Breastfeeding During the COVID-19 Crisis
Updated: May 13, 2020
As the COVID-19 pandemic continues to ravage the US (as well as the rest of the world), parents are understandably worried. While the disease is less likely among children, they are not completely immune, leading to many questions for parents and other caregivers. Pregnant and breastfeeding parents are rightly concerned as it’s their body a baby relies on for sustenance. With that in mind, here is a roundup of what’s known so far:
What can I do to prevent illness in my family?
Because someone can be a carrier of the disease without being sick themselves, they may unwittingly spread it to others. This means that you can catch it from someone who isn’t themselves sick. The most important step you can take to keep yourself and your family safe right now is to stay home as much as possible. If you can work from home, do so. Don’t go out except for necessary trips to the supermarket (without your children in tow) or if you require medical care (always calling a doctor’s office first to find out about any changed policies they have in place). Beyond that, you should:
Wash your hands frequently, and help your children wash theirs, too. Use soap and water, taking at least 20 seconds for washing. Sing songs while washing, like ‘Happy Birthday’ or the Alphabet Song, to ensure you’re sudsing up enough (and to keep your kids entertained). Use hand sanitizer if you don’t have access to soap and water.
Don’t touch your eyes, nose or mouth with your unwashed hands. Try to keep your children from doing the same (though this is nearly impossible for a baby).
Wipe down frequently touched surfaces around your home often, including countertops, doorknobs, light switches, etc. The virus can live on different surfaces for different amounts of time (WebMD has a longer list):
Metal: 5 days
Wood and Glass: 4 days
Plastic: 2 to 3 days
Stainless steel: 2 to 3 days
Cardboard: 24 hours
Cover your coughs and sneezes with a tissue and dispose of it immediately, then wash your hands. If you don’t have a tissue on hand, use the inside of your elbow, then wash your hands. Teach your children these same cough etiquette tips.
Practice social distancing, staying at least 6 feet away from others. Avoid contact with anyone who is sick.
Wash toys often, especially those your baby puts in their mouth. Consider laundering any plush toys.
If your baby has a scheduled well-baby exam or one of your children needs a sick visit (whether related to COVID-19 or not), you will want to call their doctor first. Most practices have changed their workflow to keep doctors, nurses and other staff, as well as all patients and their caregivers, safe. This goes for visits to your OB or midwife, too, if you are currently pregnant.
Right now, experts don’t believe pregnant women are at increased risk of contracting this novel coronavirus, or that they are at a risk greater than any other group of having complications from the disease.
Are pregnant women at greater risk?
Right now, experts don’t believe pregnant women are at increased risk of contracting this novel coronavirus, or that they are at a risk greater than any other group of having complications from the disease. With that said, the WHO (World Health Organization) cautions that because pregnant women have altered immune systems in order to support the growing fetus, they should be vigilant about protecting themselves and their unborn baby from exposure.
As of now, the virus hasn’t been found in amniotic fluid and no babies whose mothers tested positive for COVID-19 at birth have been themselves positive for the virus (though this sample size is very small). More research needs to be done to know if there are any lasting effects for a baby with exposure during pregnancy or birth.
The virus that causes COVID-19 has not been found in breastmilk.
Can I breastfeed if I’ve been exposed to COVID-19?
The virus that causes COVID-19 has not been found in breastmilk. If you do not have any symptoms of the disease, you can breastfeed as normal. In fact, experts recommend continued breastfeeding since your body will produce antibodies to any germs you’re exposed to, and these will be delivered to your baby via breastmilk, theoretically, affording them some protection.
If you develop COVID-19 symptoms, you can continue to breastfeed if you feel up to it. Wash your hands before touching your baby and wear a mask when caring for your baby, including when breastfeeding. If possible, have someone else care for the baby at all other times outside of feeding.
