOW they’re breathing also matters. If they’re breathing 40 times in a minute, but they’re taking 20 rapid, shallow breaths, then having long periods without a breath, that is also a problem and they need to see a doctor. Breathing should be rhythmic. 
• How much work are they doing to breathe? If you think your baby might be struggling, get them undressed. Can you see the muscles between their ribs pull in while they’re breathing? Are they sucking in at the belly? Those are called retractions and they’re never normal. 
• Over the counter medicine ain’t what it used to be. I remember getting a Dimetapp cocktail if I so much as sneezed as a toddler. New studies have shown that not only do these meds not actually do a lot for kids under 4yrs, they can actually hard their growing bodies if given often. One of the most common emergency room visits is accidental drug overdose. A lot of parents don’t know that cough and cold meds also contain things like Tylenol and Benadryl, and might give extra medicine, accidentally poisoning their child. The popular “natural” medicines that advertise as “safe” for babies under 1 (not naming brands, but might rhyme with “Barbies”) are just purified water, citric acid, and “natural ingredients”. Safe for babies? Sure. Helpful? Nope, other than they might taste nice.

RESPIRATORY INFECTIONS IN A BREASTFED BABY

• Just like with fevers, babies might prefer those short, frequent nursing sessions and that's okay. That will keep them hydrated and keep their energy up.
• If they seem unusually irritable or they're refusing to nurse, remember that a baby can't talk to you to tell you why. Try clearing their nose with a couple of drops of saline (or milk in a pinch!) in each nostril and gently rub them together. Give it a few minutes and try again. The saline should help shrink up swollen nasal passages. If they have a lot of congestion, try nursing in the bathroom with the hot shower steam or next to a humidifier. If they have a lot of drainage, do saline or milk drops followed by suction with a Nose Frida or bulb syringe. Will they scream like they're being murdered? Yes. Will they feel much better and more willing to nurse without a throat fill of snot? Yes. Remember, a baby will always choose breathing over food. If you make breathing easier, nursing often goes better.
• If their throats hurt, as your doctor about an appropriate dose of OTC pain reliever. They'll nurse better if they're comfortable. 
• If they're congested or have fluid in their ears, suckling can sometimes be uncomfortable. Try different positions like Straddle or Side Lying. If they're just too stuffy or snotty to nurse, frequent syringes or spoonfuls of milk will help keep them hydrated.
• Sometimes these babies have a hard time handling active milkflow, even though they're hungry and want to nurse. Remember, they'll always choose breathing. One way to help might be to pump until your milk is coming out in slow, fat drops, then latch your baby. By removing the letdown milk, you're giving them rich, fatty milk that flows slowly and is easier for them to handle when they can't breathe well. It might not be as many ounces as they usually drink, but this milk has 2-3x the calories of the milk you pumped out, so it will keep them full on less milk.​​
• Always protect your supply. If they aren't emptying your breasts as frequently, you'll want to pump to replace those feedings
• What they have, you'll probably get. OTC meds for moms with respiratory infections get a little tricky. Decongestants and antihistamines in mom are safe for baby, but notorious for decreasing milk supply. Sudafed and Benadryl are the biggest culprits. Medicines for fever, sore throat, and cough are often just fine. Check with your Lactation Consultant for specifics, or check MommyMed or Infant Risk Center. 
• For croup and other barky type coughs, inflammation around the vocal cords makes for that high pitched, sad, persistent cough. Try to keep them from crying. If that means extra nursing and cuddles and songs and movie time, so be it. Cold air can sometimes help. Nurse outside or near an open window if the weather is cold with you and baby wrapped up in a blanket so they can breathe the cold air. You can also stand next to an open freezer and nurse (just make sure your frozen milk stash is protected from temperature change!).

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Sick babies are never a good time, and experiencing your first fever can be really scary. Always, if you EVER have a gut feeling something is just not right, it’s better to be safe and get baby checked out. Sometimes the peace of mind is worth the copay, and things can change quickly in little ones. But hopefully these tips will help you care for your breastfed baby so you can handle their fevers with confidence.

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AUTHOR

Hey! I’m Allison, one of the Lactation Experts with Successful Breastfeeding! I am an International Board Certified Lactation Consultant (IBCLC) and have over seven years of experience as a pediatric nurse working one on one with mothers and babies. My most important credential is being “Mama” to two little ones. ​I am so happy to be part of the Successful Breastfeeding team; to be able to offer support in a more relaxed setting! I can help you meet your breastfeeding goals no matter where you are - virtual sessions for convenient, accessible help no matter where you live. Breastfeeding is a relationship between you and your baby, and it’s my job to support it, whatever your goals and needs happen to be.