By Christie Halter, FNP, MS, CNM, SMGOR Family Medicine

This year has brought many challenges to patients and providers alike as we continue to learn about COVID-19 and how it impacts different aspects of our lives. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the strain of coronavirus that causes COVID-19, and much is still unknown about this virus, including its effects during pregnancy and breastfeeding. Although the future effects of COVID-19 on certain facets of health is still unchartered territory, the benefits of breastfeeding for both mother and child are well known.

August is National Breastfeeding Month, and this is what we do know.

Breastfeeding immediately after birth helps the infant regulate blood sugars and body temperature through close contact to the mother’s body, stimulates gastrointestinal growth and development, decreases respiratory diseases and ear infections, and decreases the risk of Sudden Infant Death Syndrome (SIDS). It promotes bonding between mother and infant, and the process of milk letdown helps decrease bleeding after birth and can decrease risk of ovarian and breast cancers. The content of breastmilk includes important antibodies that help boost the infant’s immune protection against common infections. Additionally, it provides all appropriate nutrients for infants through the age of six months, at which time solid foods can be introduced.

Below are recommendations for those breastfeeding their babies during the time of COVID-19:

  • Because it has not been shown that breastmilk can transmit the virus, breastfeeding is still recommended even if the mother has suspected or confirmed COVID-19 infection. It is generally thought at this time that infants who have developed COVID-19 may have been exposed by respiratory droplets and close contact with caregivers.
  • If a mother is suspected or confirmed to have COVID-19, it is currently recommended that the milk be expressed (manual or electric breast pump) and fed to the infant via bottle to reduce the chance of respiratory droplet exposure during feeding. Proper hand hygiene, wearing masks, and keeping pump parts and bottle parts clean and sterilized are all good practices to help decrease infant exposure.
  • Exclusive breastfeeding is still encouraged for the first six months of infant life, whenever feasible.
  • Current contraindications to breastfeeding, or situations when formula feeding is preferred include maternal HIV infection, abuse of street drugs, TCLV infection (human T cell lymphotropic virus), undergoing certain treatments for cancer therapy, active herpes, or untreated tuberculosis.

For any questions or concerns regarding breastfeeding, it is recommended to have a consultation with a health care provider, gynecologist, midwife, or pediatrician to further discuss individual risks and benefits. As knowledge of COVID-19 and its impact on women’s health continues to evolve, it is recommended to reach out to health care providers to obtain the latest information.

References

American College of Obstetricians and Gynecologists. COVID-19 FAQs for obstetricians-gynecologists, obstetrics. Washington, DC: ACOG; 2020. Available at: https://www.acog.org/clinical-information/physician-faqs/covid-19-faqs-for-ob-gyns-obstetrics. Retrieved August 21, 2020.

Coronavirus disease (covid-19) and breastfeeding. June 9, 2020.  Centers for Disease Control and Prevention. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/covid-19-and-breastfeeding.html. Retrieved August 21, 2020.

Grob, R., et al. Detection of SARS-CoV-2 in human breastmilk.  May 21, 2020. The Lancet, 395 (10239) 1757-1758.

Novel coronavirus 2019 (covid-19) practice advisory.  August 12, 2020. American College of Obstetricians and Gynecologists.  https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus-2019#. Retrieved August 21, 2020.

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