Breastfeeding During the Pandemic
By Temitope Awelewa, MBCHB, MPH, FAAP, IBCLC for the American Academy of Pediatrics
Breastfeeding can offer many perks, most especially during the COVID-19 pandemic. You can even breastfeed if you test positive for COVID-19 or are not fully vaccinated, as long as you take extra safety precautions to protect your baby.
Breastfeeding is good for babies. It protects them from many infections. It is not proven that breast milk protects babies from SARS-CoV-2, the virus that causes COVID-19. However, several studies have found antibodies that target the virus in human milk. In addition, breastfed infants are generally less likely to have severe respiratory symptoms when they get sick in comparison to their formula-fed counterparts.
Breastfeeding is good for moms. Hormones released in the mother’s body during breastfeeding promote wellness and can relieve stress and anxiety.
Breast milk is readily available. No purchase necessary! This can be important during public health emergencies when it can be more challenging to find formula and other feeding supplies which could be or become out-of-stock.
Do I need to take any extra precautions while breastfeeding if I’m vaccinated against COVID-19?
If you’re fully vaccinated against COVID-19, you do not need to take any special precautions when feeding your baby at the breast or expressing milk. However, if you have symptoms of COVID or have had close contact with someone who has the illness, the U.S. Centers for Disease Control and Prevention (CDC) recommends wearing a mask.
Can I get vaccinated while breastfeeding?
COVID-19 vaccines are considered safe for breastfeeding mothers and babies. Many lactating people have received the COVID-19 vaccine. Recent studies demonstrated COVID-19 mRNA vaccine antibodies in the breast milk of vaccinated lactating mothers, which can potentially pass along protection to the breastfed infant. More studies are needed to determine how these antibodies protect the baby.
What if I am not fully vaccinated and want to breastfeed my baby?
SARS-CoV-2 (the virus that causes COVID-19 disease) spreads during close contact between people when an infected person coughs, sneezes, or talks. People without symptoms of or confirmed COVID-19, who have not been in close contact with someone with COVID, do not need to take special precautions. So far infectious SARS-CoV-2 virus has not been found in breast milk. Breastfeeding has been shown to be safe when a mom has other viral illnesses like influenza.
How can I keep my baby safe while breastfeeding if I have COVID-19?
Yes, babies can still receive breast milk even if you test positive for COVID-19. Breast milk is safe and important for the baby.
During direct breastfeeding make certain to wash your hands with soap and water before holding your baby and wear a face mask while nursing. Holding your baby skin-to-skin helps the baby latch on and helps trigger milk release.
When pumping breast milk, put on a face mask, wash your hands well, and clean any pump parts, bottles, and artificial nipples. Express milk as often as your baby eats, or at least 6 to 8 times per 24 hours. The expressed milk can be fed to your baby by a healthy caregiver. Remind all caregivers to wash their hands well before touching bottles, feeding, or caring for your baby. Remember to clean your breast pump after each use, following CDC guidelines.
If I have COVID-19, can I stay in the same room with my infant?
If you and your family decide to keep your baby in the same room as you, try to keep a reasonable distance away when possible. Wear a face mask and wash your hands whenever you directly care for your baby.
Continue taking these precautions until you have been fever-free for 24 hours without taking any fever medicines (acetaminophen or ibuprofen); at least 10 days have passed since your COVID-19 symptoms first started, and all your symptoms have improved. If you tested positive but have no symptoms, wait until at least 10 days after the positive test result.
How can I maintain my milk supply if I am sick with COVID-19?
Hand pumping and hand expressing breast milk is especially helpful in the first few days after your baby is born to get the milk supply going. Frequent pumping (or breastfeeding if you have chosen to directly breastfeed and are following the strict precautions noted above) should line up with your infant’s feeding demands, about 8-10 times in a 24-hour period.
Most medications are safe to take while breastfeeding but always check with your doctor. While this may be a stressful time, try to stay optimistic and practice healthy habits to reduce stress as much as possible. This includes getting enough sleep, eating plenty of healthy foods, and getting regular exercise.
Get Help and Care
Ask your pediatrician for help with getting your baby to latch on again once you can restart breastfeeding. Do not hesitate to ask for help if you have trouble with feeding, nipple pain, low milk supply, or with any other concerns.
After leaving the hospital, it is important that your baby’s first follow-up visit happen within one to two days in person so your baby can be examined, measured, and weighed. Many doctors are scheduling newborn visits during specific times (such as first thing in the morning) to limit exposure to sick patients. Your pediatrician also can help if you need more breastfeeding support, a lactation consultant, or help from local groups and resources.
Remember the best way to protect your baby is to get the COVID-19 vaccine. If you aren’t fully vaccinated or test positive for COVID, it is still a good idea to breastfeed your baby if you can. Just be sure to take steps to minimize COVID-19 infection. Talk with your pediatrician about how to keep your baby healthy and what resources might be available in your community to help you.
Office of Women’s Health National Women’s Health and Breastfeeding Helpline: 1-800-994-9662 (leave a message 9 a.m.– 6 p.m. ET).
La Leche League International: 1-877-4-LALECHE (1-877-452-5324)(messages will be returned by an LLL Leader in 24-48 hours).
LactMed (National Library of Medicine): A great resource and a free online database/mobile app with the most up-to-date information on which medications are safe for breastfeeding mothers. LactMed is available online at https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm and is now available on your mobile device! The free LactMed App for iPhone/iPod Touch and Android can be downloaded at http://toxnet.nlm.nih.gov/help/lactmedapp.htm.
Courtesy of the American Academy of Pediatrics (aap.org).