Is it Safe to Breastfeed With COVID-19?

Breastfeeding and COVID-19

Receiving news of a COVID-19 diagnosis can be devastating for any person. When that news is given to a breastfeeding parent, one of the first follow-up questions is usually "is it safe to breastfeed?".

In general, is it safe to breastfeed if a patient has COVID-19? What safety precautions does a COVID-positive breastfeeding parent need to take?

The World Health Organization and the Academy for Breastfeeding Medicine have determined that it is safe for parents with COVID-19 to breastfeed if specific precautions are put in place.

• First, parents should practice hand hygiene by using hand sanitizer containing 60% - 95% alcohol or washing their hands for 20 seconds prior to holding their infant.
• They should wear a surgical face mask or, preferably, a N95/KN95 respirator while breastfeeding to prevent transmission of the viral respiratory particles. 
• After breastfeeding, they should clean their hands again.
• Lastly, parents should quarantine from their infant when not breastfeeding, if another caregiver is available. 

Can COVID-19 be passed through breast milk?

After years of the COVID-19 pandemic, the medical research community has been able to publish several studies on pregnant and breastfeeding women with COVID-19. Collectively, these study conclusions show that the SARS-CoV-2 virus was not likely to be detected in breast milk (~5%)1. In addition, research studies have not concluded that any detection of the virus in breast milk has caused COVID-19 infection in infants. 

Under what circumstances should patients isolate from their baby and pump, instead of directly breastfeed?

If a breastfeeding parent is severely ill from COVID-19 and unable to care for herself, then the parent may not be able to care for her infant as normal. In this case, the breastfeeding parent should isolate from the infant and instead pump, if possible. The infant will still be able to benefit from the antibodies that their parent's expressed breast milk will supply. Hand hygiene should also be practiced prior to touching any breast pump parts or expressed milk. Once the mother's health has improved, interactions with her infant - including breastfeeding - can resume. 

What if a patient has been exposed to COVID-19, but isn't yet positive? Can they continue breastfeeding?

If a parent is concerned that they have been exposed to COVID-19, it is recommended to continue breastfeeding while wearing a face mask and practicing good hand hygiene. On day #7 after exposure, the breastfeeding parent should be tested for COVID-19. 

What's Next?

COVID-positive breastfeeding parents are rightfully concerned about whether to initiate or continue breastfeeding, whether they should only pump their breast milk, if they could pass coronavirus on to their infant, and how to quarantine with a breastfeeding infant. All of these are valid concerns, especially considering that there is no vaccine approved for children less than 5 years old at the time of this publication. 

The medical community has sought to come up with the best evidence-based recommendations to help breastfeeding parents make good decisions.

-Dr. Glass
 The Vine Pediatrics and Lactation PLLC

References

1. Zhu F, Zozaya C, Zhou Q, De Castro C, Shah PS. SARS-CoV-2 genome and antibodies in breastmilk: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2021 Sep;106(5):514-521. doi: 10.1136/archdischild-2020-321074. Epub 2021 Feb 10. PMID: 33568494.