Deciding about travel and breastfeeding
Travel need to be a reason to stop breastfeeding. A mother traveling with a nurse infant may find breastfeeding makes travel easier than it would be if traveling with a bottle-fed infant. A mother traveling without her nursing infant or child may take steps to preserve breastfeeding and maintain her milk supply while separated. The major factors for a mother traveling without her nursing infant or child to consider are the amount of time she has to prepare for her trip, her flexibility of time while traveling, her options for storing expressed milk while traveling, the duration of her travel, and her destination. Mothers planning travel away from a nursing infant may access information from her pediatrician.
Preparation for travel while breastfeeding
Breastfeeding mothers may wish to find local breastfeeding support before beginning travel and keep pertinent contact information handy throughout the trip. La Leche League International has breastfeeding experts in many countries.
A mother traveling with a nursing infant <6 month old need not plan on supplementing breastfeeding because of international travel.
Breastfeeding infants do not require water supplementation, even in extreme heat environments, if the mother is adequately hydrated. A breastfeeding mother traveling without her nursing infant or child may wish to build a supply of milk to be fed to the infant or child during her absence by expressing milk and storing it for later use by another caregiver.
Depending on her destination, a mother may need to plan for milk expression without a reliable electrical power source. Expressing milk without an electrical power source is less reliable for maintaining milk supply over a long time than expressing milk with a hospitalgrade electric breast pump. Intermitted milk expression can be successful with battery and manual breast pump, as well as manual expression.
The destination for travel can impact decisions for milk storage. Once milk is cooled, a cold chain needs to be maintained until milk is consumed. Refrigerated milk can subsequently be frozen; however, once frozen milk is fully thawed, it should be used within 1 hour.
Guidance on human milk storage for healthy infants
Vaccination of breastfeeding mothers
Most nursing mothers may be immunized routinely, based on recommendations for the specific travel itinerary. Breastfeeding is not a contraindication to the administration of vaccines, including live-virus vaccines; however, there is a theoretical risk to the infant with the use of the yellow fever vaccine in breastfeeding mothers. Breastfed infants should be vaccinated according to routine recommended schedules.
Breastfeeding mothers should take the usual adult dose of the antimalarial drug appropriate for the itinerary. Nursing mothers with infants weighing <11kg (approximately 24 pounds) should not take atovaquone/proguanil for prophylaxis. Data are limited on the use of doxycycline during breastfeeding; however, most experts consider its short-term use compatible with breastfeeding. Primaquine is contraindicated during lactation unless both the mother an breastfed infants have normal G6PD levels. It is critical to note that breastfed infants require their own antimalarial medication if traveling to an endemic area. Mother's milk does not provide malaria protection, even when the mother is taking an adequate medication and dose for herself.
Traveling with a breastfed infant
Infants are particularly susceptible to painful pressure due to eustachian tube collapse as a result of pressure changes during air travel. Breastfeeding during ascent and descent often relieves this discomfort.
No special precautions are necessary for airport security screenings while breastfeeding. Breast milk does not need to be declaired. Electric breast pumps are considered personal items during air travel and may be carried on and stowed underneath the passenger seat, similar to a laptop computer, purpose or diaper bag.
Breastfed infants are protected from traveler's diarrhea, and thus it is often recommended that a nursing mother try, if reasonable, to continue to breastfeed until returning home. A nursing mother with traveler's diarrhea should increase her own fluid intake and frequency of breastfeeding; she should not stop breastfeeding because of traveler's diarrhea. The use of oral rehydration salts is fully compatible with breastfeeding.
In addition to the usual contents of the travel health kit, breastfeeding mothers may wish to include an antifungal cream, which can be used to treat periareolar yeast.
…have a nice time!
Travel need to be a reason to stop breastfeeding. A mother traveling with a nurse infant may find breastfeeding makes travel easier than it would be if traveling with a bottle-fed infant. A mother traveling without her nursing infant or child may take steps to preserve breastfeeding and maintain her milk supply while separated. The major factors for a mother traveling without her nursing infant or child to consider are the amount of time she has to prepare for her trip, her flexibility of time while traveling, her options for storing expressed milk while traveling, the duration of her travel, and her destination. Mothers planning travel away from a nursing infant may access information from her pediatrician.
Preparation for travel while breastfeeding
Breastfeeding mothers may wish to find local breastfeeding support before beginning travel and keep pertinent contact information handy throughout the trip. La Leche League International has breastfeeding experts in many countries.
A mother traveling with a nursing infant <6 month old need not plan on supplementing breastfeeding because of international travel.
Breastfeeding infants do not require water supplementation, even in extreme heat environments, if the mother is adequately hydrated. A breastfeeding mother traveling without her nursing infant or child may wish to build a supply of milk to be fed to the infant or child during her absence by expressing milk and storing it for later use by another caregiver.
Depending on her destination, a mother may need to plan for milk expression without a reliable electrical power source. Expressing milk without an electrical power source is less reliable for maintaining milk supply over a long time than expressing milk with a hospitalgrade electric breast pump. Intermitted milk expression can be successful with battery and manual breast pump, as well as manual expression.
