COVID-19 and Breastfeeding

April 28, 2020 Lactation Care

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:

Encourage the mother to breastfeed, and delay weaning.
More than ever infants need the antibodies mothers to produce if exposed to COVID-19.
If she needs help with breastfeeding:
- Check www.ontariobreastfeeds.ca (inquire ahead as services are changing).
- Find a professional lactation consultant https://www.clca-accl.ca/Find-an-IBCLC-in-your-area (ask about services and possible fees).
- Connect with La Leche League https://www.lllc.ca/about/contact (free peer support).

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:

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.
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).