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COVID19: Mama, keep calm and keep boobing

COVID19 and Breastfeeding

If you’ve received a COVID positive test result and have younger and breastfed children, it’s normal to feel worried and apprehensive, particularly if your child remains negative. But take heart, all the peer reviewed research and advice from leading health organisations including WHO, UNICEF, NHS, and the CDC is to keep on breastfeeding.

Thousands of years of evolutionary biology are on your side.

Breastmilk is not “just food” – it’s an immune boosting, living substance, packed full of the building blocks to help your baby battle illness.

There has been no evidence in the studies conducted so far that COVID spreads through breastmilk.

Instead studies DO show that mothers who have COVID, or indeed have had it in the past 6-10 months, can pass on antibodies produced when their battled the virus, through breastmilk.

Early also research suggests it is the similar for vaccinated mothers – the antibodies produced after the jab pass on through the milk – though the types of antibodies produced may differ.

But in both cases, it means that breastfeeding can help protect little ones that aren’t eligible for the inoculations.

So, you’ve just tested positive?

Don’t panic and think about what you need to do to alleviate your symptoms (your oxygen mask first). If your child is positive too, then your antibodies will help them. If your child is negative, while it’s not a given they will get COVID, they are likely to have been exposed before you tested positive, so the antibodies will still help.

“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.#WorldHealthOrganisation

What next?

If you are well enough to do so, then breastfeed as normal but take precautionary hygiene measures

WHO and UNICEF guidelines advise

  • Frequent hand washing with soap and water, or an alcohol-based hand rub

  • Make sure your hands are clean before picking up or holding baby

  • Clean and disinfect any surfaces you have touched

  • Cough and sneeze into a tissue and throw away, washing hands after doing so

  • Wearing a mask during any contact with baby even when breastfeeding

  • Washing breastmilk pumps, milk storage containers and feeding utensils after every use.

What if I am too sick to breastfeed?

This could be by pumping milk and asking another caregiver to give it via bottle, cup, spoon, or syringe.

Expressing milk will help keep your supply going for when you are well enough to breastfeed.

There is no need to wait for a negative test result to return to breastfeeding, it should simply be down to if you feel well enough to do so and can see your baby safely.

UNICEF also suggests donor milk as an option if it is available in your area – in Hong Kong @ittasteslikelove has a pinned post where people can request or donate breast milk.

You can also get in touch with La Leche League for tailored advise to your case.

The importance of the dyad

While the advise by some health authorities is to limit contact with the baby, and in some cases - such as the current situation in Hong Kong - separate the baby from a caregiver if one is positive and the other is negative.

It is worth considering the importance of the mother-baby dyad, the impact of stress on the immune system of both mother and child, and the impact of a forced end to nursing.

Abruptly stopping nursing can cause emotional trauma for the child – breastfeeding is not simply about nutrition and immunological benefits, it is also reassurance, comfort, security and “home”.

La Leche League International states that disruption of breastfeeding may lead to several issues:

  • significant emotional trauma for the nursing baby or toddler,

  • a drop in milk supply due to the need to express milk,

  • later breast refusal by the infant due to the introduction of bottles,

  • a decrease in protective immune factors due to lack of direct breastfeeding/expressed milk not matching the infant’s needs at a particular time

  • an increased risk of the infant becoming ill due to lack of immune support from direct breastfeeding.

The last point is of critical importance: when any member of the family has been exposed, the infant has been exposed. Hence, any interruption of breastfeeding may actually increase the infant’s risk of becoming ill and even of becoming severely ill.

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