Tips on breastfeeding during COVID-19

Singapore has entered its circuit-breaker to reduce contact and exposure among citizens, and this has taken a toll on everyone, parents and babies included. For mummies who have only just begun their breastfeeding journeys, what can you do during this time?

Do you continue breastfeeding?

The answer is yes. Breastfeeding is not only beneficial for your baby, it also gives mums health benefits (including weight loss!). During COVID-19, here are some tips you can try to breastfeed your little one, as advised by one of our breastfeeding consultants!

1. All mothers in affected and at-risk areas who have symptoms of fever, cough or difficulty breathing, should seek medical care early, and follow instructions from a health care provider;
2. For symptomatic mothers well enough to breastfeed, the following measure should be applied: 
   1. Wearing a mask when near a child during breastfeeding
   2. Washing hands before and after breastfeeding the child 
   3. Cleaning/disinfecting contaminated surfaces – where anyone with confirmed or suspected COVID-19 interacts with you or children
3. If a mother is too ill, she should be encouraged to express milk and give it to the child via a clean cup and/or spoon – all while following the same infection prevention methods.

Can COVID-19 be transmitted through breast milk?

Should mothers with COVID-19 be separated from their infants while infected with the virus and provide their babies expressed breast milk instead of feeding them directly at the breast?

The choice to breastfeed belongs to the mothers and families. However, the decision to separate a mother with COVID-19 from her baby should be made by a health care team and is based on many factors that include the health of the mother and baby.  

The mother and baby are able to remain together, breastfeeding is encouraged. Currently, the primary concern is not whether the virus can be transmitted through breast milk, but rather whether an infected mother can transmit the virus through respiratory droplets. Therefore, the mother should always wear a mask and use good hand hygiene before and after breastfeeding. 

The limited studies on breastfeeding women with COVID-19 and other coronavirus infections have not detected the virus in breast milk. It is not known whether mothers with COVID-19 can transmit the virus via their breast milk.

Currently, the primary concern is not whether the virus can be transmitted through breast milk, but rather whether an infected mother can transmit the virus through respiratory droplets. Precautions to avoid spreading the virus to the infant include the mother washing hands before holding her baby, and wearing a face mask when in close contact with her baby.

Is breastfeeding safe considering the risk that I could get COVID-19? Should I switch to formula?

Breastfeeding is the safest, most reliable method of infant feeding in an emergency. Given the risk that COVID-19 can spread through formula manufacturer factories and delivery warehouses, there is a risk of supply chain interruption if these factories and warehouses need to shut down. 

Considering the benefits of breastfeeding and the current evidence of the insignificant role of breast milk in the transmission of other respiratory diseases, you can continue breastfeeding.

If I have COVID-19 and am too unwell to breastfeed or have been separated from my baby for a period of time, can I restart breastfeeding?

If you have been separated from your baby for a period of time and breastfeeding has been interrupted, re-establishing lactation when you are together with your baby again is generally possible and worth trying even if a return to full breastfeeding is not always achievable. 

The following essential measures for management of breastfeeding for re-lactation: 

1. Start actions to increase hormonal response, including plenty of skin-to-skin contact, nuzzling at the breast and breast massage. 
2. Breast massage and hand/pump expression (8-10 times in 24 hours) may help when separated from baby or in-between feeds.
3. The baby should suckle frequently from both breasts at least 8-12 times in 24 hours, at least 15 minutes on each breast. Consider night feeds. 
4. Try having the baby also at the breast while pumping. The baby should be well attached to the breast for effective suckling and to avoid nipple trauma. 
5. Monitor baby’s stool and urine output.
6. Contact your doctor to receive additional guidance and support to re-establish your milk production and control your baby’s growth.

What if this is my first time breastfeeding?

We encourage you to have a look through our comprehensive blogpost on breastfeeding for first-time mothers.

We’ll get through this, mummies. Stay safe, stay strong, and have hope!