Using oseltamivir and zanamivir during breastfeeding
Oseltamivir and zanamivir can be used during breastfeeding when clinically indicated (1)
- recommendations apply to full term, healthy infants only
Oseltamivir and zanamivir are used for the prevention and treatment of influenza:
- oseltamivir is the preferred choice during breastfeeding -infant monitoring is still required
- limited data suggest that oseltamivir passes into breastmilk in negligible amounts
- is no published evidence for the use of zanamivir in breastfeeding, however infant exposure is expected to be insignificant
- zanamivir can be used by any route during breastfeeding when indicated
- treatment choice should be based on the clinical scenario with safety in breastfeeding a secondary consideration
- if the breastfed infant also needs direct treatment or prevention for influenza, the recommended dose of oseltamivir or zanamivir for infants should be given directly to the infant
- is regardless of whether they are also exposed to oseltamivir or zanamivir via breast milk
Breastfeeding with influenza infection
- breastfeeding should continue as normal
- is no evidence that influenza can be transmitted via breast milk
- breast milk contains antibodies and other bioactive factors which can help protect the infant from influenza
Minimising risk of infant infection through close contact
- in order for breastfeeding to be facilitated it is important that mother and baby stay close together
- however, consider the following to reduce the risk of the infant becoming infected:
- wash hands for at least 20 seconds before touching the infant or any expressing equipment
- avoid coughing or sneezing on the infant while breastfeeding
- if used, clean breast pumps as recommended by the manufacturer after each use
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