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COVID-19 and Breastfeeding

What is generally known?

  • Given low rates of transmission of respiratory viruses through breast milk, the World Health Organization states that mothers with COVID-19 can breastfeed.

  • Breastfeeding is biologically normal and encouraged. There are clear health advantages for a baby who is breastfed as well as for a mother who breastfeeds.

  • Breastfeeding is protective.

What is best to do with COVID-19?

There are 3 scenarios discussed below.

For a mother who does not have COVID-19:


For a mother who may have been exposed or has mild symptoms of COVID-19 and is home:

  • Keep breastfeeding.

  • Have mother hand wash frequently and carefully including before touching the infant.

  • Wear a face mask when taking care of the infant (diaper changes, cuddling, breastfeeding).

  • Wear a mask at least 5-7 days until cough and any secretions are greatly improved.

For a mother in the hospital with COVID-19:

  1. Rooming-in (mother and infant stay in the same room without any other patients).

    • Breastfeed.

    • Have mother hand wash hands frequently and carefully including before touching the infant.

    • Wear a mask to minimize respiratory secretions to the baby.

    • When content, a baby is in bassinet 6 feet from mother.

    • Ideally, another well adult will be in the room and care for the baby.


  2. Temporary separation – when the mother (or infant) is sick with COVID-19 and needs more intensive hospital care.

  • Hand wash, mask as above and assist with hand expressing and/or pumping. See Expressing, Collecting and Storing Human Milk protocol.

  • If possible, leave a dedicated pump with the mother.

  • Have a healthy caregiver feed this expressed breast milk to the baby.

  • After a pumping session, thoroughly sanitize all pump parts that come into contact with human milk, and disinfect the entire pump per manufacturer’s instructions.

  • Consider re-lactation or other options as needed.

* Note skin-to-skin contact has many benefits with or without COVID-19 status and continues to be recommended. There is no evidence to support disinfecting the mother’s skin before skin-to-skin care and there are known harms to disinfect. The disinfectant was not meant for ingestion by infants, and mothers’ smells are important for bonding and breastfeeding. Mothers who are or may be COVID-19 positive should wear a mask and wash hands before handling their infant. Delayed cord clamping may also continue (SOGC, WHO).

Resources:

Breastfeeding & COVID-19 infographic & posters https://stores.praeclaruspress.com/free-posters-and-graphics/

Expressing, Collecting, and Storing of Human Milk Protocol

https://breastfeedingresourcesontario.ca/resource/breastfeeding-protocols-health-care-providers

Global Health Media https://globalhealthmedia.org/what-we-do/projects/about-breastfeeding/?fbclid=IwAR34biisk79pzT4OGGQIiGBoUFnQ67X3bD9DTQ3BLDowkoaBeelUGOeBwn8

La Leche League https://lllusa.org/wp-content/uploads/2020/03/Coronavirus-sheet.pdf

Maximizing Breastfeeding and Re-lactation https://www.unicef.org.uk/babyfriendly/maximising-breastmilk-and-re-lactation-guidance/

Safely Fed Canada http://safelyfed.ca/covid19-resources/

References:

Academy of Breastfeeding Medicine https://www.bfmed.org/abm-statement-coronavirus

Health Canada https://www.canada.ca/en/public-health/services/publications/diseases-conditions/how-to-care-for-child-with-covid-19-at-home-advice-for-caregivers.html

International Lactation Consultant Association https://lactationmatters.org/2020/03/18/ilca-statement-on-breastfeeding-and-lactation-support-during-the-covid-19-pandemic/

Infant and Young Child Feeding https://www.ennonline.net/covid19iycfbrief

Public Health Agency of Canada https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/coronavirus/how-to-care-for-child-with-covid-19-at-home-advice-for-caregivers/how-to-care-for-child-with-covid-19-at-home-advice-for-caregivers.pdf

SOGC https://sogc.org/en/content/featured-news/Updated-SOGC-Committee-Opinion__COVID-19-in-Pregnancy.aspx

UNICEF https://www.unicef.org/stories/novel-coronavirus-outbreak-what-parents-should-know

World Health Organization (WHO) http://www.emro.who.int/nutrition/nutrition-infocus/breastfeeding-advice-during-covid-19-outbreak.html

World Health Organization (WHO) https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts


Please note information may change as more is known about this novel virus.


© 2020 April 28, Lactation Care, Sonya Boersma MScN, RN, IBCLC

May be reproduced without additional permission and with acknowledgement.