What You Need To Know About Breastfeeding, Donor Milk, And COVID-19

Unlike viruses like HIV and Ebola, the novel coronavirus doesn't spread through breast milk.
Nursing a newborn is hard enough without a global pandemic.
Nursing a newborn is hard enough without a global pandemic.

Most new parents who feed their babies breast milk already have a ton of questions, but during a global pandemic, things get ratcheted up several thousand notches.

“This is a really anxious time to be the parent of a young child,” lactation consultant and public health advocate Michelle Pensa Branco told HuffPost Canada. As the co-founder of Safely Fed Canada, a nonprofit focused on safe feeding for babies and young children in emergency situations, she’s fielding a lot of questions from scared parents about feeding their baby breast milk during the COVID-19 pandemic.

We asked Pensa Branco to answer some of the most pressing questions about coronavirus, breast milk, and the best practices for breastfeeding, chestfeeding and using donor milk in this very unusual time.

Q: Is is safe for someone who’s experiencing COVID-19 symptoms to nurse?

A: Yes. At the moment, the recommendation from Health Canada and the World Health Organization is that, in the case of a presumed or confirmed COVID-19 infection, we can continue nursing.

Q: What precautions should they be taking?

A: The same precautions we’d use with any respiratory infection: we’re going to wash our hands. Before we’re in contact with the baby, we’ll wear a mask, if we have one available to us. We’ll also clean the hard surfaces that the infected person is in contact with.

If you’re preparing food for the baby, make sure that you’re cleaning the counter where you’re changing the diapers, that you’re regularly wiping down the sink and the faucet, those sorts of things.

Also, a nursing parent and their baby can obviously stay together, because they’re going to be in close contact anyway and that’s important for the baby’s wellbeing.

But, they should both try to stay a two-metre distance away from other caregivers. If there’s a grandma, or a dad, or an older child or a teenager in the house, try and maintain distance as much as possible.

Q: If a breastfeeding or chestfeeding parent is infected with the virus, should they wear a mask while feeding the baby?

A: The current general advice from the World Health Organization and from Health Canada is that if a mask is available to you, you should wear it.

Q: So, even if you have COVID-19, nursing — with a mask if possible — is still considered safer than pumping?

A: Yeah, and the reason for that is twofold.

One: as soon as we start pumping, even if we’re really careful, we’re introducing another way for there to be contamination. The virus may not be in the milk itself, but it could be on a pump that you accidentally coughed on, or a bottle that caught droplets that you coughed out.

Also, we want to remind people that they should not stop nursing right now. Statistically, babies who are bottle fed are more likely to get sick from gastrointestinal infections, respiratory infections, and other issues. They’re more likely to end up in the hospital than a baby who’s exclusively fed breast milk.

So that’s really one of the reasons why: from a public health perspective right now, we’re trying to keep babies from getting sick so they don’t need medical care.

Disinfecting breast pumps and other equipment is more important now than ever.
Disinfecting breast pumps and other equipment is more important now than ever.

Q: How much do we know about the potential impact of COVID-19 on nursing? What research is being done?

A: The virus is so new. But we do have some peer-reviewed research at this point, mostly from China, because they have the longest window of time to get the data through peer review and published in a journal.

What we see from that data is that, by and large, babies are less likely to be to be infected than older people. [Although babies can in fact catch the virus.] We haven’t seen any cases of transmission through breast milk or through the placenta. So even babies born of mothers who have active COVID-19 infections are not being born with the virus themselves.

And even though we don’t have a lot of data on this particular coronavirus, we do have data on other similar kinds of viruses. And those kinds of viruses tend not to be very effectively transmitted by blood or by breast milk. The virus lives in our lungs and in our respiratory system, and it passes to other people through the droplets that we cough or breath out. So that’s why it’s quite different from other things like, say, HIV or ebola [which are both transmitted through bodily fluids including breast milk].

Q: If you’re feeling too sick to nurse, what are your options?

If someone is not feeling up to breastfeeding or chestfeeding, they can express their milk — so either hand-expressing, or using a pump and have someone else feed that to the baby.

[If you’re opting for formula, Safely Fed Canada also recommends trying to keep two to four weeks’ supply on hand, and making sure to keep up with sterilization requirements.]

Q: Is it safe to use donor milk?

A: At this point there’s there’s been no change to the recommendations on donor milk. The Human Milk Banking Association of North America has issued a statement saying they believe that human donor milk is safe to use, and they’re recommending its continued use. They’ve put into place a couple of new screening questions for donors and are also recommending that people do things like wipe down the containers and clean their pumps regularly.

Donor milk can make a huge difference for new parents who can't produce their own breast milk.
Donor milk can make a huge difference for new parents who can't produce their own breast milk.

Q: Is there virtual support available for new parents who are having challenges feeding their baby?

A: This is one of the things that we’re really worried about, because obviously parents are not going to be getting the same kind of support as they would normally get, either in the hospital or when they’re coming home.

But there are a number of different services out there. A lot of health units have telephone lines and text lines. There are also, at the public health level, peer support programs, so people who breastfed or chestfeed their own kids, can offer emotional support and information over the phone or by text.

There are also a number of Telehealth options, whether that’s through your pediatrician’s office or your family doctor’s office. There are also likely lactation consultants offering video services. I would encourage people to to try and find someone who’s fairly local to them, because they’ll know what services are available in your area.

Q: Can people find those services at the provincial health level?

A: It’s actually pretty local. Here in Toronto, we have Toronto Public Health, which has their set of programs. I would encourage people to go to their municipal public health site and they’ll be able to access information there. I know in Alberta and B.C. they also have their provincial Telehealth number that offers support by phone.

Q: For people who are having mastitis or other complications, what’s the best way to get treatment while avoiding crowded hospitals and clinics as much as possible?

A: Many pediatricians and family doctors are doing telemedicine, so that would be generally where we would start: call your doctor. Something like mastitis actually might not require you to go in physically at this point — they might be able to do an assessment over the phone, and possibly prescribe antibiotics over the phone.

Q: Is there anything else you think parents need to know right now?

A: Parents are putting a lot of pressure on themselves, and having lost so many of the supports that we build up and that we put into place for them, it’s going to be really tough for some folks. So I think that continuing to seek out support, even if it’s just moral support, is really important.

A lot of folks are really worried about the impact that this is going to have on their babies, and they should know: if you’re doing OK, your baby’s doing OK. Babies and toddlers are 100 per cent parent-focused. And if their parents are there for them, and are happy and well, then they’re happy and well too.

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