Breast feeding during COVID-19

1. BREAST FEEDING DURING COVID-
19 PANDEMIC
PURNIMA SAHOO
ASST PROFESSOR
KALINGA INSTITUTE OF NURSING
SCIENCES
KIIT DEEMED TO BE UNIVERSITY

2. BREASTFEEDING
AND COVID-19
Breastfeed to protect infants and children from
getting sick and for their healthy growth and
development.
Breastfeeding is particularly effective against
infectious diseases because it strengthens the
immune system by transferring antibodies from
the mother.

3. BREASTFEEDING MOTHERS
AND COVID-19
Use of a medical
mask when near
the child
Mother should wash hands
thoroughly with soap
or sanitizer before
and after contact
with the child
Routinely clean
and disinfect any
surfaces a mother touches

4. BREASTFEEDING MOTHERS
AND COVID-19
If mother is too unwell to breastfeed or express breastmilk, she should use another
approach, one that is acceptable and available to her.
Re-lactation
(restarting breastfeeding after a gap)
Wet nursing
(another woman breastfeeding or caring for the child)
Donor human milk

5. BREASTFEEDING MOTHER
AND COVID-19
If the mother is severely ill with COVID-19
or suffers from other complication that
prevents her from caring for the infant or
continuing direct breastfeeding, express
milk to safely provide breastmilk to the
infant.

6. BREASTFEEDING MOTHER
AND COVID-19
If the mother, the infants, or young children is
suspected or confirmed COVID-19 and feel stressed
or worried, then she should seek breastfeeding
counselling, basic psychosocial support, or practical
feeding support from trained health care
professionals and breastfeeding counsellors.

7. BREASTFEEDING ADVICE DURING THE COVID-19
OUTBREAK
Breastfeeding protects newborns from getting sick and helps protect them throughout
their infancy and childhood. Breastfeeding is particularly effective against infectious
diseases because it strengthens the immune system by directly transferring
antibodies from the mother. As with all confirmed or suspected COVID-19 cases,
mothers with any symptoms who are breastfeeding or practicing skin-to-skin contact
should take precautions.

8. Actions for breastfeeding mothers
 Practice respiratory hygiene, including during feeding. If the
mother has respiratory symptoms such as being short of
breath, use a medical mask when near the child.
 Mother should wash hands thoroughly with soap or sanitizer
before and after contact with her child.
 Routinely clean and disinfect any surface she touches.
 If she is severely ill with COVID-19 or suffers from other
complications that prevent her from caring for the infant or
continuing direct breastfeeding, express milk to safely
provide breastmilk to her infant.
 If the mother is too unwell to breastfeed or express
breastmilk, she should explore the possibility of relactation
(restarting breastfeeding after a gap), wet nursing (another
woman breastfeeding or caring for the child), or using donor
human milk. Which approach to use will depend on cultural
context, acceptability to the mother, and service availability.
Actions for health facilities and
their staff
 If the mother is providing maternity and newborn
services, she should not promote breastmilk
substitutes, feeding bottles, teats, pacifiers or
dummies in any part of her facilities, or by any of
her staff.
 Whether or not the mother or child has
suspected, probable, or confirmed COVID-19, she
should enable mothers and infants to: -remain
together -practice skin-to-skin contact and -
room-in throughout the day and night, especially
straight after birth during establishment of
breastfeeding

9. WHY IS HUMAN MILK IMPORTANT FOR INFANTS DURING COVID-
19 PANDEMIC?
 Colostrum is a baby’s first vaccine, personalized medicine
 Continuously nursing baby or providing expressed human milk offers ongoing
immunological support:
• Influenza
• RSV
• Pneumonia
• Diarrhoea
Reduces reliance on formula feeding post-discharge
Reduces burden on stressed health systems

10. PERINATAL HEALTH
EXPERTS WARN OF THE
HARMFUL EFFECTS OF
SEPARATING INFANTS FROM
THEIR MOTHERS, WHETHER
THEY ARE INFECTED WITH
COVID19 OR NOT –
SEPARATION IS AN
UNNECESSARY MEASURE
WHICH AT THIS MOMENT IS
UNADVISED BY THE WHO IN
THE CURRENT EVIDENCE.

11. History and the scientific literature
clearly illustrates that when public
health, medical systems, and social
services systems are weakened by
disasters and emergencies, protecting,
promoting, and supporting
breastfeeding is the single most
important intervention for infant
survival.

