COVID-19 and Breastfeeding: 5 questions answered

COVID-19 and Breastfeeding: 5 questions answered
According to official recommendations, breastfeeding can continue even if the mother is infected with COVID-19.

March 19, 2020 | The increasing number of COVID-19 cases could be worrisome for mothers who breastfeed their babies. Here are five questions answered by a pediatrician who is an expert in breastfeeding to fully understand this issue.

Updated on April 9, 2020

If a woman has a cough, a sudden loss of sense of smell and a fever or is infected with COVID-19, can she still carry on breastfeeding?

The World Health Organization, UNICEF, the government of Canada and the CDC in the United States all concur on the importance of continuing to breastfeed even when the mother is infected with SARS-CoV-2, the virus responsible for COVID-19. All agree that the benefits of breastfeeding are many while the risk of transmitting it through the mother’s milk is low because it is a respiratory virus.

Is the virus transmitted through breast milk?

Because SARS-CoV-2 is a novel virus, scientists still know very little about it. To this day, only a very small scale study conducted in China and involving 6 infected women tried to evaluate its presence in breast milk. The virus was not found in any of the samples.

“This is good news,” admits pediatrician and epidemiologist Michael Kramer who is also a breastfeeding expert. “I am almost certain that it is much more important via the respiratory tract and skin contact.”

Indeed, based on what we know so far about the virus, it infiltrates the respiratory tract via tiny droplets produced when an infected person coughs or sneezes. As a matter of fact, according to the Society of Obstetricians and Gynaecologists of Canada, a mother-to-child transmission via the amniotic fluid, the placenta or beast milk is very unlikely.

What precautions should an infected mother take to avoid infecting her baby?

“Babies and children seem less affected by the virus than adults are,” says Dr. Kramer. “What is more, it would be difficult and even nearly impossible to separate mother and child for two weeks.” He therefore recommends continuing to breastfeed while wearing a mask and washing your hands before touching the baby.

If the mother is too sick to breastfeed, she can express her breast milk and another caregiver can feed the child until she recovers. She should obviously wash her hands before touching any part of the breast pump and wash it thoroughly afterward.

Are breastfed babies protected against the coronavirus?

Breast milk can protect babies against many infections. There is, however, little information available in the case of COVID-19. According to the Association of obstetricians and gynecologists of Québec, “it is possible that the mother can transmit antibodies to the infant through breastmilk; however, there is limited evidence of this transmission and the potential benefits are unclear.”

Dr. Kramer reminds us that this is a novel virus. Consequently, a vast majority of mothers have not yet been exposed to it and have therefore not started producing antibodies that could be transmitted in their breast milk. “Breastfed babies could, however, be partially protected by oligosaccharides, one of the types of sugar contained in breast milk,” he adds.

Most breastfeeding clinics and support groups have suspended their activities. What resources are available for mothers experiencing issues with their breastfeeding?

In order to comply with the government of Québec’s recommendations, many breastfeeding support groups have limited their activities. “Our Board of Directors has asked its 8 regional subsidiaries to suspend its breastfeeding drop-in centres, prenatal meetings and home visit services to reduce the spread of COVID-19,” says Julie Richard, coordinator for Fédération Nourri-Source. The organization continues to support mothers, however. “We can still pair mothers with a breastfeeding godmother by telephone or electronic messaging (email, SMS, etc.),” says Ms. Richard.

The same goes for MAM, an organization located on the south shore of Montréal. “MAM’s godmothers are still there for breastfeeding mothers,” confirms its director, Kim Couture. “So does our breast pump and breastfeeding accessories rental service. We also offer the MAM line for mothers who do not have a godmother but have occasional questions. They can leave a message and we will get back to them the same day, guaranteed.”

As for lactation consultants, most have stopped in-person consultations. So do, however, offer virtual consultations. “This poses certain challenges,” says Annabelle Boucher, a consultant based in Longueuil. “There are a few things we cannot do, such as examine the baby’s mouth. It is easier with the help of a third person who holds the camera.”

Sources : The Lancet, Société des obstétriciens et gynécologues du Canada, OMS, UNICEF, Gouvernement du Canada, CDC

Kathleen Couillard – Naître et grandir

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