Does breastfeeding protect against RSV? Yes, studies show

According to an interview with Mandy Cohen, CDC Director, we likely reached the peak of RSV cases in December 2023, but the virus is still circulating. It’s important to remember that the majority of RSV cases are mild, with symptoms similar to the common cold, often passing in a week or two. But for some babies born prematurely or with chronic health conditions, RSV can lead to a more severe illness, such as bronchiolitis or pneumonia. 

Given that the RSV shot for infants is still in short supply, you might be looking for other ways to protect your baby against the respiratory virus. Statistics estimate that for every 100 babies under 6 months of age, one or two may need hospitalization for RSV. It’s not an equal alternative to the RSV shot, but recent research shows that breastfeeding for at least two months and ideally four to six may offer some protection to babies against severe forms of the illness.  

“Breastfeeding is protective against RSV and other viruses because human milk contains components that bolster babies’ immune systems and help protect them from infection,” says Jessica Madden, MD, FAAP, IBCLC, a breastfeeding medicine and infant feeding specialist and the medical director of Aeroflow Breastpumps. “These include antibodies, white blood cells, lactoferrin, antioxidants, and vitamins.”

While the WHO recommends exclusive breastfeeding for the first six months of life for best immune protection against viral illnesses, exclusive breastfeeding isn’t always an option for every family. But even some breast milk offered in combination with formula can provide helpful immune support for your baby or toddler during RSV season. And be sure to speak to your child’s pediatrician about availability of the RSV shot.

Here’s what to know about how breastfeeding can help prevent severe RSV, as well as tips on feeding a baby with RSV. 

Breastfeeding is protective against RSV, studies show

Results from a February 2022 systematic review published in “Pediatrics” showed that breastfeeding is associated with lower rates of babies hospitalized with RSV bronchiolitis. 

The most significant results were seen with babies who were exclusively breastfeeding for at least four months, but the review shows that even partial breastfeeding (breastfeeding in combination with formula feeding) may reduce the severity of the disease, length of hospital stay and need for supplemental oxygen. Other studies support the benefits of combination feeding in preventing RSV too. 

Duration may be an important factor here: The 2022 review showed that infants who were hospitalized with RSV were more likely to be breastfed for less than two months or not at all.  

More research is needed, but some researchers state that breastfeeding may protect against airway damage, and can also promote lung growth and function.  

But what if your little one already has RSV? Feeding your baby with RSV can be difficult, because all that stuffiness can make it harder for them to take in as much milk as they might normally. Dr. Madden shares her best tips for feeding a baby with RSV. 

Related: Amy Schumer’s son hospitalized with RSV: ‘The hardest week of my life’

Feeding your baby with RSV: An expert shares what you need to know  

“Babies who develop symptoms of RSV often have a lot of nasal congestion and mucus, which can make it hard to breathe while feeding,” says Dr. Madden. Employing some supportive techniques can make feeding sessions more comfortable. 

Prepare for more frequent feeds

Remember cluster feeding from those early days? That might be helpful here. “Babies with RSV might need more frequent, short feeding sessions to be able to drink enough milk to stay hydrated,” Dr. Madden notes. 

Related: Pfizer’s RSV vaccine for pregnancy can protect newborns from serious illness

Offer lots of comfort

And bring on the snuggles: Whether you’re breastfeeding, bottle feeding, or combination feeding, be prepared for your baby to want to be held a lot when they’re sick, adds Dr. Madden. 

Try saline

Using a saline spray and suction two to three times per day can help clear out your baby’s stuffy nasal passages. “The easiest way to do this is to instill one to two saline drops into each nostril and then suction out mucus and secretions with either a NoseFrida or bulb syringe,” Dr. Madden suggests. (We also like the saline micro mist inhaler from The Boogie Brand.) 

Create a steam room

For some little ones, congestion may get worse at night. Create a steam room by running your shower at the highest heat with the door closed, letting the steam fill your bathroom. Then do any night feedings in that steamy setting to help your little one breathe easier. Don’t forget to run a humidifier during the day and in their room at night, too. 

Make sure you rest up, too

If you’re breastfeeding, don’t underestimate the importance of getting a lot of rest yourself, especially during cold, flu, and RSV season, stresses Dr. Madden. Getting sufficient sleep and staying hydrated can not only help boost your milk supply, but can also help ensure you don’t catch cold, too. 

Sources

Gómez-Acebo, I., Lechosa-Muñiz, C., Paz-Zulueta, M. et al. Feeding in the first six months of life is associated with the probability of having bronchiolitis: a cohort study in Spain. Int Breastfeed J 16, 82 (2021). doi:10.1186/s13006-021-00422-z

Jang MJ, Kim YJ, Hong S, et al. Positive association of breastfeeding on respiratory syncytial virus infection in hospitalized infants: a multicenter retrospective study. Clin Exp Pediatr. 2020;63(4):135-140. doi:10.3345/kjp.2019.00402 

Mineva G, Philip R. Impact of Breastfeeding on the Incidence and Severity of RSV Bronchiolitis in Infants: Systematic Review. Pediatrics. 2022 Feb 23;149(1 Meeting Abstracts February 2022):280-. 

A version of this story was originally published on Nov. 7, 2022. It has been updated.