Breastfeeding and Coronavirus

We live in challenging and uncertain times. A new illness (Novel Coronavirus (2019-nCoV), commonly known as Coronavirus or COVID-19, is now a worldwide pandemic. It is a worrying situation for everyone, but pregnant and breastfeeding women have extra concerns in regards to feeding their babies.

Numerous questions have been asked in recent weeks regarding breastfeeding and Coronavirus, and we hope to answer as many as we can in this article, which is monitored regularly and was last updated 17/04/2020.

What if I’m pregnant?

Pregnant women do not appear to be more likely to suffer from Coronavirus than the rest of the population, according to The Royal College of Obstetricians and Gynaecologists (RCOG).

With this in mind, it is essential if you intend to breastfeed, to continue with your plans and stay as healthy as possible.

Learn as much as you can about breastfeeding before the birth, and discover where you can access help should you need support once you begin breastfeeding. 

Take the time to talk, sing, and respond to your baby’s movements, helping you to connect with your unborn baby, which will, in turn, help to reduce your stress and be great for your baby’s brain development.

This connection before the birth will prepare you emotionally and physiologically, so you will be more responsive to all of your baby’s needs for comfort, warmth, and nutrition, once he is born.

Should I still breastfeed?

Yes. The most recent statements from numerous international and local national organizations, including the World Health Organisation, encourage continued breastfeeding.

Thousands of studies show that breastfeeding your baby has both short and long term health benefits for you and you and your baby and reduces the risk of babies developing many potential infectious diseases.

Breast milk is a living, active substance (not unlike blood itself), which has anti-infective properties that help to destroy harmful bacteria and viruses. Breastfeeding your baby will also help to boost your baby’s immunity.

Formula milk does not have anti-infective properties like breastmilk and is therefore not able to offer any protection. Additionally, it’s essential to ensure that you prepare formula feeds in as safe a way as possible to reduce the risks of contaminations Consider How to prepare infant formula and sterilize feeding equipment to minimize the risks to your baby from the Unicef UK Baby Friendly Initiative.

Regarding breastfeeding, the World Health Organisation has stated:

“Mothers and infants should be enabled to remain together and practice skin-to-skin contact, kangaroo mother care and to remain together and to practice rooming-in throughout the day and night, especially immediately after birth during establishment of breastfeeding, whether they or their infants have suspected, probable or confirmed COVID-19 virus infection.”

So you and your baby need to be kept together and allowed the opportunity to have skin to skin time and to be able to feed your baby whenever you see feeding cues. 

Seek out support from the maternity staff around you, particularly around positioning at the breast, to get breastfeeding off to a good start. Gain knowledge around how to know that your baby is getting enough milk, and learn about the normal and ever-changing feeding patterns that babies have. All of this support and knowledge will increase your confidence.

Ongoing skin to skin and close, responsive feeding of your baby is also encouraged. All this closeness and comfort will help you to build up a relationship with your baby, which, as well as reducing stress for both of you, will also be good for your baby’s development.

Regardless of whether you or your baby are displaying symptoms of Coronavirus, you should be encouraged and helped to remain together.

Can Coronavirus be passed through breastmilk?

There is no clinical evidence to date to suggest that the Coronavirus transmits through breastmilk. 

In a very recent study, the virus was not found in samples of amniotic fluid or breastmilk. 

Most experts believe the well-recognized benefits of breastfeeding outweigh any potential risks of transmission of Coronavirus through breastmilk.

Is my baby better protected from COVID-19 if I breastfeed?

Your baby’s immunity should, in theory, be better if you are breastfeeding, and therefore it is feasible that he may be less likely to catch the virus, but until more studies emerge, this is still unknown.

In a very recent study, the virus was not found in samples of amniotic fluid or breastmilk. 

Most experts believe the well-recognized benefits of breastfeeding outweigh any potential risks of transmission of Coronavirus through breastmilk.

Breastfeeding if you have no symptoms

If you are breastfeeding your baby and you have no symptoms of Covid-19, it is essential to continue to practice social distancing (except when feeding your baby). Wash your hands for 20 seconds before and after touching your baby, and other measures recommended to prevent infection.

If you are expressing milk, wash your hands before touching the pump or bottles.

What measures do I need to take if breastfeeding with COVID-19?

