Breastfeeding and the Coronavirus COVID-19

CQ #186 – March 2, 2020
by Anne Eglash MD, IBCLC, FABM
#LACTFACT
The Centers for Disease Control recommends continuing to either breastfeed or give infants breastmilk when the mother is ill or infected with COVID-19.
The US Centers for Disease Control Website

What are the recommendations for a breastfeeding mother who is ill/infected with COVID-19?

The coronavirus COVID-19 is certainly on the minds of most people, as it disrupts our finances, travel, and creates concern regarding our risk of severe illness.

We have been here before, with SARS, MERS, and H1N1 influenza. Breastfed infants are more likely to have fewer complications of a COVID-19 infection as compared to infants who are artificially fed. Those of us in clinical practice observe this annually in our breastfed patients during influenza season.

The US Centers for Disease Control recommends that mothers who have COVID-19 infection continue to breastfeed or provide expressed breastmilk. They state that so far there is no evidence that the coronavirus is spread via breastmilk. If the breastfeeding dyad is at home, they recommend that the mother take precautions to prevent spreading the virus to her infant, such as wearing a mask and washing her hands before handling the infant.

What do you think are true statements regarding COVID-19, mother-infant care in the hospital postpartum, and breastfeeding? Choose 1 or more:
  1. A neonate born to a mother with COVID-19 is considered a person under investigation, and at risk for spreading COVID-19.
  2. The Centers for Disease Control recommends separating a neonate from their mother who is infected with COVID-10 at the time of birth, but acknowledges that some ill/infected mothers may decide to room-in with their asymptomatic infants.
  3. Hand sanitizer with 60%-90% alcohol helps to prevent the spread of COVID-19.
  4. A fetus can become infected with COVID-19 during pregnancy when mother is infected.
  5. Expressed breastmilk may be given from a mother infected with COVID-19 to her asymptomatic newborn.
  6. A mother infected with COVID-19 should remain separated from her newborn until 3 days after she tests negative for the virus.

See the Answer

Correct Answers: All except D and F
The US Centers for Disease Control Website
The US Centers for Disease Control

Abstract

No abstract is available.

IABLE Comment by Anne Eglash MD, IBCLC, FABM

So far it appears that there is no evidence for vertical transmission of COVID-19 from an ill pregnant mother to her fetus. A recent report from China in the Lancet Feb 2020 tested 9 neonates born to mothers ill with COVID-19, and none were positive for the virus.

There is also no evidence that the virus is spread via breastmilk.

The Centers for Disease Control recommends that the decision to end separation of mother-newborn should be made on a case-by-case basis, so there is no ‘rule’ regarding awaiting a negative test to end the isolation.

Over the last few years, many physicians and other hospital staff who care for mothers and infants postpartum have expressed concern that their hospital facility does not allow a mother ill/infected with influenza to make an informed decision regarding isolation vs rooming-in. The same issue will likely be true for COVID-19. Perhaps families will feel empowered to make their own decision if they are given the CDC resource to read.

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