Maternal Coronavirus 2019-nCoV infection (COVID-19)

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, 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, but there are vaccines to prevent it. 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)} Health authorities warn of the uselessness and very serious risk to health of the use of certain products marketed as miracle remedies to treat or prevent Covid-19. ^{(WHO 2020, PAHO 2020, FDA 2020)}

BREASTFEEDING: ^{(Murano 2023, Centeno 2021/01,WHO 2020/06, AAP 2020/05, WHO 2020/04, MS Argentina 2020/04, Stuebe 2020/04, Davanzo 2020/04, Italian SN 2020/04, LLLI&CDC 2020/03, SFC-2020/03, RCOG 2020/03, WHO/OMS 2020/01, UNICEF 2020/03, LLLi 2020/02, AELAMA 2020, IESMP 20202/03, ILCA 2020/03, INSP México 2020)}

Specific antibodies against the 2019 coronavirus-nCoV have been found in breast milk. ^{(Fox 2020/04)} 

SARS-CoV of 2003 and 2012 were not detected in breast milk.

Although virus RNA particles of SARS-CoV-2 have been detected in around 10% of analyzed milk samples ^{(Murano 2023, Chambers 2020/08, Costa 2020/06, Tam 2020/05, Groß 2020/05, Wu 2020/05, Liu 2020/04, Chen 2020/03)}, no viable or transmissible SARS-CoV-2 has been detected in breast milk ^{(Centeno 2021/01, Chambers 2020/08, Marín 2020/07)}and there are no documented cases of infection to the infant through breast milk ^{(Murano 2023, Centeno 2021/01, Chambers 2020/08, Marín 2020/07, Groß 2020/05, Lackey 2020/05, De Rose 2020/04, Chen 2020, CDC 2020/02)}, as is the case with other viruses such as rubella or hepatitis C.

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)}.

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, MS Argentina 2020/04, Italian SN 2020/04, UNICEF 2020/03, LLLi 2020/02, CDC 2020/02)}. For donation purposes for milk banks, pasteurization completely eliminates SARS-CoV-2. ^{(Chambers 2020/08)}

See below the information of these related products:

• (Corticosteroids) (Safe substance and/or breastfeeding is the best option.)
• Bamlanivimab (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Baricitinib (Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.)
• COVID-19 vaccine (Safe substance and/or breastfeeding is the best option.)
• Casirivimab (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Colchicine (Safe substance and/or breastfeeding is the best option.)
• Favipiravir (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Hydroxychloroquine Sulfate (Safe substance and/or breastfeeding is the best option.)
• Imdevimab (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Interferon Alfa (IFN-α) (Safe substance and/or breastfeeding is the best option.)
• Ivermectin (Safe substance and/or breastfeeding is the best option.)
• Lopinavir / Ritonavir (LPV /r) (Safe substance and/or breastfeeding is the best option.)
• Peginterferon beta-1a (Safe substance and/or breastfeeding is the best option.)
• Remdesivir (Safe substance and/or breastfeeding is the best option.)
• Ritonavir (RTV, /r) (Safe substance and/or breastfeeding is the best option.)
• Tocilizumab (Safe substance and/or breastfeeding is the best option.)