The Covid-19 pandemic is disrupting normal life globally, and every area of life is touched. The pandemic demands quick action, and as new information emerges, reliable syntheses and guidelines for care are urgently needed.

It is no secret that breastfeeding protects mother and child. Its health benefits are undisputed and based on evidence. But how does the coronavirus affect breastfeeding? Prof Welma Lubbe from the School of Nursing at the North-West University (NWU) says in order to plan for and support breastfeeding in the current pandemic, two areas need to be understood:

• The clinical characteristics of Covid-19 as they apply to breastfeeding.
• The protective properties of breastfeeding, including the practice of skin-to-skin care.

Prof Lubbe says although most of the infections occur in adults older than 60 years, some pregnant women have also been infected, causing concerns for the management of the perinatal period (the period of time from when you become pregnant and up to a year after giving birth).

“Findings from international research, including case studies done in Spain, Vietnam, China and the USA, suggest that there is currently no evidence to show that respiratory viruses, including the coronavirus, can be transmitted through breast milk. Breastfeeding benefits outweigh possible risks during the Covid-19 pandemic and may even protect the infant and mother. The protective effect is particularly strong against infectious diseases, due to the direct transfer of antibodies as well as anti-infective factors and long-lasting transfer of immunological competence and memory,” Prof Lubbe says.

With this in mind, it is also important for general infection control measures to be in place and adhered to very strictly. Current research suggests that the coronavirus is transferred from person to person when someone is in close contact with an infected person. The virus is transferred via respiratory droplets produced when coughing and sneezing. Droplets can either land on a healthy individual close to a cavity in the facial area or be inhaled into the lungs of persons in close proximity to an infected person. It is important to note that airborne transmission over long distances is unlikely.

Prof Lubbe says a newborn child has an immature immune system, but colostrum – a powerful immune booster derived from breast milk – not only protects the newborn from infections: it also serves as a growth and tissue repair miracle. “It plays an important role in absorbing and engulfing harmful micro-organisms, targeting specific bacteria and providing protection by regulating the immune response. All the above are compelling reasons for every infant to receive only breast milk, and preferably their own mother’s milk.”

So, the benefits of breastfeeding are clear, but is skin-to-skin care safe? “Skin-to-skin contact is the safest and best transition for mothers and their infants to a new life together. By ensuring it happens immediately after birth, the infant’s microbiome is given a chance to develop from the mother’s flora, which is very beneficial during a pandemic.”

Prof Lubbe adds that skin-to-skin contact between mother and infant also increases blood glucose levels after birth, it improves the stability of the heart and lungs, and significantly reduces stress levels in the infant and mother. “Keeping mother and infant together can reduce birth stress and even prevent neurodevelopmental disorders in the infant. The smell, touch and voice of the mother naturally calm the infant,” she says.

Breastfeeding should therefore be encouraged, mothers and infants should be cared for together, and skin-to-skin contact ensured throughout the Covid-19 pandemic. Prof Lubbe suggests if mothers are too ill to breastfeed, they should still be supported to express their milk, and the infant should then be fed by a healthy individual.

Prof Welma Lubbe