Can breastfeeding be still given to babies from Covid – 19 infected or suspected mothers?
Breastfeeding is the basic pillar for infant and young child survival, nutrition and development and maternal health. The World Health Organization recommends (1) exclusive breastfeeding for the first 6 months of life, (2) continued breastfeeding with appropriate complementary foods for up to 2 years and beyond, (3) Early and uninterrupted initiation of skin-to-skin contact, rooming-in and kangaroo mother care to reduce maternal and infant mortality.
Since the end of 2019, concerns about Covid-19 infection have been raised whether mothers with COVID-19 can transmit the SARS-CoV-2 virus to their infant or young child through breastfeeding. Before there is any recommendation whether breastfeeding should still be continued or not, a full consideration should be there not only of the potential risks of COVID-19 infection of the infant, but also the risks of morbidity and mortality associated with not breastfeeding, the inappropriate use of infant formula milks, as well as the protective effects of skin-to-skin contact.
Until before there is any scientific evidence on vertical transmission of Covid – 19 infection from the mother to the infant, the following precautions have to be taken thoughtfully for mothers and caregivers also.
- Take precautions if your newborn is rooming-in with you in the hospital.
If you are in isolation for COVID-19 and are sharing a room with your newborn, take the following steps to reduce the chance of spreading the virus to your newborn:
- Wash your hands with soap and water for at least 20 seconds before holding or caring for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
- Wear a well-fitting mask whenever you are within 6 feet of your newborn.
- Keep your newborn more than 6 feet away from you as much as possible.
- Talk to your healthcare provider about how you can protect your newborn, such as using a physical barrier (for example, placing the newborn in an incubator) while in the hospital.
You most likely will not pass the virus to your newborn or any other close contacts after your isolation period has ended.
If you had symptoms, your isolation period ends after:
- 5 days since symptoms first appeared, and
- 24 hours with no fever, without fever-reducing medicine, and
- Other symptoms of COVID-19 are improving.
If you never had symptoms, your isolation period ends after
- 5 days have passed since you tested positive for COVID-19.
Once your isolation period has ended you should still wear a mask until day 10. After 10 days, you should still wash your hands before caring for your newborn, but you don’t need to take the other precautions. These timeframes do not apply if you have a severely weakened immune system or were severely ill with COVID-19.
B. Precautions while feeding at the breast, expressing milk, or feeding from a bottle
Breastfeeding people should follow these precautions during their recommended period of isolation:
- Wash their hands using soap and water before touching their child or expressing breast milk either by hand expression or with a breast pump. If soap and water are not available, use hand sanitizer with at least 60% alcohol.
- Wear a mask when they are less than 6 feet from the child (including when feeding at the breast or feeding from a bottle) and when expressing breast milk
- Clean and sanitize breast pumps and all infant feeding items.
- Any healthy caregiver, preferably one who is fully vaccinated against COVID-19 and not at increased risk for severe illness from COVID-19, may feed expressed breast milk to the child. If this person is not vaccinated and is living in the same house or has been in contact with the breastfeeding person, they should wear a mask while feeding the child for the duration of the lactating parent’s recommended period of isolation and during their own quarantine thereafter.
In conclusion, WHO recommends that mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue to breastfeed. Mothers should be counselled that the benefits of breastfeeding substantially outweigh the potential risks for transmission. Mother and infant should be enabled to remain together while rooming-in throughout the day and night and to practice skin-to-skin contact, including kangaroo mother care, especially immediately after birth and during establishment of breastfeeding, whether they or their infants have suspected or confirmed COVID-19.