RSV and Breastfeeding: Everything You Need to Know

Breastfeeding and Respiratory Syncytial Virus (RSV) can be complicated to navigate. RSV is a highly contagious virus that can cause breathing problems, especially for infants and small children. Breastfeeding provides many essential health benefits to babies, but it can be interrupted when a child has RSV. In this article, we will discuss what mothers need to know about RSV and breastfeeding to ensure the safety and health of their babies.

RSV and Breastfeeding

RSV has been causing havoc over the past few years among infants and toddlers.

While RSV has always been a thread (one that’s particularly personal to my family), the cases have been terrible this year and last. Not a day goes by that I don’t see news of another child hospitalized.

RSV can present unique challenges regarding feeding, especially for breastfed infants. I will share everything you need about breastfeeding through RSV in this article. Check out this article if you need more general advice on getting through an RSV diagnosis.

Always work with your trusted healthcare provider and follow their advice for your infant’s care. This article is meant for informational purposes only.

What is RSV?

RSV, or Respiratory Syncytial Virus, is a highly contagious virus that primarily affects the respiratory system. It is one of the leading causes of lower respiratory tract illness in infants and young children. RSV typically causes cold-like symptoms such as fever, runny nose, coughing, and sore throat. In some cases, severe symptoms can occur, such as wheezing, difficulty breathing, bronchiolitis (inflammation of the small airways in the lungs), and pneumonia.

While RSV is very common among children under 5 years old, it can also affect adults with weakened immune systems or those who are otherwise immunocompromised. In addition to its effects on the respiratory system, it can also cause diarrhea and dehydration if not treated properly.

How can you Prevent RSV?

To prevent infection from RSV, it’s important to practice good hygiene, including washing your hands regularly and avoiding close contact with people who are already infected.

RSV can often appear very mild in older children and young to mid-age adults, so be aware of anyone who has any cold having contact with your infant.

It’s also important to clean toys and other objects that may have come into contact with saliva or mucus from an infected person since this can spread the virus quickly.

Is there an RSV vaccine for children?

There is an RSV vaccine called Synagis. Unfortunately, it is costly and currently only available for infants born at 35 weeks or earlier and less than six months during the RSV season.

With that said, there are clinical trials for an RSV vaccine that will be more widely available. Pfizer is developing one that has been especially notable. It has been trialed during pregnancy with 7,400 pregnant women, and it had a “Vaccine efficacy of 81.8% was observed against severe medically attended lower respiratory tract illness due to RSV in infants from birth through the first 90 days of life with high efficacy of 69.4% demonstrated through the first six months of life.”

Is RSV Dangerous?

While not every child will respond the same way, it is responsible for 58,000-80,000 hospitalizations in children under five each year. Around 100-300 deaths occur yearly in the same age group (source).

Some children are more susceptible than others, but you never know if your child will respond negatively. For instance, our children have no known predisposing factors for severe RSV, yet all three have been hospitalized.

Does breastfeeding help with RSV?

Breast milk is thought to help prevent the severity of respiratory illnesses. This study specifically looked at breastfeeding and the severity of RSV, and it found, “Exclusive breastfeeding for >4 months significantly lowered hospitalization and supplemental oxygen use. Breastfeeding for 4 to 6 months also reduced healthcare utilization in the form of unscheduled GP visits and ED presentation. Hospitalised infants were significantly more likely to be breastfed for ≤ 2 months or not at all. Formula-fed infants face higher risks of infectious morbidity in the first year of life.”

Of course, this doesn’t guarantee your infant won’t get RSV or get very ill, but breastfeeding does appear to have a protective benefit agains it.

Tips for Breastfeeding through RSV

Keep offering Breast Milk

Breast milk is one of the best defenses against illnesses. It changes to help fight off all sorts of illnesses, including respiratory infections.

Do whatever you can to continue offering breast milk directly from the breast or expressed breast milk. Donor milk, while it may not contain the specific components to fight off your child’s particular illness, will still provide your baby with an increased ability to fight off illness.

If your child is hospitalized, request a hospital-grade pump from the hospital to allow you to express breast milk if needed. Many hospitals will have donor milk available, too.

Monitor Symptoms and Count Diapers

RSV is an illness that can take a turn for the worse quickly. Make sure you are closely monitoring your baby to ensure they are not getting dehydrated. While their milk intake may decrease, they should still be staying hydrated. Watch their diaper count carefully to ensure they are getting enough to eat.