The most recent recommendations are to continue breastfeeding, and it is still possible to touch and hold your baby, but there are some critical things that you can do to limit the spread of the virus to your baby:

  • Wash your hands thoroughly for 20 seconds before and after contact with your baby.
  • Routinely clean and disinfect any surfaces that you may have touched.
  • Thoroughly clean any infant feeding equipment, before and after use, including breast pumps, bottles, and teats.
  • Practice respiratory hygiene, including during feeding, for example, by avoiding coughing or sneezing on your baby, and by wearing a face mask or suitable alternative, or when having your baby close for any reason.
  • Take care to avoid falling asleep with your baby. 

You may be feeling unwell, but conserve your energy by continuing to breastfeed. It’s also possible that your milk supply could drop a little if you are ill, but this will increase again as you recover.

Will my breastfeeding pattern change if I have Coronavirus?

It is still important to feed your baby according to their feeding cues with no specific restrictions and understand that it’s normal for your baby’s feeding patterns to continue to change.

Problems you may face

Many women face various hurdles when breastfeeding, and the most important message is to seek out skilled help where needed. Make contact with your healthcare professional and find out what support is available in your area.

You may also find it useful to use local and national breastfeeding helplines and well-known breastfeeding organization’s websites. There are also private IBCLC’s who may offer both telephone and or virtual consultations. 

I’m combination feeding. Should I breastfeed more?

If you are currently combining breastfeeding with bottle feeding formula (combination feeding), you need to know that it is possible to increase your breastmilk. 

Should I pump my milk if I am unwell with COVID-19?

Pumping your milk is an option, but not always necessary. 

If you would rather express your milk, you could ask a family member who is well, to feed the expressed milk to your baby. Always follow the recommended guidelines for cleaning and sterilizing the pumping equipment.

If your baby is fed expressed milk from a bottle, ensure that you wash the bottles and teats in hot, soapy water and sterilize carefully before each use.

Can I still breastfeed if I am hospitalized with Coronavirus?

Being hospitalized with Coronavirus will be a challenging time for you.

The ideal situation is for you and your baby to stay together, where possible. If you are well enough to breastfeed, seek out the support you need to enable you to do this.

The main important message, however, is that you get support to provide your baby with milk feasibly and safely.  

Learn how to hand express now, as this is a fantastic skill which can help you to keep up your supply, and to prevent or treat blocked ducts or mastitis.

If you are not able to breastfeed, consider renting a good quality hospital-grade pump and asking staff to help you express some milk (a shop-bought electric pump would be the next best option).

If someone else needs to feed your expressed milk to your baby by a bottle, this can be done in a responsive way.

It’s reassuring to know that even if your milk supply takes a drop during this time, you can begin to boost your milk supply when you are feeling better and can feed your baby at the breast again.

Whichever way your baby needs to be fed at this time, keep your baby close and responding to his need for food, love, and comfort. Doing this will be good for his health, wellbeing, and development – even if this is another family member, temporarily.

If you can’t breastfeed

If you are too unwell to breastfeed or express breastmilk, whether due to Coronavirus or some other illness, please be assured that it is possible to relactate once you’re well enough.

If you need to stop breastfeeding suddenly, get help to pump your milk as often as your baby would have fed, then gradually start to reduce one of the pumping sessions for two to three days, but ALWAYS keep yourself comfortable in between. If you start to feel uncomfortably full, then use your hand only to get a minimal amount of milk off the breast, which will prevent a blocked duct from occurring, and mastitis potentially.

You can then start to reduce another pumping session over another two to three days, but ensure that you keep as comfortable as you can. Gradually your body will make less and less milk.

Another strategy is to reduce the actual pumping time so that less milk is taken off the breast in each session, too – this will gradually cause your breasts to make less milk until your supply has reduced substantially. 

A well family member could feed the expressed milk to your baby by a bottle until it is used up. If available, donor milk could then be offered or infant formula. Bottles and teats would need to be washed in hot, soapy water and sterilized carefully before each use.

Should I use breastmilk offered by another mother?

No. Even if the offer is from a close family member, it is not recommended. 

Donor breastmilk from a human milk bank, on the other hand, has been through a special and stringent screening and pasteurization process, so this is deemed safe. See the information at the end of the article for more details.

Can I express breastmilk if my baby is in the neonatal unit?

Yes. Breastmilk is essential for sick and preterm babies as it significantly reduces the risk of serious complications both in the short and long term.

Your fresh breast milk should be the first choice for your baby, followed by your frozen breast milk. After that, donor milk, followed by formula.

Ask for support to enable you to express as soon as possible after birth (ideally within 2 hours) and then at least 8-10 times in 24 hours, including at night.

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