CORONAVIRUS DISEASE (COVID-19) PANDEMIC
COVID-19 AND BREASTFEEDING
CURRENT GUIDANCE FOR BREASTFEEDING MOTHERS WITH COVID-19
Here are current recommendations for breastfeeding mothers who have, or who are being tested for, COVID-19. This guidance has been sourced directly from world-leading health organisations and experts. It will be updated as new information becomes available.
Further languages:
WORLD HEALTH ORGANIZATION (WHO)
Q&A: Breastfeeding and COVID-19
The WHO updates the information regularly. Please use the links below to go directly to the websites.
Breastfeeding advice during the COVID-19 outbreak
Q&A: Breastfeeding and COVID-19
Frequently Asked Questions: Breastfeeding and COVID-19 for health care workers (PDF)
UNITED NATIONS CHILDREN'S FUND (UNICEF)
Is it safe for a mother to breastfeed if she is infected with novel coronavirus?
“All mothers in affected and at-risk areas who have symptoms of fever, cough or difficulty breathing, should seek medical care early, and follow instructions from a health care provider.
Considering the benefits of breastfeeding and the insignificant role of breastmilk in the transmission of other respiratory viruses, the mother can continue breastfeeding, while applying all the necessary precautions.
For symptomatic mothers well enough to breastfeed, this includes wearing a mask when near a child (including during feeding), washing hands before and after contact with the child (including feeding), and cleaning/disinfecting contaminated surfaces – as should be done in all cases where anyone with confirmed or suspected COVID-19 interacts with others, including children.
If a mother is too ill, she should be encouraged to express milk and give it to the child via a clean cup and/or spoon – all while following the same infection prevention methods.”
CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC)
Breastfeeding if you have COVID-19
"Breast milk provides protection against many illnesses and is the best source of nutrition for most infants. Learn more about breastfeeding.
You, along with your family and healthcare providers, should decide whether and how to start or continue breastfeeding.
We do not know for sure if mothers with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggest this is not likely.
If you have COVID-19 and choose to breastfeed:
• Wear a cloth face covering while breastfeeding and wash your hands before each feeding.
If you have COVID-19 and choose to express breast milk:
• Use a dedicated breast pump.
• Wear a cloth face covering during expression and wash your hands before touching any pump or bottle parts and before expressing breast milk.
• Follow recommendations for proper pump cleaning after each use, cleaning all parts that come into contact with breast milk.
• If possible, expressed breast milk should be fed to the infant by a healthy caregiver who does not have COVID-19, is not at high-risk for severe illness from COVID-19, and is living in the same home."
INTERNATIONAL SOCIETY FOR RESEARCH IN HUMAN MILK AND LACTATION (ISRHML)
Live Q&A session on COVID-19 with breastmilk lactation experts
Lars Bode, PhD; Professor and Principal Investigator at University of California, San Diego (UC San Diego); Director of the Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence (LRF MOMI CORE), UC San Diego
Shelley McGuire, PhD; Director and Professor, Margaret Ritchie School of Family and Consumer Sciences, University of Idaho
Paula Meier, PhD, RN; Director of Lactation Services, Neonatal Intensive Care Unit and Professor of Pediatrics and Nursing at Rush University Medical Center, Chicago
ISRHML activities and guidance related to COVID-19
"The purpose of this summary, generated by a Working Group of ISRHML members, is to collate the rapidly evolving scientific evidence and clinical resources regarding the novel coronavirus (SARS-CoV-2), human milk and lactation. It is not intended to replace public health authority recommendations. Information on the COVID-19 pandemic is changing quickly. This document will be updated regularly to reflect new developments."
EUROPEAN MILK BANKING ASSOCIATION (EMBA)
EMBA Task Force: COVID-19 in the perinatal period
"The Task Force will take into account the suggestions, directions, recommendations, and guidelines published in literature from national and international societies, international organizations and institutions, panel of experts, on COVID-19 pandemia in the perinatal period.
This information will be evaluated and included as summary in the EMBA website."
BABIES IN NEONATAL INTENSIVE CARE UNITS
Is it Safe to Provide Milk for My NICU Baby if I Have or Have Been Exposed to Coronavirus Disease 2019 (COVID-19)?
