With the current coronavirus pandemic creating hysteria as far as it spreads, scientists have recently established that this virus has not yet been found to be transferred in breast milk. This mainly because breast milk has protective agents against infections.

According to a recent study published in the medical journal The Lancet, all previous studies on the pneumonia outbreak caused by the novel 2019 coronavirus disease were based on information from the general population.

Limited data were available for pregnant women with COVID-19 pneumonia, which led to this study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the transmission potential of COVID-19 infection from mother to child via breast milk.

During the study, clinical records, laboratory results, and chest CT scans were retrospectively reviewed for the pregnant women with laboratory-confirmed COVID-19 pneumonia. Evidence of intrauterine vertical transmission was assessed by testing for the presence of the virus in amniotic fluid, cord blood, and neonatal throat swab samples. Breast-milk samples were also collected from patients after the first lactation and tested.

Findings from this group of cases suggest that there is currently no evidence to show that respiratory viruses can be transmitted through breast milk. This has been confirmed by the World Health Organisation and the United Nations Children's Fund (UNICEF). Breastfeeding women should therefore not be separated from their newborns. The mother can continue breastfeeding, as long as the necessary precautions below are applied:

• Symptomatic mothers well enough to breastfeed should wear a mask when near their child (including during feeding), wash their hands before and after contact with the child (including feeding), and clean/disinfect contaminated surfaces.
• If a mother is too ill to breastfeed, she should be encouraged to express milk that can be given to the child via a clean cup and/or spoon – while wearing a mask, washing hands before and after contact with the child, and cleaning/disinfecting contaminated surfaces.

The International Confederation of Midwives furthermore stated that, to date, there is no scientific evidence about the increased susceptibility of pregnant women to COVID-19. However, pregnancy brings physical changes that might make some pregnant women more susceptible to viral respiratory infections. Pregnant women with respiratory illnesses must be treated with the utmost priority due to increased risk of adverse outcomes.

The statement further warns that pregnant women should take the same preventive actions to avoid infection that are recommended for all adults, such as avoiding close contact with anyone who is coughing and sneezing, washing their hands often with soap and water or an alcohol-based hand rub, covering their mouth and nose with a tissue or elbow when coughing and sneezing, and thoroughly cooking meat and eggs.

At this time, there is not yet a vaccine to prevent infection by or treatment to cure the virus, but there is recommended treatment for the symptoms. Treatment for pregnant women with suspected or confirmed COVID-19 infection should be provided with supportive therapies.

According to Prof Welma Lubbe, an associate professor and researcher at the North-West University’s (NWU’s) School of Nursing, the research unit NUMiQ and the Centre of Excellence in Nutrition has a long history of breastfeeding research.

“Breastfeeding practices have been in place for a long time, and now we can just reiterate previous research and good clinical practices when advising on aspects such as breastfeeding during the COVID-19 pandemic.”

In the light of the available research shared above, the following guidelines regarding breastfeeding can currently be suggested:

• The COVID-19 virus is not transmitted in breast milk, therefore mothers should continue breastfeeding or expressing and feed babies with human breast milk, irrespective of the mother’s infection status.  The protective properties of breastfeeding are much higher that the potential risk of transmitting the virus.
• Normal personal hygiene should be adhered to – wash your hands for at least 30 seconds with water and soap before and after breastfeeding.
• When expressing, ensure that no equipment is shared between mothers/babies, i.e. use your own tubing or pump to express for your baby, wash the equipment with warm water and soap and sterilise as normal by boiling or microwaving.
• Avoid crowds of people such as church gatherings, shopping malls, large events.
• Do not allow anyone to kiss your baby, and ask them to disinfect their hands when they come into your house or plan to touch your baby.
•  Do not allow anyone who is ill to visit you and your baby.
• Do not panic – no child under the age of nine has died from this infectious disease.
• Finally, use this time to spend more time with your little one at home

The NWU has long been advocating support of breastfeeding in the workplace, and according to Prof Lubbe, this proposed policy supports their commitment towards health in the community.

Furthermore, the NWU has been involved with breastfeeding initiatives, such as collaborating in the establishment of the human breast-milk bank based at Potchefstroom hospital, since 2012, with current research projects aiming to support the expansion to other hospitals in the province.