Pregnancy, Breastfeeding and Swine Flu

So, swine flu is spreading and although the sense of sheer panic seems to be abating  (possibly because the media are playing it down a little in contrast to a few weeks ago), I thought it would be useful to point out that the UK Department of Health has published information for pregnant and breastfeeding mothers wondering what to do in the case of swine flu. 

In the case of pregnancy, some of the drugs used in the treatment of swine flu, ie oseltamivir and zanamivir,  are not licensed for use during pregnancy (or breastfeeding) and will only be considered if the treating physician feels it is absolutely necessary. However, because zanamivir (also known as Relenza) is the safer of the two, it will be the recommended choice for women who are pregnant.

It is also advised that pregnant women only use paracetamol to control any fever they may have.

'Pregnant women should not take non-steroidal anti-inflammatory drugs for the treatment of flu symptoms, because they may interfere with the baby’s pulmonary blood flow.'

If you are a breastfeeding mother it is advised that you should not stop breastfeeding: 

'Women who are breastfeeding should continue while receiving antiviral treatment or prophylaxis as they are not contraindicated in breastfeeding.

In particular mothers should feed on demand. Where possible additional formula should not be used so that the infant receives as much of the maternal antibodies as possible.

If a mother is ill, she should continue breastfeeding and increase feeding frequency. If she becomes too ill to feed then expressing milk may still be possible.

It the baby becomes too ill to breastfeed then expressed milk should be used.

The risk for swine influenza transmission through breast milk is unknown. However, reports of viraemia with seasonal influenza infection are rare.'

In the event that you or your baby do contract swine flu, you are advised to keep adopt a sensible approach in regards to hygiene. Thus you should:

Wash your hands frequently using soap and water or a sanitiser gel.

Cover your nose and mouth with a clean tissue if you are about to sneeze or cough. Then bin the tissue!

It is also recommended that mothers and their babies stay together and have lots and lots of skin-to-skin contact.

In addition you should wash your baby's hands if they have been in their mouth and limit the sharing of any toys that baby has been sucking or chewing on. Toys also need to be washed frequently.

If your baby uses a dummy, you should ensure other adults and children do not put any part of the dummy into their mouths.

If you have been diagnosed or you are suspected of having swine flu, you should drink plenty of fluids and only take paracetamol or ibuprofen if you have a fever:

Paracetamol is well tolerated and is licensed for women during pregnancy and for small children. It is also widely used for neonates, particularly in hospital and specialist care, although not specifically licensed for this group.

Over-the-counter influenza treatments containing decongestants and/or sedatives in addition to paracetamol are not recommended. They are only marginally effective and there is also a risk that safe paracetamol dosage could be exceeded if over-the-counter remedies are used while paracetamol is also being taken. Instead nasal decongestant sprays, steam inhalations and a simple cough linctus can be used alongside paracetamol.

There are also suitable antibiotics, should these become necessary for the treatment of complications, such as bacterial respiratory infections.

Click here to read the guidelines in their entirety...