Breastfeeding plays a vital part in the growth & development of an infant. Breast milk is supplemented with the energy, essential nutrients & antibodies which helps fortify the infant’s immune system against some common childhood infections like pneumonia & diarrhea and certain chronic diseases which can manifest later in life. There is also evidence that breastfeeding aids in the promotion of cognitive development in children. Mothers who diligently breastfeed their children during the early years are supposedly at a lesser risk of developing breast and ovarian cancer at later stages in their life.
According to the UNICEF and WHO, newborns should be exclusively breastfed for at least the initial 6 months of their lives after which they can slowly be introduced to other foods. Exclusive breastfeeding entails the following:
- Exclusive breastfeeding means giving the child only breast milk as a source of nutrition without supplementing other foods, water included
- Initiating breastfeeding within 1 hour from birth
- Breastfeeding each time the child feels hungry or thirsty, day and night, on demand
- Not using bottles, teats or pacifiers as alternatives
When the mother is positive for COVID-19, feeding the child using breastmilk can be continued because currently there exists no concrete evidence suggesting the transmission of the virus via breast milk from mother to child. However, it is advised that the mother maintains physical distance from the child until she has made complete recovery (she can transmit the infection through aerosol that can spread on speaking, sneezing or coughing). As a result, direct breastfeeding is not possible and thus, the mother can follow some precautionary methods and alternatives to provide the child with breast milk;
- Wearing a mask and/or a face shield while coming in contact with the baby, even while feeding
- Washing hands with soap and sanitizing with alcohol-based rubs when touching the baby
- Using disposable tissues when sneezing.
- Disinfecting surfaces touched by the infected mother frequently
- Providing the child with expressed milk – i.e., breast milk pumped into a bottle
- Washing hands before touching the pump and bottle used for providing expressed milk is imperative
- An uninfected person can feed the baby using the expressed breast milk from the COVID positive mother
- In case the mother is too unwell to pump breast milk, alternative methods such as donor milk, wet nursing or using baby formula milk can be used to feed the infant.
A study published in the International Breastfeeding Journal mentions certain issues that might arise when a COVID positive mothers opts to breastfeed her newborn.
- Evidence suggests that the medication used for the treatment of COVID symptoms such as azithromycin, hydroxychloroquine sulphate, lopinavir-ritonavir, tocilizumab and methylprednisolone might get excreted into the breast milk in trace amounts. Although there doesn’t exist any study which mentions complications due to the presence of these medicines in breast milk, it seems that they are safe and do not affect the child’s wellbeing.
- If the mother has severe symptoms of the COVID-19 infection and a viral load, then the mother has to be separated for some time, especially if she is admitted in the Intensive Care Unit (ICU). During this time the baby can be fed using donor-milk, wet nursing, formula milk, and if the mother is feeling up to it then expressed milk can be used.
- There are situations where a COVID positive mother delivers her baby preterm and the child has to be separated from the mother and admitted to the Neonatal ICU (NICU). In such cases even though the mother is able to express milk, there are chances that the medical professionals in the neonatal unit might decline the same suspecting chances of contamination of the milk or the container with the virus. Such a situation can lead to postpartum depression in new mothers and they might need psychological support from family, friends, and the medical staff.