World breastfeeding week: Mothers can safely breastfeed their newborns even if they test positive for COVID-19

Breastfeeding offers a variety of health benefits not only to an infant but also to a young mother. It helps the mother return to her pre-pregnancy weight and reduces the risk of developing breast, ovarian and uterus cancer. It can also lower the risk of developing type-2 diabetes, cardiovascular diseases and post-menopausal osteoporosis in future.

Immediate breastfeeding benefits:

• Early expulsion of placenta
• Helps uterus contract and return to pre-pregnancy stage
• Reduces post-delivery bleeding
• Acts as a contraceptive

Breastfeeding tips for new mothers with COVID-19 infections

In cases where a new mother is confirmed/suspected to have COVID-19, she should continue to breastfeed her child, as it is safe. Till date, there have been no cases where the active COVID-19 virus has been detected in the breastmilk of mothers who have tested positive.

While there have been a few cases of newborns testing positive, the infants may have been exposed to the virus from other sources, and most of them only experience mild or asymptomatic illness.

Mothers can also continue to provide the infant skin-to-skin contact, including kangaroo mother care, as it improves thermal regulation of the newborn, helps in early initiation of breastfeeding, reduces neonatal mortality and provides several other physiological benefits.

Breastfeeding and skin-to-skin contact are beneficial for both baby and mother as they improve their survival, enhances brain development and reduces the risk of serious illness and death. These benefits substantially outweigh the risks posed by COVID-19.

Mothers should implement appropriate hygiene measures in order to reduce the possibility of spreading COVID-19 via droplets. These steps must be followed while the mother is symptomatic or till 14 days after the start of symptoms, whichever is longer.

It is not necessary for mothers to wash their breasts before breastfeeding or expressing. But, if the mother has coughed over her exposed breast/chest, then she should gently wash the breast with soap and warm water for at least 20 seconds prior to feeding/expressing.

Recommended hygiene factors:

• Wash your hand frequently with soap and water or use alcohol-based hand rub, especially before touching the baby.
• Wear a medical mask (if not available, use a cloth mask) while feeding/expressing. It is important to replace the mask as soon as it becomes damp, and dispose of it immediately.
• While removing the mask, don’t touch the front of the mask but untie it from behind.
• Don’t reuse a mask.
• Sneeze/cough into a tissue and immediately dispose of it; wash your hands with soap and water or use an alcohol-based hand rub.
• Regularly clean and disinfect surroundings.

Direct breastfeeding using appropriate hygiene measures

· If the mother is breastfeeding, there is no need to top up with formula.

· If a mother is unable to breastfeed because she was ill, she can begin breastfeeding when she feels healthy enough to do so. There is no fixed time interval to wait. The mother needs to be supported for her general health & nutrition to ensure full recovery, and also needs support for initiating breastfeeding or for re-lactation.

Expressed breastmilk tips

Expressed breastmilk is the best alternative to breastfeed a newborn/ infant, and also helps in sustaining milk production.

• The mother (and anyone helping her) should wash their hands with soap and water or use an alcohol-based hand rub before expressing or touching any pump parts.
• Expressed breastmilk should be fed to the infant preferably using clean wati (cup)/ wati-spoon by a caregiver who has no sign/symptoms of COVID-19 infection.
• Pump, milk storage containers & feeding utensils need to be cleaned after every use with liquid soap and warm water, followed by a rinse after washing with hot water for 10-15 seconds.

Aftercare for new mothers who receive COVID-19 vaccines

Do’s

• Continue Breastfeeding

The antibodies produced through COVID-19 vaccination could be passed on to the baby through the milk and provide immunity like a vaccine.

• Drink a lot of water

Staying hydrated is extremely important, both before and after vaccination, as the most common side effects of vaccines include muscle pain, fatigue, headache and fever. Being properly hydrated will not prevent the mother from feeling sick, but will shorten the duration and intensity of the side effects.

• Eat a well-balanced diet

To avoid the serious side effects of the vaccine, a well-balanced diet is a must. Superfoods such as green leafy vegetables, turmeric and garlic are high in nutrients and boost immunity. Seasonal fruits rich in Vitamin C also aid in fighting side effects of the vaccines.

• Have good sleep

Breastfeeding improves the quality and quantity of sleep by providing mothers more slow-wave deep sleep, which reduces daytime fatigue. After vaccination, the body relies on immune response to develop protection. Avoid sleep deprivation, as it suppresses immunity (since the body rebuilds its defence mechanism during sleep) and also builds up stress, which can further suppress the immune system.

• Do some light exercise.

Listen to your body. But exercise (eg. light walk ) supports blood circulation that helps in reducing vaccine side effects.

• Apply a clean wet cloth (preferably with some ice) over the arm after vaccination to reduce the pain and discomfort.

Don’ts

• Don’t think one is completely immune after COVID-19 vaccination.
• No vaccines have a 100 percent success rate, but there are still chances of infection, so following COVID appropriate behaviour is a must.
• Avoid strenuous exercises for at least two to three days, as your body needs time to recover from the side effects of the vaccine.
• Avoid alcohol and tobacco.

Dr Mansi Shah is a Lactation Consultant at Jaslok Hospital and Research Centre, Mumbai.

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