The current recommendations when vomiting or diarrhea is present in the breastfed child are as follows:
- Breastfeeding should be the FIRST choice if your child can take anything by mouth. Because of the ease and rapidity with which breastmilk is digested, even if your child vomits or stools shortly after nursing, he will still have retained some of the nutrients. Other foods that are often suggested (such as Pedialyte, sports drinks, gelatins and sodas) offer little nutritional value and none of the antibodies that human milk contains.
- When your breastfed child is ill you'll want to offer more frequent feedings -- this can limit the volume taken in at one time and helps to comfort and soothe a sick child. If your child is vomiting often and not keeping the milk down for long, it may be helpful to breastfeed frequently but limit the length of each nursing session (so your child takes in less milk at once). Another option is for Mom to express some milk before breastfeeding so that the milk flow is slower. RARELY does the baby who is allowed to breastfeed at will during a vomiting or diarrhea illness become dehydrated.
The use of an oral rehydration therapy such as Pedialyte is a sound recommendation for a formula-fed infant who is vomiting or who has diarrhea, but using this in place of breastmilk offers no benefit
to the breastfed baby. Human milk is a natural fluid, unlike formula and other milk products, that again is easily and rapidly digested.
Forego the Pedialyte as long as baby continues to nurse well and as long as there are no signs of dehydration. If baby is showing signs of dehydration, talk to your doctor. Following are signs of dehydration
- fewer than 2 wet diapers in a 24-hour period
- baby not behaving normally (more irritable, less active, sleeping more)
- weak cry
- no tears (in an infant older than 3 months)
- dry mouth
- skin that stays wrinkly-looking when pinched (pull up the skin on the front of the hand; it should pop easily back into place - not stay pinched or wrinkly-looking)
- eyes that look sunken
- cool, clammy extremities, especially the fingers and toes
- fast breathing, or a heart that is beating faster than usual
Babies who are allowed to continue breastfeeding through an illness such as this are less likely to become dehydrated than those who are taken off the breast. Continued nursing also provides your child with precious antibodies that will prevent the illness from worsening and speed healing. Nursing is also very comforting to your child, which is healing in itself.
Breastfed babies sometimes need oral rehydration therapy (Pedialyte, etc), though far less often than artificially fed infants. The World Health Organization recommends continuing to breastfeed during and after oral rehydration therapy
. Research shows that babies lose more weight and actually have more stools during diarrhea when they are deprived of breastmilk.