Hong Kong authorities are still separating COVID-19 positive parents from their babies and children, a harrowing practice that goes against UN and WHO guidelines. We take a look at the expert opinion on how best to treat breastfeeding mothers during the pandemic.
WHO recommends that mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue to breastfeed. Mothers should be counselled that the benefits of breastfeeding substantially outweigh the potential risks for transmission.
Mother and infant should be enabled to remain together while rooming-in throughout the day and night and to practice skin-to-skin contact, including kangaroo mother care, especially immediately after birth and during establishment of breastfeeding, whether they or their infants have suspected or confirmed COVID-19.
Secretory IgA have been detected in breastmilk of mothers with previous COVID-19 infection. Although the strength and durability of sIgA reactive to COVID-19 have not yet been determined, multiple bioactive components have been identified in breastmilk that not only protect against infections but improve neurocognitive and immunologic development of the child since Lars A Hanson first described sIgA in breastmilk in 1961.
Relevant points include:
Children should not be separated from their parents unless they are not being properly looked after
Governments must protect children from violence, abuse and being neglected by anyone who looks after them.
Parents are the main people responsible for bringing up a child. Parents and guardians should always consider what is best for that child. Governments should help them.
La Leche League International strongly encourages all stakeholders to recognise the importance of breastfeeding in providing immunological protections to the breastfed child. The practice of separating an infected mother from her child can actually increase the risk of the child becoming ill, due to the lack of immune support from direct breastfeeding.
Furthermore, a breastfeeding mother who becomes infected will produce specific antibodies, as well as many other critical immune factors in her milk, which serve to protect her breastfed child.
Finally, since an individual can be infectious before displaying symptoms, it should be assumed that the breastfed child has already been exposed to the virus. Thus, separating a breastfeeding mother and child against their will offers little benefit.
It cannot be expressed more firmly that the practice of preventing a COVID19-positive breastfeeding mother from breastfeeding her child increases the child’s risk of illness. LLLI’s position on keeping infected mothers with their breastfed children is aligned with the WHO and UNICEF’s recommendations.
The UN Convention on the rights of the child stipulates that families should be kept together, while the World Health Organization recommends that mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue to breastfeed.
WHO not only states that the benefits of breastfeeding substantially outweigh the potential risks for transmission, but insists that women should be told this when diagnosed.
Yet in Hong Kong, authorities operate a practice of forced separation.
We know breastfeeding mothers who are suspected to be COVID-19 positive have been hospitalised, however minor their symptoms, with no option to bring their breastfed baby with them.
We also know that mothers are not being provided facilities to store pumped milk or assisted to transport their expressed milk to the child who needs it.
The mental health implications of separating families are grave across the board, but there are additional factors that exacerbate the situation for nursing mothers.
There have been cases where babies, used to direct feeding, reject the bottle or have suffered an allergic reaction to formula milk, leaving them vulnerable to dehydration. This means otherwise healthy infants are being needlessly put at risk of hospitalisation and requiring IV replacement of fluids, by misguided government policy.
Allowing breastfed babies to stay with their mother, and enabling them to continue to nurse would clearly protect them from such dehydration. This combined with the immunological benefits of breastmilk highlighted by WHO, UNICEF and La Leche League International, underlines the benefit of enabling parents to make informed choices.