What new mums need to know about breastfeeding, bottle-feeding and COVID-19
New mothers may understandably be feeling uncertain about breastfeeding and bottlefeeding their babies during the COVID-19 pandemic. Here are the answers to some common questions, from the Ministry of Health and the New Zealand College of Midwives.
Though breastfeeding is ultimately a personal decision, the World Health Organisation (WHO) and the New Zealand Ministry of Health supports mothers giving breast milk to their babies even if they're infected with COVID-19, because of its immunological protections to the breastfed child.
Can I breastfeed during the COVID-19 pandemic?
Yes. There’s no evidence that COVID-19 is transmitted through breastfeeding or in breastmilk expressed by the baby’s own mother and given to her baby. Skin-to-skin care after birth and early initiation of breastfeeding within the first hour is still recommended.
Breastfeeding provides immunological protections to the breastfed child. Most often babies who are breastfed remain healthy even when their parents or other family members are unwell with an infectious illness.
Those women who become infected with COVID-19 shortly before giving birth and then begin breastfeeding, and those who become infected when already breastfeeding, will produce specific antibodies and other critical immune factors in their milk to protect their breastfeeding infant and enhance their infant’s immune responses. If you become unwell and are breastfeeding your baby, it’s important not to interrupt direct breastfeeding. Your baby will already have been exposed to the virus and will most benefit from continued direct breastfeeding at the breast.
This advice is for women and babies who are not admitted to hospital.
Can women with COVID-19 infection breastfeed?
Yes, it is okay for you to breastfeed if you have confirmed or probable COVID-19, as it is beneficial to your baby for you to continue breastfeeding, and there’s no evidence of transmission of the virus in breastmilk. To reduce spread while breastfeeding, hand washing before you feed is essential. You should also wear a surgical mask during breastfeeds. Avoid kissing and touching your baby’s face.
If you’re well enough, you should continue to breastfeed directly, while using the necessary precautions. This includes washing hands before and after contact with your baby (including feeding), avoiding coughing or sneezing on them, and cleaning/disinfecting contaminated surfaces – as should be done in all cases where anyone with confirmed or suspected COVID-19 interacts with others, including children.
If you’re too unwell to breastfeed, you should express your milk and give it to your baby via a clean spoon, cup or bottle – all while following the same infection prevention methods.
Your baby will also be considered a 'close contact' of a confirmed case and you’ll be provided advice about this from your Public Health Unit.
Appropriate infection prevention practices for women with COVID-19 infections are:
1 Wearing a medical face-mask while feeding.
2 Following best practices on wearing, removing and disposing of face-masks, and hand hygiene after removal.
3 Hand hygiene before and after feeding (wash hands with soap and water for at least 20 seconds).
4 Avoid touching eyes, nose and mouth.
5 Cleaning and disinfecting any potentially contaminated surfaces.
Self-isolation after potential exposure to COVID-19
If you’re in self-isolation after potential exposure to COVID-19, your breastfed baby should remain with you so that you’re able to continue breastfeeding. Wash your hands before touching your baby, avoid touching their face and coughing or sneezing on them. Exclusive breastfeeding offers the best protection for babies, so if your baby is less than six months old, aim for exclusive breastfeeding. Even if your baby is older than six months, keeping them with you and continuing your breastfeeding relationship is beneficial for you both.
Re-starting breastfeeding (re-lactation)
If you’ve recently stopped breastfeeding, it’s possible to re-lactate or re-establish the production of breastmilk. Many women who re-lactate can produce enough milk to breastfeed an infant exclusively. The easiest way to bring back a milk supply is through a baby suckling at the breast. The more often a baby suckles at your breast, the more likely your breasts will make milk. Talk to your midwife or Well Child nurse for more information on re-establishing your breastmilk supply if this is something you’d like to do.
Hygiene advice on bottle feeding
If you’re bottle-feeding take extra care preparing feeds and cleaning all bottles, teats, cups and other equipment including breast pumps.
Will the supermarkets run out of formula?
Supplies of infant formula should continue as per usual and remain in stock in supermarkets. Stockpiling tins of formula is unnecessary and this will cause problems for parents buying products, and for retailers in terms of restocking products.
What if my baby’s usual formula isn’t available?
If you can’t find your baby’s usual stage one product on the day of a supermarket visit, remember all the stage one products have a similar nutritional composition to comply with legislation, so any of them products can be used until the age of one year. For babies one year and over formula is no longer a necessary part of nutrition.
Published 02 April, 2020.
Sources: the New Zealand College of Midwives, the New Zealand Ministry of Health.