COVID-19 and Breastfeeding

Current evidence suggests that breast milk is not a source of transmission of SARS-C0V-2. When possible, breastfeeding mothers with suspected or confirmed COVID-19 (regardless of vaccination status) should continue to breastfeed while taking hygiene precautions.

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 symptoms, but some people become severely ill.

Can SARS-COV-2 be transmitted through breast milk?

Current evidence suggests that SARS-COV-2 (the virus that causes COVID-19) is not spread to infants through breast milk. The virus spreads when an infected person breathes out droplets and very small particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouth. In some circumstances, they may contaminate surfaces they touch.

Should mothers continue breastfeeding if they have suspected or confirmed COVID-19 or come in contact with someone with COVID-19?

Breastfeeding mother wearing a mask

Yes. A mother’s breast milk contains antibodies and other immunological factors that can help protect her infant from infections and is the recommended source of nutrition for most infants, even while the mother is ill. Research indicates that the breast milk of mothers with COVID-19 contains antibodies and other factors that may provide immunological protection to infants.  Breastfeeding mothers with suspected or confirmed COVID-19 should follow information on isolation and take these precautions:

  • Wash their hands using soap and water before touching their child or expressing breast milk either by hand expression or with a breast pump. If soap and water are not available, use hand sanitizer with at least 60% alcohol.
  • Wear a mask when in close contact with the infant, such as when feeding at the breast or feeding from a bottle, and when expressing breast milk.
  • Clean and sanitize breast pumps and all infant feeding items.

If a mother is too sick to feed her infant at the breast and another healthy caregiver is caring for the infant, the breastfeeding mother should be encouraged and supported to regularly express her milk so that the infant continues to receive her breast milk and the mother maintains her milk supply. Healthcare providers may need to refer mothers for lactation support to learn how to maintain milk production and how to supplement with donor human milk or infant formula while not feeding at the breast.

Can infants who have COVID-19 continue to breastfeed?

Yes. 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 also be given from a cup, syringe, or bottle if the infant is unable to breastfeed directly at the breast.

Mothers who are breastfeeding a child with suspected or confirmed COVID-19 should be considered as a close contact of a person with COVID-19, and should follow CDC recommendations for what to do when exposed to COVID-19.

To minimize possible exposure, precautions include

  • Wearing a mask during any close contact with the child, including while feeding at the breast, expressing milk, or feeding from a bottle. (Because of the danger of suffocation, masks should NOT be put on children younger than 2 years).
  • Frequent handwashing (especially after touching their child).

Is the COVID-19 vaccine safe for breastfeeding mothers and their infants?

Yes. CDC recommends that people who are breastfeeding, and infants 6 months of age and older get vaccinated and stay up to date with their COVID-19 vaccines.

Vaccines are safe and effective at preventing COVID-19 in mothers who are breastfeeding. Available data on safety of COVID-19 vaccination while breastfeeding indicate no severe reactions after the first or second dose in the breastfeeding mother or the breastfed child. There has been no evidence to suggest that COVID-19 vaccines are harmful to either people who have received a vaccine and are breastfeeding or to their babies.

Studies have shown that breastfeeding mothers who have received mRNA COVID-19 vaccines have antibodies in their breast milk, which could help protect their babies.

Considerations for lactation services

Lack of access to professional lactation support is a barrier to breastfeeding. It is critical to ensure that people who are breastfeeding or who desire to breastfeed continue to have access to this support during infectious disease outbreaks in the community, such as COVID-19. Breastfeeding problems are often urgent and require immediate assistance. Further, breastfeeding consults typically require very close contact between the lactation support provider and the breastfeeding dyad; therefore, the use of appropriate personal protective equipment (PPE) may be warranted when there are infectious disease concerns.

Lactation support is delivered in a variety of settings including outpatient clinics or offices, online through telemedicine consults, or in the breastfeeding person’s home. In-person support may be necessary to assist some breastfeeding dyads effectively. 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 healthcare providers have been met.

Lactation support providers working in healthcare settings should follow recommended infection prevention and control measures for those settings.

For in-person, home-based lactation visits where there is suspected or confirmed COVID-19, these hygiene precautions should be carefully followed:

  • 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.
  • Wear a surgical mask while inside the client’s home and 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.
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