What do I need to know about breastfeeding with COVID-19?
This post is meant to dispell some myths and give you resources should you find yourself in the situation where you're either confirmed postive or suspected of having COVID-19 and need to know if you should be breastfeeding your baby.
First of all, the answer to both of these scenarios is YES, you can and should continue to breastfeed your baby.
Let me explain. The World Health Organization (WHO) has been closely monitoring and making recommendations when it comes to breastfeeding during the pandemic and they have continually stated that it is safe and preferable to initiate and continue direct breastfeeding even when a mother is confirmed or suspected of having COVID-19 for the following reasons:
The COVID-19 virus has not been detected in the breastmilk of any confirmed positive woman, making it unlikely that the virus is passed through breastmilk.
The transmission of COVID-19 through breastmilk and breastfeeding has not been detected. Among the few cases of confirmed COVID-19 infection in children from other sources, most have experienced only mild or asymptomatic illness.
The numerous benefits of skin-to-skin contact and breastfeeding substantially outweigh the potential risks of transmission and illness associated with COVID-19.
What are the benefits of breastfeeding my baby, especially if I've been exposed to a virus?
We know that one of the major benefits of breastfeeding is it's impact on your baby's developing immune system. Your breastmilk is made up of many different components that help your baby stay healthy, including:
Antibodies - human milk has numerous antibodies that are directed at different pathogens the mother comes into contact with. These effectively prevent the entry of bacteria, viruses and other pathogens into your baby's body.
Free secretory component - this blocks pathogens from sticking to body tissues
Lysozyme - an enzyme that can destroy the outer wall of bacteria
These are just a few of the MANY protective factors in breastmilk. This is why ANY breastmilk is better than no breastmilk.
If you want to see the journal article explaining these factors, you can get it here.
If I am positive, is there anything I should do to protect my baby while breastfeeding?
Yes, the WHO also gives guidelines for this:
Wash hands frequently with soap and water or use alcohol-based hand rub, especially before touching the baby
Wear a medical mask while feeding
Sneeze or cough into a tissue, immediately dispose of it and use alcohol-based hand rub or wash hands again with soap and clean water
Regularly clean and disinfect surfaces
What if I'm feeling too ill or I'm just not comfortable directly breastfeeding my baby?
If you're too ill to breastfeed your baby, or you've read the information and would still feel more comfortable not breastfeeding your baby while ill, the next best option would be to feed your expressed breastmilk, followed by donor milk and then formula.
If you want to express your milk, here are a few guidelines from the WHO:
The mother, and anyone helping the mother, should wash their hands before expressing breastmilk or touching any pump or bottle parts and ensure proper pump cleaning after each use.
The expressed breastmilk should be fed to the child preferably using a clean cup and/or spoon (easier to clean), by a person who has no signs or symptoms of illness and with whom the baby feels comfortable. The mother/caregiver should wash their hands before feeding the newborn/infant.
If breastfeeding or providing breastmilk for your baby by pumping is important to you, it is very important that you continue to do so even while sick to keep your milk supply. If you want to resume breastfeeding after recovering, the WHO states that:
A mother can start to breastfeed when she feels well enough to do so. There is no fixed time interval to wait after confirmed/suspected COVID-19. There is no evidence that breastfeeding changes the clinical course of COVID-19 in a mother.
Why do I keep hearing different things about whether breastfeeding is safe or not during COVID-19?
Part of the reason I wanted to write this post is that these recommendations from the WHO do differ from what other organizations may be recommending.
The WHO is making their recommendations by fully considering not only the risks of infection of the infant with COVID-19, but also the risks of serious morbidity and mortality associated with not breastfeeding or the inappropriate use of infant formula milks as well as the protective effects of skin-to-skin contact and breastfeeding.
They state that: "Recommendations of other organizations may focus only on the prevention of COVID-19 transmission without full consideration of the importance of skin-to-skin contact and breastfeeding."
The Centers for Disease Control (CDC) has recently updated their recommendations to state that the decision for infant feeding when a mother is confirmed or suspected of COVID-19 should be made on a case-by-case basis in shared decision making between a woman and her health care providers.
This was a positive change from their earlier recommendation to separate mom and baby and feed expressed breastmilk to the baby by a healthy caregiver.
Unfortunately, from stories I've heard and protocols I've seen from healthcare facilities, some hospitals are enforcing practices such as separation of mom and baby and only allowing mom to pump. Or, if mom and baby are allowed to stay in the room - health care providers are still encouraging mom to pump only and limit contact with baby.
As this pandemic goes on and we know more, policies will continue to change. The WHO guidelines may even change! But from what we know right now, it appears that direct breastfeeding continues to be the best way to feed your baby if that's what you've determined is right for you and your family.
I encourage you to read the information for yourself and be knowledgable about this subject in case the hospital you deliver at is using different practices. It is your right to feed your baby how you want to and separation should only happen with your consent!
You can find the updated WHO information here:
This is a stressful time for everyone and the information can be overwhelming and hard to keep up with even for healthcare providers. Don't be afraid to ask questions or seek another opinion when you need to.
YOU are the best person to make decisions for you and your baby.