Shanna Jesch, IBCLC, RLC

With over 60 years of breastfeeding experience, La Leche League International stands firm in encouraging all families to recognize the importance of breastfeeding in providing immunological protections to the breastfed child. Most often, babies who are being nursed remain healthy even when their parents or other family members fall ill with an infectious illness. There is a growing body of research showing babies benefit from multiple and diverse immunologic proteins, including antibodies, provided in human milk, particularly through direct breastfeeding.

Those who become infected shortly before giving birth and then begin breastfeeding, and those who become infected while breastfeeding, will produce specific secretory IgA antibodies and many other critical immune factors in their milk to protect their nursing infants and enhance their infants’ own immune responses. At this time, these immunologic factors will aid their infants’ bodies to respond more effectively to exposure and infection. Following good hygiene practices will also help reduce transfer of the virus.

If someone who is breastfeeding becomes ill, it is important not to interrupt direct breastfeeding. The baby has already been exposed to the virus by the mother and/or family and will benefit most from continued direct breastfeeding.

Disruption of breastfeeding may lead to several issues:

significant emotional trauma for the nursing baby or toddler,
a drop in milk supply due to the need to express milk,
later breast refusal by the infant due to the introduction of bottles,
a decrease in protective immune factors due to lack of direct breastfeeding and expressed milk not matching the infant’s needs at a particular time, and
an increased risk of the infant becoming ill due to lack of immune support from direct breastfeeding.
The last point is of critical importance: when any member of the family has been exposed, the infant has been exposed. Hence, any interruption of breastfeeding may actually increase the infant’s risk of becoming ill and even of becoming severely ill.

Anyone who believes they may have COVID-19 (also known as novel coronavirus; 2019-nCoV; SARS-CoV-2) is encouraged to follow good hygiene practices, such as thoroughly washing their hands and wearing a protective mask to prevent spread of the virus. If someone becomes ill enough to require hospitalization, the baby should be allowed to continue breastfeeding if at all possible, keeping in mind the above list of possible results from any separation or disruption of breastfeeding. In an extreme circumstance, if an interruption of breastfeeding is deemed medically necessary, hand expressing or pumping the milk is encouraged. In such cases, the expressed milk, which contains multiple immune factors, may be fed to the baby to help prevent the baby from getting the infection or to help reduce the severity and duration of an infection if the baby does get sick.

The World Health Organization (WHO) offers guidance and other information on coronavirus in multiple languages on the WHO website. UNICEF also provides information for breastfeeding through COVID-19 infection. Links are included in the references below.
All of the information above also applies to families at risk of or experiencing influenza and other respiratory viruses.

Watching the news about the current coronavirus (Covid-19) can be nerve-wracking. What’s the parent of a young child to do?

Current knowledge from the Centers for Disease Control (CDC) and the World Health Organization (WHO) indicates that breastfeeding parents, even those with confirmed Covid-19, should continue to nurse. By the time the nursing parent has symptoms, the child has already been exposed, therefore stopping breastfeeding increases the child’s chance of becoming ill. Human milk provides important protection and nutrition to nursing children and abruptly stopping can cause more problems than it solves.

Here are some practical steps families can take to limit the spread of Covid-19 and some ways to cope if the nursing parent becomes ill. Much of this is common sense and applies to similar illnesses like the flu. It’s best to have some basic items on-hand before anyone gets sick. If a nursing parent does get sick, a bin or basket to keep these items nearby works best:

Hand sanitizer and/or wipes
Tissues
Plenty of non-sugary liquids or rehydration fluids—it’s important to stay hydrated to maintain milk supply
Fruit juice popsicles—feverish people who won’t drink will often be willing to suck on popsicles for fluids
Nutritious snacks
Thermometer
Phone charger
Remote control and/or a good book
Diapers and clothing changes for the child
Basket of quiet books, toys, or puzzles for a toddler to play with nearby

If a nursing parent does become ill, the guidelines are similar to those of other viral respiratory illnesses:

“Breastfeeding women should not be separated from their newborns, as there is no evidence to show that respiratory viruses can be transmitted through breast milk, according to UNICEF. 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 a child (including during feeding), wash 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.”

UNFPA statement on novel coronavirus (COVID-19) and pregnancy UNFPA, the UN sexual and reproductive health agency, is closely monitoring and working with partners, governments and UN agencies to address the outbreak of the new coronavirus disease (COVID-19), which has been declared a public health emergency of international concern by the World Health Organiza...