We traveled to Phuket, Thailand, when baby was 7 months old and unfortunately on that trip I managed to pick up food poisoning from a meal or water we ate or drank somewhere. I narrowed it down to two places that I ate at but, as is often the case, it was hard to tell for sure where exactly the poisoning came from. Having food poisoning while taking care of a 7 month old baby presented three main challenges in terms of breastfeeding: two of which passed quickly and the other having seemingly slightly longer term implications.
Challenge #1:
The first challenge was finding out whether I could pass on the infection to the baby through the breast-milk. Some people in the know may think this sounds crazy but, for me, I knew that so many other viruses and substances that the mother ingests (medicines, alcohol etc.) can be passed through breast-milk, and so I wanted to be sure that I wouldn’t pass any harmful infection on to the baby. In terms of food poisoning, the one thing worse than having horrible symptoms of your own, would be having to watch your baby suffer through those horrible symptoms. It turns out that breastfeeding after food poisoning is fine in most cases. I found this article on kellymom about breastfeeding when sick to be helpful. Additional useful information from the CDC on breastfeeding with food-borne and waterborne illnesses like travelers diarrhea.
What the experts say:
A nursing mother with diarrhea believed to have been caused by food or water sources should be encouraged to increase the frequency of breastfeeding while significantly increasing her own fluid intake… The organisms that cause travelers’ diarrhea do not pass through breast milk. Use of oral rehydration salts by breastfeeding mothers and their children is fully compatible with breastfeeding. Breastfeeding mothers should carefully check the labels of over-the-counter antidiarrheal medications to avoid using bismuth subsalicylate compounds, which can lead to the transfer of salicylate to the child via breast milk… Most experts consider the use of short-term azithromycin [antibiotic] compatible with breastfeeding.
Centers for Disease Control and Prevention
As long as the symptoms are confined to the gastrointestinal tract (vomiting, diarrhea, stomach cramps), breastfeeding should continue without interruption as there is no risk to the baby.
Kellymom.com
Challenge #2:
The second challenge was getting through the 2 – 3 days where I was feeling very sick – the first 24 hours being the worst. Without getting into too much undesirable information here, I could barely make it to the bathroom, did not leave the hotel room for at least 36 hours, was not able to drink very much and was able to eat only dry, plain crackers.
Needless to say, taking care of a crying, pooping, hungry baby was not easy. I had barely any energy to lift a glass of water, never mind lift the baby to breastfeed her, and it was so hard to be patient when she was crying. It is no fun trying to care for the baby when you can barely even take care of yourself, but we did because there is no alternative! I do think she sensed that something was wrong though, and was calmer for us.
Challenge #3:
3. The third challenge was the implications on our breastfeeding quantity, which I was not aware of until after it had happened. Normally, her most filling breastfeed was first thing in the morning when we would wake up, and then each feed later in the day was a little smaller than. On the first morning after being awake all night with the food poisoning symptoms, I could tell my breasts were not as full as they normally would be at that time in the morning, after not having fed her for about 9 hours or so.
I could barely lift the baby and I decided not to breastfeed her that morning so I asked my partner to feed her the solid food breakfast earlier than usual. I knew I had lost a lot of liquids through diarrhea and sweating, and not being able to keep up my usual water intake. And I knew that dehydration could have a detrimental effect on breastfeeding.
I figured that by the next day I would be better hydrated and the milk supply would be back to normal. Although I had been drinking some oral rehydration salts in my water, I unfortunately had not been able to consume as much liquids that first daytime as I had hoped and I was still very dehydrated.
On the second day after the food poisoning, I woke up again with my breasts not as full as they usually would be first thing in the morning. This time, I was strong enough to hold the baby and I fed her, but I knew it would not be enough to fill her and so straight after that I gave her some solids (whereas normally we would wait an hour or two until ‘solid food breakfast’).
The same thing happened on the third morning. And by the fourth morning, I began to wonder if we had entered a ‘new normal’ in that my body was producing less in the morning now as standard, rather than because I was sick.
After recovery…
Unfortunately, my ‘normal’ milk supply and full-feeling in my breasts never returned after that bout of food poisoning, even two months later as I write this.
Now, if the baby was still under 6 months old and exclusively breastfeeding this whole scenario would have been much more challenging and stressful, but we were fortunate in the timing since she was already used to eating solid food and had been doing so for just over a month. It was therefore easy to supplement more of the solids to compensate for the reduced amount of breast-milk. Had we not been able to add more of the solids, we would have struggled more as she would have been hungry and crying more. In that scenario, it would have been good to be able to use some previously expressed milk stored in a fridge or freezer, however, when you’re traveling you may not have access to a pump or to a fridge or freezer or facilities to sterilize all the necessary equipment for expressing milk.
Medical advice in this scenario is to increase the frequency of the breastfeeding sessions and increase intake of liquids. However, having been in the position of being very sick and unable to even lift or barely hold my baby, I’m not sure this will work in every situation. If your baby is not on solids yet and/or is not used to drinking milk or formula from a bottle, food poisoning could potentially be a concern for you on your travels to consider how you would ensure baby gets enough to feed on.
6 practical tips on breastfeeding when you have food poisoning…
- try to avoid or minimize consumption of foods that are known to increase the chances of contracting food poisoning (for example, shell fish, raw foods like salads, unpasteurized dairy, ice cubes, meat not thoroughly cooked) and to eat at places that look busy and/or are well reviewed by many others;
- carry a supply of oral re-hydration salts with you when you travel to help re-hydrate more quickly;
- carry a supply of loperamide (Imodium) anti-diarrheals, which are considered compatible and safe with breastfeeding;
- wash your hands often – after going to the bathroom and before touching baby – to minimize risk of passing any germs;
- try to consume as much water as possible, even if you don’t feel like it and it’s difficult to swallow down: you need the liquids for re-hydrating your own body so that you can keep producing milk for baby;
- if you feel that your milk supply has decreased, as mine did, increase the frequency of the feedings so that your body gets the message to keep producing more for baby (according to the body’s supply and demand mechanisms of breast-milk production).
Wishing you safe and healthy travels with no food-borne or waterborne illnesses!