Can breastfeeding be continued if mother is positive for COVID-19?

Breastfeeding is the cornerstone of infant and young child survival, nutrition and development and maternal health. However, concerns have been raised about whether mothers with COVID-19 can transmit the SARS-CoV-2 virus to their infant or young child through breastfeeding.

In the latest scientific brief by World Health Organization (WHO), it has been recommended that- "Mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue breastfeeding."

Recommendations on mother-infant contact and breastfeeding must be based on a full consideration of not only of the potential risks of COVID-19 infection of the infant, but also the risks of morbidity and mortality associated with not breastfeeding.

A systematic review of available literature has been done by the researchers and included 46 mother-infant dyads in the analysis.

Few important findings are:

-Breast milk samples from 43 mothers were tested negative for COVID-19 virus while samples from 3 mothers tested positive for viral RNA by RTPCR.

-Among 3 infants whose mothers' milk was positive, one infant was positive for COVID-19 but infant feeding practices were not reported in this case.

-15 breast milk samples were tested for secretory IgA against COVID-19 out of which 12 samples had detectable levels of IgA.

RT-PCR does not provide information on viability and infectivity of the virus. Source in the infection in one neonate who tested positive is not clear. Transmission of COVID-19 would need replicative and infectious virus being able to reach target sites in the infant and also to overcome infant defense systems. Hence further evidence is required to document COVID-19 replicative viral RNA from cell cultures of breast milk samples.

Considering the various benefits of breastfeeding-thermoregulation, blood glucose control, and maternal-infant attachment, and decrease the risk in mortality and severe infection in neonates; beyond the neonatal period, the positive effects of mother-infant holding include improved sleep patterns, lower rates of behavioral problems in the child and higher quality parental interaction; WHO recommends exclusive breast feeding for the first 6 months of age and continued breastfeeding upto 2 years of age.

Precautions to be followed while breastfeeding from a COVID-19 mother(CDC guidelines)

1.Regular hand washing with soap and water or sanitizing hands with 60% alcohol.

2.Wear a face mask while feeding from breast or even when expressing milk.

3. If using breast pump, clean and sanitise breast pump before every use.WHO concludes- "COVID-19 in infants and children represents a much lower threat to survival and health than other infections that breastfeeding is protective against."

Source: World Health Organization