We felt our Owlet was a life saver during our 2nd and 3rd child’s RSV cases (and alerted us to get them help before they outwardly showed distress). However, it is not a medical device and should be used with caution.

Suction Before Nursing

RSV produces a ton of mucus. This can make it difficult for an infant to nurse. The extra mucus can also increase spit-up. One of the best things you can do is clear their nasal passageway using suctioning minutes before nursing.

When my children were hospitalized with RSV, the nurses always had us do this, and we never had issues nursing.

In my experience, the blue bulb is not strong enough for the amount of secretions produced. Products like the Nose Frida can be helpful, though exhausting.

I like electronic nasal aspirators. While too much suctioning can cause increased secretions or even damage to the nasal passageway, it can be the only way to clear the baby’s airway in situations like RSV. This is a good option, and if you are looking for something less expensive, here is one our old pediatrician recommended.

When our third child had RSV, the hospital credited our electronic machine for why our son didn’t get as bad, and that was why they let us go home earlier than some. Of course, please discuss this with your care provider for their specific instructions.

I do not recommend the Spectra hack for making a homemade nasal aspirator.

Offer Appropriate Medication

RSV is a virus, so there is no medication to shorten the duration of the illness. However, it can cause high fever and discomfort. While there is debate on treating fever with Tylenol or Advil (if your child is over six months), if the fever is causing lethargy and preventing your baby from eating, the pros may outweigh the cons. RSV can cause them to feel so miserable, so treating the symptoms can make them feel better, resulting in better feeding.

Of course, consult with your doctor on any medication.

Adjust Positions

Feed your baby in upright or seated positions. These positions can help keep them breathing better and allow more effective draining of their nasal passages. I find that laid-back nursing works well.

Offer Small, Frequent Meals

Because of the amount of mucus produced with RSV, and your infant may be exhausted from having to work so hard to breathe, it can be hard to eat full meals. Focus on offering small meals more frequently if they can take food by mouth.

Express milk if the baby isn’t nursing well/can’t nurse

If your baby is nursing less than usual, you will want to make sure you are protecting your milk supply by pumping regularly. Sometimes, a child may have to be intubated and unable to eat as they usually would. You should pump with a hospital-grade pump and ask them to provide that milk to your baby.

Skin to Skin

Skin-to-skin has many benefits, especially for your supply and to help your baby feel better. If your baby is well enough, do skin-to-skin. This will also allow them to have more access to their breast. This is not the time to be spacing out feeds!

Expect a stall in weight gain.

When an infant is sick, it is not uncommon for them to stop gaining weight or even lose a little bit. As long as their diaper count is adequate (if your baby is hospitalized, this will be tracked carefully) and they show no signs of dehydration, it usually isn’t a cause for concern. They will pick up their weight gain as soon as they feel better. As usual, contact your doctor with any significant concerns.

Milk Supply Dropped

The biggest question I get from moms who have a baby with RSV is that their milk supply has dropped. If your baby isn’t nursing well and you aren’t able to pump, this definitely can happen. Fortunately, the drop is usually temporary and recoverable. Here are a few things to try.

Increase your Electrolytes

While I’m not one to recommend blue Gatorade for milk supply, there is some truth to electrolytes helping with supply. It’s better than just drinking a bunch of water as well. I recommend a product like Relyte, which you can mix into water. You can use the code CLARKS for 10% off. Liquid IV is another popular choice.

Offer the breast frequently.

The best way to increase milk supply, especially if you didn’t have supply issues before, is to increase the stimulation to the best. If your baby. is feeling better and nursing again, take a nursing vacation and let them nurse as much as they want (while, of course, monitoring for any signs of dehydration).

Pump/Hand Express

You can also add in some additional pumping or hand expression sessions to help with supply.

Work with a lactation consultant.

In most situations where milk supply is an issue, working with a lactation consultant is your best course to develop a specific plan for you and help you determine if any lactation supplements may be helpful. If you need help, feel free to book a virtual consult here.

Baby Refusing Breast after RSV

Another issue you may encounter after RSV is your baby refusing the breast, especially if they can’t nurse as much. If this is the case, I recommend doing lots of skin-to-skin, taking a bath together, and being patient. Most babies will return to the breast.

Having an infant diagnosed with RSV is a scary situation, and it can impact breastfeeding. I hope this article has given you some helpful tips for navigating this time. Always reach out to a medical provider for personalized support and advice.

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