If infected with coronavirus, should a mother continue to breastfeed?

Dear Dr Ombeva,

Thank you so much for your recent article on coronavirus infection in children. My question concerns breastfeeding mothers. If one is infected and has a baby, can she continue to breastfeed?

Caroline

Response

The guidelines regarding Covid-19, the disease caused by coronavirus, are still being developed by WHO and CDC. The current recommendations for pregnant women are that they should take the same precautions as everyone else to avoid Covid-19 infection.

These include: Washing your hands frequently with an alcohol-based hand rub or soap and water; keeping space between yourselves and others; avoiding touching your eyes, nose and mouth; practising respiratory hygiene.

This means covering your mouth and nose with the inside of your elbow or tissue when you cough or sneeze then dispose of the tissue immediately.

Pregnant women and women who have recently delivered -- including those affected by Covid-19 -- should attend their routine care appointments. After delivery, breastfeeding during maternal Covid-19 infection is not contraindicated, and all possible precautions should be taken to avoid spreading the virus to the infant, including washing hands before touching the infant and wearing a face mask.

When separation of the mother from the newborn is initiated, mothers who intend to breastfeed should be encouraged to express their breast milk to establish and maintain milk supply. Usually, doctors will give you adequate counselling regarding potential risks and benefits.

All mothers with Covid-19 can breastfeed if they wish to do so. They should practice respiratory hygiene during feeding, wearing a mask where available; washing hands before and after touching the baby and routinely cleaning and disinfecting surfaces they have touched.

Mothers with Covid-19 can touch and hold their babies. Have close contact and early, exclusive breastfeeding help a baby to thrive. They should be supported to breastfeed safely, with good respiratory hygiene; hold your newborn skin-to-skin, and share a room with your baby. Wash your hands before and after touching your baby, and keep all surfaces clean.

Mothers who are too unwell to breastfeed due to Covid-19 or other complications should be supported to safely provide the baby with breast milk in a way possible, available, and acceptable to them. This could include: expressing milk; relactation; or use donor human milk.

Dr Ombeva Malande is a specialist paediatrician. Reach him on [email protected]