Alketa Qosja (Hoxha)1
1 University of Medicine, Tirana, Albania.
The COVID-19 pandemic is disrupting normal life globally and every area of life is affected. This may be especially true for mothers who are breastfeeding and concerned about their baby’s health. To plan and support breastfeeding within the current pandemic, two areas need to be understood: i) the clinical characteristics of COVID-19 as it applies to breastfeeding and; ii) the protective properties of breastfeeding, including the practice of skin-to-skin care.
Breastfeeding protects neonates, infants and children against morbidity and death.
The protective effect is particularly strong against infectious diseases, due to the direct transfer of antibodies as well as anti-infective factors and long-lasting transfer of immunological competence and memory.
Breastfeeding has both short and long-term benefits for the mother and her infant. To benefit from the protective factors in breast milk, every effort should be made to support and enable early and immediate initiation of breastfeeding. Not only does the early initiation decrease neonatal deaths, but together with frequent breastfeeding, ensures that the breastfeeding dyad are not separated.
The neonate has an immature immune system and colostrum, a powerful immune booster, protects infants from infections by means of bioactive factors and secretory IgA antibodies. Breast milk with its abundant source of immunoglobulins, lactoferrin, lysozyme and cytokines play an important role in absorbing and engulfing harmful micro-organisms and targeting specific bacteria and providing protection by regulating the immune response. Human milk oligosaccharides, abundant in human milk, shape the microbiome, provide probiotics and modulate the developing immune system also displaying anti-adhesive effects for bacterial antigens. All the above are compelling reasons for every infant to receive only breast milk and preferably their own mothers’ milk.
Continued breastfeeding and zero-separation of the mother-infant dyad appears to be the best practice in this situation.
The ICM concur with UNICEF, the ABM and RCOG in that currently there is no evidence that respiratory viruses can be transmitted via breast milk. Therefore, breastfeeding should be continued while general infection control measures are applied in symptomatic mothers and when mothers are too ill to breastfeed. Mothers who are too ill to breastfeed could express milk, and a healthy individual could then cup, or spoon feed the infant.
Breastfeeding should be encouraged, mothers and infant dyads should be cared for together, and skin-to-skin contact ensured throughout the COVID-19 pandemic.
If mothers are too ill to breastfeed, they should still be supported to express their milk, and the infant should be fed by a healthy individual.
Keywords: breastfeeding, COVID -19, mothers, vulnerable new-borns.