Last update: May 23, 2020
Minimal risk for breastfeeding and infant.
Coronaviruses are a family of viruses that cause respiratory infections in animals and humans.
Most often they cause a mild cold with cough, runny nose, sore throat, fever and mild respiratory distress.
For several years, several strains of coronavirus have spread throughout the world and are the cause of a high percentage of colds in children and adults. They have a low mortality rate and, as in other influenza viruses, medical complications and mortality are higher in elderly and in patients suffering from chronic illnesses (respiratory, cardiovascular, diabetes, etc.).
Some strains of coronavirus that have recently mutated from animals to humans are more aggressive and can cause serious respiratory problems, such as severe acute respiratory syndrome (SARS-CoV) which originated in China in 2003 and the Middle East respiratory syndrome (MERS-CoV) from 2012. Both strains had a relatively high mortality rate but were not very contagious and no cases of them have been detected since.
The new Wuhan coronavirus (2019-nCoV, SARS-CoV-2) from China in 2019, as of this update, is known to be more contagious than the previous ones but has a low mortality rate. Again, the elderly and those with chronic illnesses are at greater risk of presenting severe symptoms.
The vast majority of children, including newborns, have a mild illness or are asymptomatic (DE Rose 2020/04/29, Wei 2020, Ludvigsson 2020).
The virus is transmitted before, during and after the period when the patient has symptoms.
The disease, called COVID-19, has no specific treatment and no vaccines. The treatment is supportive: rest, fever and cough medications, hydration, humidification, respiratory support if necessary, etc.
Measures to prevent contagion are frequent hand washing with soap and water and staying more than a metre away from people who cough (WHO / OMS 2020/03/04)
(AAP 2020/05/21, WHO 2020/04/17, MS Argentina 2020/04/15, Stuebe 2020/04/07, Davanzo 2020/04/06, Italian SN 2020/04/03, LLLI&CDC 2020, SFC-2020/03/14, RCOG 2020/03/13, WHO/WHO 2020/01/20, UNICEF 2020/03/04, LLLi 2020/02/20, AELAMA 2020, IESMP 20202/03/15, ILCA 2020/03/18, INSP Mexico 2020)
SARS-CoV from 2003 and 2012 was not detected in breast milk. The 2019-nCoV virus has been detected only in a small proportion of breast milk samples, without transmission to infants having been demonstrated (Groß 2020/05/21, Lackey 2020/05/20, De Rose 2020/04/29, Chen 2020, CDC 2020/02/19). The American Academy of Pediatrics strongly supports breastfeeding as the best feeding option for newborns and infants even for mothers affected by CoViD-19 (AAP 2020/05/21).
Since the symptoms, at least initial ones, are those of a common cold, it is very difficult and ineffective to isolate in time a mother with cold symptoms from her breastfeeding baby.
Taking into account the benefits of breastfeeding and the insignificant role of breastmilk in the transmission of other respiratory viruses, mothers can continue to breastfeed.
Neonatal case: a mother positive to COVID-19, after childbirth, should wear a medical mask when close to her newborn baby and wash her hands well before close contact with the baby.
If the mother is too sick to breastfeed, milk should be expressed in order to avoid breast engorgement problems. This milk can be consumed by the infant (AAP 2020/05/21, MS Argentina 2020/04/15, Italian SN 2020/04/03, UNICEF 2020/03/04, LLLi 2020/02/20, CDC 2020/02/19).
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.
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