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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
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751