I had another post planned for today, but with the news circulating that breastfeeding should be temporarily stopped for lactating parents diagnosed with Covid-19, I felt it necessary to discuss this.

More parents are being diagnosed with Covid-19 in the United States and as more people get tested, that number will only increase. The concern regarding breastfeeding and Covid-19 is that there is uncertainty if the virus is transmissible via human milk.

The Current CDC guidelines say to continue to breastfeed, yet that hasn't stopped ill-informed OBGYNS, Pediatricians, and even Epidemiologists from recommending halting breastfeeding until after recovery.

The thing is, they don't know what they are talking about.

Note: The CDC guidelines say that the decision should be made by the breastfeeding parent in conjunction with her healthcare team. This obviously required doctors to have a deep understanding of not only lactation but the mechanisms for virus transmission in lactating parents, which many do not, unfortunately. Feeding expressed milk is suggested as a viable alternative to breastfeeding, which is a valid option but defeats the whole “stop breastfeeding because of the virus in milk argument”.

Even if the virus were transmissible via human milk, babies are already exposed to the virus by being in close contact with the parent. By the time testing confirms Covid-19 in a breastfeeding parent, the baby has already been exposed- not via breastmilk but by typical day to day living.

From the CDC:

Transmission through breast milk

Q: Is maternal illness with COVID-19 during lactation associated with potential risk to a breastfeeding infant?

A: Human-to-human transmission by close contact with a person with confirmed COVID-19 has been reported and is thought to occur mainly via respiratory droplets produced when a person with infection coughs or sneezes.

In limited case series reported to date, no evidence of virus has been found in the breast milk of women with COVID-19. No information is available on the transmission of the virus that causes COVID-19 through breast milk (i.e., whether infectious virus is present in the breast milk of an infected woman).

In limited reports of lactating women infected with SARS-CoV, virus has not been detected in breast milk; however, antibodies against SARS-CoV were detected in at least one sample.

It's the same reason parents are encouraged to breastfeed through colds or flu unless they are physically unable to do it safely. Considering that most cases of Covid-19 are mild, the recommendation to stop breastfeeding is not only scientifically inaccurate; it's highly dangerous.

Breast milk protects against illness by conferring antibodies and other immunologic properties to limit and reduce symptoms of any illness the baby may be exposed to.

The LAST thing a breastfed baby at risk for COVID 19 needs is exposure to infant formula, which not only is lacking in many of the immune properties of human milk but poses additional health risks. When considering that any baby in contact with someone who has COVID-19 is exposed to the illness, the recommendation to stop the one line of protection makes no sense.

If there was one recommendation that could be made during this time is that parents who are currently ill with possible COVID-19 symptoms should not express human milk for donation.

Though the odds of COVID-19 transmission via human milk is low, until more information comes out, erring on the side of caution in this regard, makes the most sense.

If you’re receiving informally shared human milk and you have concerns about COVID-19 Transmission, Flash heating and holder pasteurization is the preferred method of pasteurizing. We are not yet sure if it would kill COVID-19 in the event of transmission through human milk but it has the highest chance of eliminating the virus as it does kill other strains of Coronaviruses.

Here’s information on Mers-COV, The middle east Coronavirus from , which has a high fatality rate.

It says “An exception may be considered for a breastfeeding mother. Considering the benefits of breastfeeding and insignificant role of the breast milk in transmission of other respiratory viruses, the mother could continue breastfeeding. The mother should wear a medical mask when she is near her baby and perform careful hand hygiene before close contact with the baby. She would need also to apply the other hygienic measures described in this document”

For Sars-Cov-2, also known as COVID-19, If a baby is born to a SARS- Positive Parent, breastfeeding is not recommended for some time: “Newborns of mothers positive for SARS-CoV-2 should be isolated for at least 14 days or until viral shedding clears, during which time direct breastfeeding is not recommended.”

In which case, Milk-banked donor milk would be the best option, if available

But if you are living with your baby and are diagnosed with COVID-19, please don't stop breastfeeding. There are no added benefits to interrupting breastfeeding, but there are increased risks for doing so.