According to official recommendations, breastfeeding can continue even if the mother is infected with COVID-19.
March 19, 2020 | COVID-19 can be worrisome for mothers who breastfeed. Here are six questions answered by a pediatrician who is an expert in breastfeeding to fully understand this issue.
Updated on July 28, 2020
If a woman has a cough, a sudden loss of sense of smell or taste and a fever or is infected with COVID-19, can she still carry on breastfeeding?
The World Health Organization (WHO), UNICEF, the government of Canada and the American Academy of Pediatrics 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. According to the WHO, to this day scientists have not detected any live viruses in maternal milk. Only fragments of the virus’s genetic material have been detected.
“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.
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. “Besides, 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 a mother does not have access to a mask, she can cover her baby with a blanket or towel.
A study carried out in New York City and involving 116 new mothers with COVID-19 seems to show that breastfeeding is safe if the mother takes the aforementioned hygienic precautions. As a matter of fact, even though the majority of these babies were being breastfed and shared a room with their mother, none of them tested positive for COVID-19 or exhibited any of the related symptoms.
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.
Another study carried out in New York City detected antibodies for the virus in the maternal milk of 13 mothers who recovered from COVID-19. Therefore, it is possible that the mother can transmit antibodies to the infant through breast milk. 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 modified 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 number of pairing requests is even increasing.
The organization also offers virtual breastfeeding drop-in centres and prenatal drop-in centres. But even better, there will be a few in-person breastfeeding meet-ups in parks throughout the summer. Such is the case in the Laurentians and Montérégie, notably. Fédération Nourri-Source also runs a Facebook forum that had over 10,000 members as of June.
At MAM, an organization located on Montréal’s South Shore, support for breastfeeding mothers by breastfeeding godmothers is ongoing. “Our breast pump and breastfeeding accessories rental service is still in operation,” confirms its director, Kim Couture. “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.”
Moreover, since the beginning of July, MAM offers outdoor breastfeeding drop-in centres. “Doing those over Zoom was fine early on, but the moms quickly got bored,” Kim Couture explains. “The social aspect of those gatherings is important, and that’s why they’re better in person.” Although the organization did get the green light from the City of Longueuil to resume its indoor activities, the team still has to plan how to carry those out while respecting social distancing guidelines.
What are the services offered by lactation consultants?
Most lactation consultants stopped in-person consultations at the beginning of the pandemic in favour of 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.”
According to her, consultants are receiving an increasing number of requests for in-person consultations and some have resumed providing this service, but outdoors, either in parks or in private backyards. Some specialized boutiques also offer designated spaces where they can carry out their consultations.
“In-person consultations during a pandemic is far from simple,” says the consultant who hasn’t herself resumed that type of meeting. “My colleagues wear a mask and a face shield and they try as much as possible to stay two metres away from the mother and her child. The mom must also wear a mask, and the rest of the family cannot be there.”
Sources: OMS, UNICEF, Gouvernement du Canada, Société américaine de pédiatrie, Reuters, The Lancet, TVA Nouvelles
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