Different health organizations seem to have different guidelines. The ones above are based on those from the WHO. The American Academy of Pediatrics (AAP), however, has recently released some more conservative recommendations. The AAP FAQs about management of mothers and babies immediately following birth suggest if a symptomatic mother wants to breastfeed directly at birth she should follow strict protocols for masking, handwashing and breast hygiene (which isn’t mentioned by the WHO). They seem to suggest it would be better if mothers and babies were separated temporarily (though we know this can cause breastfeeding issues in and of itself) with provision of pumped breastmilk for baby. Families should be provided with all of the risks and benefits so that they can make their own informed decision about whether to breastfeed directly. This article does a good job of that. The AAP information for families can be found here, while the press release about management of mothers and newborns can be found here.
If you’re having problems breastfeeding, now is the perfect time for a telehealth visit from the comfort of your home over secure live video chat. While these calls are not appropriate for pain related questions, they are great for pumping, weaning or tips to increase or decrease milk production, or even if you’d like to discuss coronavirus precautions. You can connect with Milk Diva to schedule an appointment here. You can also look for lactation near you by searching your local breastfeeding coalition’s website or visiting USLCA or ILCA websites.
What if I’m pumping and feeding my baby expressed breastmilk?
Always wash your hands and any surfaces you will touch before touching your pump, the bottles you will use, or anything else you need during a pumping session. Follow the CDC’s guidelines for proper pump cleaning after you’ve finished. If you are symptomatic, you may want to wear a mask when pumping, if available. From the information currently available, this milk is safe to store for later consumption by your baby.
What if I get sick and still need to care for my children?
If anyone in your home develops symptoms of COVID-19, you want to isolate them. Keep them to a room of their own, if possible, to prevent others in the family from being exposed. It will be difficult with a baby or very young child. If they are old enough and willing, have them wear a mask.
If you get sick, if at all possible, have someone else who is not symptomatic care for your children when you are ill (and, truly, you may not even be able to care for them if your symptoms are moderate to severe). Isolate yourself from the rest of your family as much as possible, wearing a mask and washing your hands frequently anytime you need to venture to a shared area of your home. If you are too ill to breastfeed directly, you may be able to pump to maintain your supply.
Where can I learn more?
It can be difficult to sort the myths and misinformation from the facts you need to keep your family safe. The tips above were taken from guidelines published by the World Health Organization (WHO), UNICEF, the US Centers for Disease Control and Prevention (CDC) and the Academy of Breastfeeding Medicine (ABM). Because the situation is still very fluid and we’re learning more each day, you can stay on top of any changes in policies and recommendations on the following websites:
It is also a good idea to find the website or social media channel for your local community as well as your state health department so you know what is happening near you. These resources may also have alerts you can sign up for. You can find Texas coronavirus information here: https://www.dshs.state.tx.us/coronavirus/.
A quickly evolving situation
Since writing the first portion of this post, the following studies and articles have come to my attention:
The University of California San Diego School of Medicine is working on studies about Covid-19 transmission in pregnancy and breastfeeding. You can learn more in their press release here.
The Journal of the American Medical Association (JAMA) has published information about a single case with the possible transmission of the virus between a mother and her newborn.
The Journal of Human Lactation (JHL) has some information about donor milk use during this pandemic.
JAMA Pediatrics has published an article about coronavirus and children.
A review article based on the experiences with coronavirus in Italy outlines breastfeeding management for mothers and babies during this pandemic.
The information available is changing daily, and recommendations today may be obsolete in the future. The most important thing you can do as a parent is to find trusted resources (like Milk Diva) to keep you up-to-date.
While this is a very scary and uncertain time, take moments every day to appreciate your beautiful child. Be patient with any older children and with yourself. Give yourself permission to not be a perfect parent - nobody is!
Enjoy sunshine and fresh air as often as you can. Exercise together indoors if you can’t get out for a walk. Eat healthy foods and enjoy family dinners with everyone at the table. Stay positive, stay home, stay safe.
Watch the live video interview of Naiomi, discussing breastfeeding and Corona virus questions here.
If you have more specific questions and would like expert advice from an IBCLC for your individual breastfeeding questions, check us out!
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