By: Temitope Awelewa, MBCHB, MPH, FAAP, IBCLC
The outbreak of
COVID-19 is a stressful time for everyone. This may be especially true for mothers who are breastfeeding and concerned about their baby's health. However, mothers can successfully start and maintain
breastfeeding during the pandemic, with some recommended precautions.
Is breastfeeding and expressed breast milk feeding safe during the COVID-19 pandemic?
SARS-CoV-2 (the virus that causes COVID-19 disease) spreads between people who are in close contact, mainly through respiratory droplets when an infected person coughs, sneezes, or talks. To date, there is no evidence that live, infectious SARS-CoV-2 is passed from mother to baby in breastmilk. Breastfeeding has been shown to be safe when a mom has other viral illnesses like influenza.
Can my baby continue breastfeeding or drinking expressed breast milk if I test positive for COVID-19?
Yes, babies can still receive breast milk even if you test positive for COVID-19.
Direct breastfeeding. If you want to breastfeed directly, wash your hands with soap and water before holding your baby and wear a cloth face covering while nursing. Holding your baby skin-to-skin helps the baby latch on and also helps trigger milk release.
Pumping breast milk. To pump or express your breast milk, put on a cloth face covering, wash your hands well and clean any pump parts, bottles and artificial nipples. Express milk as often as your baby eats, or at least 6 to 8 times per 24 hours. The expressed milk can be fed to your baby by a healthy caregiver.
Remind all caregivers to wash their hands before touching bottles or feeding your baby. Remember to clean your breast pump after each use.
If I have COVID-19, can I stay in the same room with my infant?
If you and your family decide to keep your baby in the same room as you, try to keep a reasonable distance away when possible. Wear a cloth face covering and wash your hands whenever you directly care for your baby.
Continue taking these precautions until you have been fever-free for 24 hours without taking any fever medicines (acetaminophen or ibuprofen); at least 10 days have passed since your COVID-19 symptoms first started; and all your symptoms have improved. If you tested positive but have no symptoms, wait until at least 10 days after the positive test result.
How can I maintain my milk supply if I am sick with COVID-19?
Hand pumping and hand expressing breast milk is especially helpful in the first few days after your baby is born to get the milk supply going. Frequent pumping (or breastfeeding if you have chosen to directly breastfeed and are following the strict precautions noted above) should line up with your infant's feeding demands, about 8-10 times in a 24-hour period.
medications are safe to take while breastfeeding, but always check with your doctor.
Do not hesitate to ask for help with getting your baby to latch on again once you restart breastfeeding. Also, talk with your pediatrician if you have nipple pain, low milk supply or any other concerns.
How can I protect my infant from COVID-19 infection?
Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use
hand sanitizer. Look for one that is 60% or higher alcohol-based. Avoid touching your face, eyes, nose, or mouth with unwashed hands. Also, be sure to clean visibly dirty or possibly contaminated surfaces your infant may touch.
If you feel sick, be extra careful to cough or sneeze into your sleeve or a tissue. Throw away used tissues immediately and wash your hands.
Outside your home, wear a cloth face covering, practice physical distancing by avoiding public spaces and keeping a 6-foot distance from others whenever possible. And be sure that everyone in your home avoids close contact with anyone with respiratory symptoms such as coughing or individuals with probable COVID-19.
Your pediatrician is here to help
After leaving the hospital, it is important that your baby's first follow-up visit happen in person so your baby can be measured and weighed accurately. Many doctors are scheduling newborn visits during specific times (such as first thing in the morning) to limit exposure to sick patients. While some doctors are also doing more work via phone and video, this is not the best option for newborns.
Breastfeeding is a key preventive health step for baby and mother, even during the pandemic. Talk with your pediatrician about how to keep your baby healthy and what resources might be available in your community to help you.
About the author
Temitope Awelewa, MBCHB, MPH, FAAP, IBCLC, is a board-certified general pediatrician, a physician informatics officer and a clinical assistant professor of pediatrics at the University of Iowa. Within the American Academy of Pediatrics, she is a member of the Section on Breastfeeding and the Chapter Breastfeeding Coordinator for the Iowa Chapter of the American Academy of Pediatrics.