12. PATIENTS UNDER INVESTIGATION
(PUI)
PUI or COVID-19+ patients who are too sick to care for their baby but wish for
their baby to receive their own milk or donor milk:
oAssistance with latching baby and support while baby nurses
oSupport to express milk, with pump or hand expression
oSupport with relactation
oAccess to pasteurized donor human milk when available
oProvide mental health and psychosocial support

13. PUI or COVID-19+ and nursing or expressing milk for baby at home
•Guidance for if they are well or have mild symptoms
•Guidance for if they are sick and have moderate to serious symptoms
•At home, another healthy caregiver can provide support to maintain lactation:
•Help with latching baby, milk expression, feeding expressed milk
•Use IPC best practices
•Mental health and psychosocial support part of essential care
•Lactation counseling and infant feeding support part of essential care
•Minimize exposure to others in the home who are at higher risk for severe disease (>50
years; smokers; asthma; high blood pressure; immunocompromised)

14. If the mother has COVD-19, there may be more worry, but it
is still reasonable to choose to breastfeed and provide
expressed milk for her child. Limiting the child’s exposure
via respiratory secretions may require more careful
adherence to the recommendations
depending on the mother’s illness.
There are several choices in the hospital concerning
housing for a breastfeeding mother and her infant.

15. IF I HAVE CORONAVIRUS DISEASE (COVID-19) WILL I PASS
IT TO MY BABY?
• We still do not know if the virus can be transmitted from a mother to her baby during
pregnancy. “The COVID-19 virus has not been found in vaginal fluid, in cord blood or
breastmilk”, although information is still emerging. To date, COVID-19 has also not been
detected in amniotic fluid or the placenta.
• The best thing Mother can do is to take all necessary precautions to prevent herself from
contracting the COVID-19 virus. However, if she is pregnant or have just given birth and feel ill,
then she should seek medical care promptly and follow instructions from the health care
provider.

16. SOME IMMEDIATE ACTIONS
• Scale up training in providing virtual and mobile support
• Hospitals
• Communities
• Private practice
• Rapidly scale up training in critical lactation counseling and support
skills
• Hand expression and cup or spoon feeding
• Relactation, weaning off supplements, power pumping
• Counseling about the introduction of complementary foods
• Safe sleep
• Reading and responding to your baby
• Postpartum mental health for infants and their caregivers

17. • Provide support to parents/caregivers of formula dependent
infants:
• Hygiene, preparation, storage and handling of formula
• IPC for formula-feeding parents PUI/COVID-19+ when another
caregiver is not available
• Reading and responding to baby
• Connecting parents/caregivers with resources to ensure they have an
adequate supply of formula for their baby, while protecting families
against exposure to predatory marketing practices and tactics

18. • Policy & Advocacy Actions
• Advocate that all public health and emergency response systems that are
mobilized consider infant and young child feeding, and prioritize continuity of
care from clinic to community
• Lactation support persons and doulas are essential to positive pregnancy,
birth, and infant feeding outcomes
• Advocate for the adoption of WHO guidance for intrapartum and immediate
postpartum care of PUI-COVID+ birthing parent and infant
• Identify and strengthen opportunities to coordinate response in ways that
center perinatal, postpartum, and infant health, particularly in marginalized
and vulnerable communities and populations

19. • Community Mobilizing
• Share key messages with parents and caregivers about infant
feeding
and care for COVID-19
• Adapt perinatal, postpartum, family care services to strengthen
community safety net
• Survey what families in your communities need
• Share needs with other community organizations
• Coordinate support resources, consider innovations in care
delivery

20. TAKE ADDITIONAL HYGIENE MEASURES AND CONTINUE
TO BREASTFEED IF MOTHER FALL SICK
Mothers who get coronavirus shortly before giving birth and begin breastfeeding, and those who
become infected while breastfeeding, will produce immune factors (antibodies) in their milk to
protect their baby and enhance the baby’s own immune responses. This means that continuing to
breastfeed is the best way to fight the virus and protect your baby.

21. USE A CUP AND SPOON TO FEED BABIES WITH
EXPRESSED BREASTMILK WHEN TOO SICK TO
BREASTFEED
When mothers are too ill to breastfeed, they should seek immediate medical advice. It may still be possible to
express milk and ask a non-infected member of the family to feed the baby using a clean cup or cup and spoon. It
will be even more important to follow the 3 Ws at all times to keep the baby healthy and safe.

22. TAKE EXTRA CARE WHEN FORMULA FEEDING
Breastfeeding is the best way of providing ideal food for the healthy growth and
development of babies. However, there are instances where a mother is unable to
breastfeed or where she has decided not to breastfeed. In addition, the widespread
marketing of formula milks undermines the confidence of many mothers and encourages
them to feed their babies using bottles and formula milks. In these cases, it is especially
important that babies are being fed according to the instructions on the packaging and
that extra care is taken with thoroughly washing bottles, teats and any other equipment
used. The 3 Ws should be followed at all times.