Breastfeeding and donor milk

It is recommended by the World Health Organization (WHO) that women with COVID-19 can breastfeed if they wish to do so, since breastfeeding is so important for a baby’s health. It protects against respiratory and gastro-intestinal illnesses and prevents malnutrition and mortality. These are the precautions you should take:

• Practice respiratory hygiene during feeding, wearing a mask where available
• Wash your hands before and after touching the baby
• Routinely clean and disinfect surfaces you may have touched

(Source: WHO, SFC)

According to the World Health Organization (WHO) women who feel too unwell to breastfeed their baby due to COVID-19 or other complications, should be supported to safely provide their baby with breast milk in a way possible, available, and acceptable to them. This could include:

• Expressing milk
• Donor human milk

Please note that donor milk is usually reserved for hospitalised preterm babies or in some cases for babies who have a severe bowel disease. Therefore, if your baby does not fall into these categories, formula is the best choice in this situation, which in most cases will last only several days.

(Source: WHO, Larsson Rosenquist Foundation)

There is the option of using a breast pump to express your milk. Ask your midwife or lactation consultant for support, they can give you information about where to get a breast pump kit, how to use it, and how to keep it hygienically clean (you can also find information about cleaning your breast pump further down). Check regularly with your healthcare professional, if there is any chance to breastfeed by yourself. Make sure to drink and eat properly, to support your milk production.

(EFCNI in collaboration with Dr Dietmar Schlembach)

Inform yourself about breastfeeding, so you know what challenges your partner might face (like sore nipples or slow milk supply) and offer encouragement when needed. Contact your midwife or nurse and ask for support regarding breastfeeding, they can give you great advice. Talk about how each of you feels and listen to each other. Make sure your partner gets drinks and eats healthy and regularly. Please help and take care of other tasks, so your partner can take a rest. Make sure that you and your partner take care of your mental health. You are dealing with many challenges at the moment and there is no shame in asking for help if needed.

(Source: NCT)

It is very important to proper clean your breast pump kit after every use. Please make sure to follow these steps, as recommended by the Larsson Rosenquist Foundation:

• Wash your hands with warm, soapy water or an alcohol hand sanitiser before you start to pump or handle milk collection equipment
• Make sure your breast pump collection kit is as clean as possible; Wash your collection kit with warm, soapy water after each use, then rinse it with clear water, then air-dry it away from other dishes or where family members might touch the pieces
• Sanitise your kit at least once daily with a microwave steam bag, by boiling in a pot on the stove, or in the dishwasher (Sani-cycle)
• Avoid coughing or sneezing on the breast pump collection kit and the milk storage containers; This tip is especially important because COVID-19 is spread by coughing, sneezing and breathing
• Cleanse the outside of the breast pump before you use it; Whether in your home or in the Neonatal Intensive Care Unit (NICU), use a germ-killing wipe on the outside of the pump each time you use it

(Source: Larsson Rosenquist Foundation)

If the human milk banks in your hospital or country are providing human milk during the actual COVID-19 pandemic, it is possible and probably much needed to donate breast milk. Please contact and discuss your plan to donate your breast milk with your midwife or lactation consultant. Alternative contact opportunity would be your local or national human milk bank or human milk bank association to discuss potential next steps.
Note: In many regions across the world, there are established breastfeeding or human milk associations, which support national or local human milk banks and can provide you with information on human milk regulations, like for example the European Milk Bank Association or the Human Milk Banking Association of North America.

Donor milk is still a save option and the best alternative to breastfeeding. Human milk banks screen their donors thoroughly and pasteurise the donated milk. If there is no human milk bank in your country infant formula can be fed as third alternative after mother’s own milk and screened donor milk from a human milk bank. Where possible, only a healthy adult should prepare and feed infant formula. Try to limit the number of caregivers feeding the baby to reduce the risk of transmission. Be prepared to provide instructions for caregivers who have not previously prepared infant formula in case you, your partner or usual caregiver fall ill. These instructions for the safe preparation of infant formula should include washing of hands, use of masks and instructions on the cleaning of surfaces and equipment as well as storage advice.

(Source: SFC).

Formula marked “pre” is suitable to feed your baby, it is most similar to breast milk and contains only lactose as a carbohydrate. Most likely, you can get in large food stores. Ask your healthcare professional if they can give you further advice.

Yes, it is safe for breastfeeding women to take the vaccine. None of the currently approved vaccines use the live virus, so there is no risk of passing the virus to the baby through breastmilk. There is also some evidence that, after vaccination, antibodies are found in breastmilk, which may help protect the baby against COVID-19. WHO does not recommend discontinuing breastfeeding after vaccination.

(Source: WHO, STIKO)