The destination for travel can impact decisions for milk storage. Once milk is cooled, a cold chain needs to be maintained until milk is consumed. Refrigerated milk can subsequently be frozen; however, once frozen milk is fully thawed, it should be used within 1 hour.
Guidance on human milk storage for healthy infants
| Location |  |
Temperature | |
Duration | |
Comments |
| Countertop, table | Room temperature (up to 77°F or 25°C) | 6-8 hours | Containers should be covered and kept as cool as possible; covering the container with a cool towel may keep milk cooler. | |||
| Insulated cooler bag | 5-39°F or -15-4°C | 24 hours | Keep ice pacs in contact with milk containers at all times, limit opening cooler bag. | |||
| Refrigerator | 39°F or 4°C | 5 days | Store milk in the back of the main body of the refrigerator. | |||
| Freezer - compartement of refrigerator | 5°F or -15°C | 2 weeks | Store milk toward the back of the freezer, where temperature is most constant. | |||
| Refrigerator/Freezer with separate doors | 0°F or -18°C | 3-6 month | Store milk toward the back of the freezer, where temperature is most constant. | |||
| Chest or upright manual-defrost deep freezer | -4°F or -20°C | 6-12 month | Store milk toward the back of the freezer, where temperature is most constant. |
Vaccination of breastfeeding mothers
Most nursing mothers may be immunized routinely, based on recommendations for the specific travel itinerary. Breastfeeding is not a contraindication to the administration of vaccines, including live-virus vaccines; however, there is a theoretical risk to the infant with the use of the yellow fever vaccine in breastfeeding mothers. Breastfed infants should be vaccinated according to routine recommended schedules.
Breastfeeding mothers should take the usual adult dose of the antimalarial drug appropriate for the itinerary. Nursing mothers with infants weighing <11kg (approximately 24 pounds) should not take atovaquone/proguanil for prophylaxis. Data are limited on the use of doxycycline during breastfeeding; however, most experts consider its short-term use compatible with breastfeeding. Primaquine is contraindicated during lactation unless both the mother an breastfed infants have normal G6PD levels. It is critical to note that breastfed infants require their own antimalarial medication if traveling to an endemic area. Mother's milk does not provide malaria protection, even when the mother is taking an adequate medication and dose for herself.
| Vaccine / Immunobiologic | |
Precautions for breestfeeding |
| Immune globulins, pooled or hyperimmune | None | |
| Diphteria - Tetanus | None | |
| Hepatitis A | Data on safety in breastfeeding are not available; it is unlikely that vaccination would cause untoward effects in breastfed infants. Consider immune globulin rather than vaccine. | |
| Hepatitis B | None | |
| Influenza | Vaccination with inactivated influenza vaccine in encouraged when feasible for children aged 6-23 months and their close contacts and caregivers. | |
| Japanese encephalitis | Data on safety in breastfeeding are not available; vaccine should not be routinely administered. | |
| Measles | None | |
| Meningococcal meningitis | None | |
| Mumps | None | |
| Pneumococcal | Data on safety in breastfeeding are not available; it is unlikely that vaccination would cause untoward effects in breastfed infants. | |
| Polio, inactivated | None | |
| Rabies | Data on safety in breastfeeding are not available; however, this vaccine is commonly given to breastfeeding mothers without any observed untoward effects in breastfed infants. | |
| Rubella | None | |
| Tuberculosis (BCG) | Data on safety in breastfeeding are not available. | |
| Typhoid (ViCPS) | Specific information concerning use during breastfeeding is not available. However, the vaccine may be used when risk of exposure to typhoid fever is high. | |
| Typhoid (Ty21a) | Specific information concerning use during breastfeeding is not available. However, the vaccine may be used when risk of exposure to typhoid fever is high. | |
| Varicella | None | |
| Yellow fever | Vaccination of nursing mothers should be avoided because of the theoretical risk for transmission of 17D virus to breastfed infant. When travel to high-risk yellow fever-endemic areas cannot be avoided or postponed, nursing mothers can be vaccinated. | |
| Vaccinia (Smallpox) | Woman who are breastfeeding should not be given this vaccine. If there is a smallpox outbreak, recommendations on who should get vaccinated may changed. |
Traveling with a breastfed infant
Infants are particularly susceptible to painful pressure due to eustachian tube collapse as a result of pressure changes during air travel. Breastfeeding during ascent and descent often relieves this discomfort.
No special precautions are necessary for airport security screenings while breastfeeding. Breast milk does not need to be declaired. Electric breast pumps are considered personal items during air travel and may be carried on and stowed underneath the passenger seat, similar to a laptop computer, purpose or diaper bag.
Breastfed infants are protected from traveler's diarrhea, and thus it is often recommended that a nursing mother try, if reasonable, to continue to breastfeed until returning home. A nursing mother with traveler's diarrhea should increase her own fluid intake and frequency of breastfeeding; she should not stop breastfeeding because of traveler's diarrhea. The use of oral rehydration salts is fully compatible with breastfeeding.
In addition to the usual contents of the travel health kit, breastfeeding mothers may wish to include an antifungal cream, which can be used to treat periareolar yeast.
…have a nice time!
PDF
print version