Breastfeeding Appears Safe For Mothers With Covid-19

September 3, 2020

Mothers with COVID-19 appear to be less likely to pass the disease on to their newborns – even if they breastfeed and share a room – as long as they take certain precautions, a small new study suggests.

The study found that of the 120 babies born to mothers with COVID-19, none contracted the disease during childbirth or in the two weeks after birth, even though most of the mothers breastfed, had skin-to-skin contact, and shared a room with their babies. The mothers took steps to prevent the spread of COVID-19, including wearing surgical masks and washing their hands and breasts before touching and breastfeeding their babies, according to the study published Thursday (July 23) in The Lancet Child and Adolescent Health.

“We hope that our study will provide some reassurance to new mothers that their risk of passing COVID-19 to their infants is very low,” study co-lead author Dr. Christina Salvatore, a pediatric infectious disease specialist at Weill Cornell Medicine – New York Presbyterian Comanche Children’s Hospital in New York City, said in a statement. However, the authors noted that their study was relatively small, so a larger study is needed to confirm the results.

Given that COVID-19 is such a new disease, data on the risk of transmission from mothers to newborns has been limited. The authors say that there have been several case reports of newborns testing positive for COVID-19 within 48 hours of birth that appear to have been infected with the disease in utero. However, such reports are rare.

Guidance for pregnant women and new mothers with COVID-19 has been in flux. At the start of the pandemic, the American Academy of Pediatrics (AAP) initially recommended that mothers with COVID-19 be separated from their newborns, and that infants be breastfed with expressed breast milk until the mother was no longer infected. However, the AAP has recently updated their guidelines to say that mothers with COVID-19 can room together and breastfeed with certain precautions.

The new study analyzed information from mothers who tested positive for COVID-19 and gave birth between March 22 and May 17 at one of three CIty hospitals in New York. About three-quarters of the mothers reported experiencing symptoms, and of those, about half had symptoms at the time of delivery.

At the hospital, mothers were allowed to share a room with their newborns, kept in enclosed cribs 6 feet (1.8 meters) away from their mothers’ beds. Mothers were also allowed to breastfeed if they felt well enough, but they were asked to wear surgical masks, wash their hands before holding the baby, and wash their breasts before feeding.

All infants were tested for COVID-19 within 24 hours of birth, and none tested positive. Of the 120 infants, 79 were tested again about a week after birth and 72 were tested two weeks after birth. Again, none tested positive, nor did they show any symptoms of COVID-19, the report said.

Fifty-three infants were examined remotely via videoconference at 1 month of age, and all were well and experiencing typical growth. Overall, the study found no difference in outcomes between infants born to mothers experiencing symptoms and those born to COVID-19 mothers who did not experience symptoms.

“We know that skin-to-skin contact and breastfeeding are important for both mother-infant bonding and long-term child health. Our findings suggest that infants born to mothers with COVID-19 infection can still safely benefit from these if appropriate infection control measures are followed,” study co-lead author Dr. Patricia DeLaMora, pediatrician at Weill Cornell Medicine-New York Presbyterian Komansky Children’s Hospital infectious disease experts said in a statement.

The authors noted that about one-third of the 120 babies were not followed up with tests for COVID-19 after birth, which they said could be due to parental fear of going to the doctor (often via public transportation) in the middle of an epidemic. In addition, the researchers were unable to screen infants’ blood, urine or stool samples for COVID-19 because these types of tests were not approved at the time of the study, they said.

Babies were not tested for antibodies to COVID-19, and it was unclear whether they could obtain protection against the disease from their mothers in utero or through breastfeeding. Because about half of mothers develop symptoms shortly before or during delivery, it is unlikely that all infants can acquire protective antibodies, the authors said, given that mothers need time to develop and pass them on.

The new study provides “valuable data suggesting that perinatal transmission of SARS-CoV-2 is unlikely and is safe as long as appropriate precautions are taken to allow neonatal rooming and breastfeeding,” wrote Dr. Melissa Medvedev, an assistant professor of pediatrics at UCSF who was not involved in the study, in a commentary accompanying the study. sars-cov-2 (It’s the name of the new coronavirus that causes COVID-19).

However, many questions about COVID-19 in pregnancy remain unanswered, Medvedev said, such as how often pregnant women or their babies experience complications from the disease and how often it is transmitted from mother to child.