What to know
Current evidence suggests that breast milk is not a source of transmission of SARS-CoV-2. When possible, breastfeeding mothers with suspected or confirmed COVID-19 should continue to breastfeed while taking hygiene precautions. This advice is regardless of COVID-19 vaccination status.
About COVID-19
COVID-19 (coronavirus disease 2019) is a disease caused by a virus named SARS-CoV-2. It can be very contagious and spreads quickly. COVID-19 most often causes respiratory symptoms that can feel much like a cold, the flu, or pneumonia. Most people with COVID-19 have mild or no symptoms, but some people become severely ill.
COVID-19 and breast milk
Current evidence suggests that SARS-CoV-2 is not spread to infants through breast milk. The virus spreads when an infected person breathes out droplets and tiny particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouths. In some circumstances, the droplets may contaminate surfaces they touch.
Breast milk is the recommended source of nutrition for most infants, even while their mother is ill. A mother's breast milk contains antibodies and other immunological factors that can help protect her infant from infections. Research indicates that the breast milk of mothers with COVID-19 contains antibodies and other factors that may provide immunological protection to infants.
Breastfeeding with COVID-19
Mothers can continue breastfeeding when they have COVID-19 or came in contact with someone with COVID-19. However, they should follow these precautions.
Precautions
- Wash hands using soap and water before touching their child or expressing breast milk by hand expression or with a breast pump. If soap and water are unavailable, use hand sanitizer with at least 60% alcohol.
- Consider wearing a mask when in close contact with the infant, such as when feeding at the breast or from a bottle.
- Clean and sanitize breast pumps and all infant feeding items.
If a mother is too sick to breastfeed
If a mother is too sick to feed her infant at the breast, and another healthy caregiver cares for the infant, mothers should be encouraged to regularly express her milk. With this support, the infant can continue receiving breast milk, and the mother can maintain her milk supply. Health care providers may need to refer mothers for lactation support to help them maintain milk production and supplement with donor human milk or infant formula.
Infants with COVID-19
When an infant has COVID-19, the mother should be encouraged to continue breastfeeding or feeding expressed breast milk to her infant. Infants who are ill need fluids to stay hydrated, and breast milk is the best option. Expressed breast milk can be given from a cup, syringe, or bottle if the infant cannot breastfeed directly at the breast.
To minimize possible exposure, precautions include:
- Consider wearing a mask during any close contact with the child, including while feeding at the breast or feeding from a bottle. Because of the danger of suffocation, masks should NOT be put on children younger than 2.
- Frequent handwashing, especially after touching the child.
- Improving ventilation indoors by opening windows, using air filters, and turning on fans.
COVID-19 vaccine
CDC recommends that women who are breastfeeding and infants 6 months of age and older receive and stay up to date with COVID-19 vaccines.
Vaccines are safe and effective at preventing COVID-19 for mothers who are breastfeeding. There has been no evidence to suggest that COVID-19 vaccines are harmful to either breastfeeding women who have received a vaccine or to their babies.
Studies have shown that breastfeeding mothers who have received mRNA COVID-19 vaccines have antibodies in their breast milk. This could help protect their babies from COVID-19.
Lactation services
Some women may need additional lactation support from a professional. Lactation support occurs in various settings including outpatient clinics or offices, online through telemedicine consults, or the breastfeeding person's home. In-person support may be necessary to assist some breastfeeding families effectively.
In-person support typically requires close contact between the lactation support provider, the mother, and the infant. Appropriate personal protective equipment (PPE) may be warranted when there are infectious disease concerns.
Lactation support providers should stay up to date with their COVID-19 vaccines. Lactation support providers should not provide in-person care to families if they are sick with COVID-19 or think they might have COVID-19. Refer all clients to another lactation support provider until return to work criteria for health care providers have been met.
Lactation support providers working in health care settings should follow recommended infection prevention and control measures for those settings.
Precautions for in-person home visits
Lactation support providers should take steps to prevent the spread of respiratory viruses. If they are sick, they should stay home and away from others. They can also take the following precautions:
- Wash hands with soap and water for at least 20 seconds when entering and leaving the home and when adjusting or putting on or taking off masks. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.
- Consider wearing a mask while inside the client's home.
- Discard disposable surgical masks between clients.
- Wear disposable patient examination gloves when handling the baby, especially for oral assessments.
- Clean and disinfect surfaces and equipment such as infant scales.
- Improve ventilation indoors by opening windows, using air filters, and turning on fans.