"With so much news in the media about COVID-19, it is natural to be concerned about whether providing milk for your NICU baby is safe or even advisable."
Please click here for guidance in English from Paula P. Meier, PhD, RN & Aloka L. Patel, MD.
It is also offered in Arabic, Bengali, Chinese, French, Spanish and Urdu.
LACTAMAP
Current breastfeeding and COVID-19 guidance for health professionals
LactaMap – the online lactation care support system - is now offering information based on what is currently known about COVID-19. Please note: additional care options for breastfeeding when mother or infant have tested positive for COVID-19 are based on limited evidence or expert opinion only.
LactaMap content has been developed by The University of Western Australia to help health professionals provide lactation support for mothers and term infants from birth to 2 years of age.
LactaMap is free, please register at: www.LactaMap.com
PROFESSIONAL ASSOCIATION OF SWISS BREASTFEEDING AND LACTATION CONSULTANTS
Breastfeeding and SARS-CoV-2
Translated by the Family Larsson-Rosenquist Foundation
"So far, the virus has not been able to be detected in breast milk. There have been no reports yet of transmission via breast milk. Antibodies have, however, been detected in breast milk samples, which gives reason to believe that breast milk might have a protective effect.
If a breastfeeding mother contracts COVID-19, the child has already been exposed to the virus during the incubation period and so the mother may continue to breastfeed as long as she feels up to it. Whilst breastfeeding, she should take the following precautions:
• Wash hands before and after breastfeeding
• Wear a protective mask whilst in contact with the child and whilst breastfeeding
• Clean and disinfect any contaminated surfaces
• If using a breast pump, this is to be cleaned afterwards each time it is used
If the mother is too ill to breastfeed her child, the milk may be expressed and fed to the child. It is important that hygiene guidelines are strictly adhered to in the process.
There is controversy over which measures should be taken in the event that a woman contracts COVID-19 at the time of giving birth or tests positive for SARS-CoV-2.
Given that SARS-CoV-2 is transmitted by droplet infection, it is advised by some that mother and child be spatially separated from each other in this instance. The mother should – if she feels up to it – be instructed to express her milk for her child. As soon as the mother is no longer considered to be infectious, the separation of mother and child can be ended and the mother may begin breastfeeding.
Other sources question the routine separation of mother and newborn owing to the lack of data at the moment and the risk associated with separating a mother from her child, for both the mother-child relationship (lack of bonding) and breastfeeding.
The Royal College of Midwives apparently recommends leaving healthy newborns with their mothers and discussing the risks and benefits of breastfeeding as well as the risks and benefits of staying together and separating mother and child with the parents. The Academy of Breastfeeding Medicine considers it necessary to separate mother and child especially if the mother’s health and the ensuing treatment call for such a separation. In each instance, it is recommended that the mother – as long as she is able to do so – expresses her milk, if she wishes to breastfeed, and that this is then fed to the child by a healthy person.
The parents make the final decision."
Website of the Professional Association of Swiss Breastfeeding and Lactation Consultants (German or French)
ACADEMY OF BREASTFEEDING MEDICINE (ABM)
ABM statement on coronavirus 2019 (COVID-19): transmission of COVID-19 through breast milk
“Much is unknown about how COVID-19 is spread. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, like how influenza (flu) and other respiratory pathogens spread.
In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk; however we do not know whether mothers with COVID-19 can transmit the virus via breast milk.
Breast milk provides protection against many illnesses. There are rare exceptions when breastfeeding or feeding expressed breast milk is not recommended."
THE GLOBAL HEALTH NETWORK
GENERAL INFORMATION ABOUT COVID-19
The Global Health Network is an open source platform that provides trusted knowledge, guidance, tools and resources to support the generation of more and better health research data. During emerging outbreaks it is vital to learn as much as possible to generate evidence on best practice for prevention, diagnosis and treatment and to facilitate effective preparedness and response for future outbreaks.
The pop-up space for 2019 Novel Coronavirus supports evidence generation by pooling protocols, tools, guidance, templates, and research standards generated by researchers and networks working on the response to this outbreak. Findings from previous outbreaks, largely obtained during MERS and SARS, are also available. This all aims to make research faster and easier and to enable standardised, quality data to be collected and prepared for sharing.