by Natasha K. Sriraman, MD MPH FAAP FABM, answering your questions about breastfeeding and COVID-19.

Is it safe to breastfeed my baby?

I have been asked this question a lot, both on social media and in my pediatric practice, over the last few weeks. The safety of breastfeeding during COVID-19 is a very common concern, especially for our mothers who are at increased risk of exposure.
While we continue to learn about COVID-19 there are still so many unknowns.

So what do we know?

As we learn new things about this novel virus on a daily basis, recommendations have been changing and continue to change. 

Studies to date have not found any transmission of the SARS-CoV-2 into breastmilk. 

Of course, practicing good hygiene whether you are breastfeeding or pumping is especially important now. We encourage good hand washing and/or sanitizing hands as well as breast pump parts.

What if I am COVID+ or a person under investigation?

If a mom is COVID+ or a person under investigation (PUI), the recommendation from the American Academy of Pediatrics and CDC is to separate mom and baby, while mom continues to express milk. An uninfected, healthy caregiver can feed the milk to the baby.  There is absolutely NO reason to pump and dump.  However, if a mom tests positive, is not ill and wants to nurse the baby directly at the breast, we recommend that mom wear a mask while she breastfeeds. 

For mothers who deliver in a hospital setting, it has been recently recommended that mom and baby be separated if mom tests positive or is a PUI.  But this may be difficult for a variety of reasons. First, mom may not show any signs of illness and will want to be with her baby. Also, depending on the staffing, this may not be feasible.  In this case, the baby and mom can be in the same room (6 feet apart) with a partition or curtain between them.

Once mom is discharged, there may not be a caregiver at home to feed the baby after mom pumps. Again, we want mom to continue breastfeeding and/or pumping milk and take the necessary precautions when feeding their infant. I recommend that all expectant mothers speak to their obstetrician about the policies and procedures in the hospital where they will be delivering since these can vary.

As a woman in healthcare, is it safe to pump milk and bring it home to my baby?

I tell fellow female physicians and all moms in healthcare that, yes, you can still pump at work. We are all under a great amount of stress as we all are dealing with the unknowns of the coronavirus. And add in the stress of leaving your baby to go to work while trying to maintain a pumping routine…well, it’s A LOT!

Listen to our podcast with Robin Kaplan for general advice on pumping at work.

I recommend taking the following steps to maintain the best possible hygiene and cleanliness when pumping at work and bringing the milk back home for your baby.

First clean the area where you will be pumping with sanitizing wipe/disinfectant. Follow general recommendations for pump cleaning and wash your hands before AND after handling your breastpump. Wash your flanges/pump parts with warm soapy water after each use and place pumped milk in a separate cooler. For extra precautions, mothers can place your pump parts in a large Ziploc bag to store, then this bag can be taken into the kitchen where the parts should be washed with warm soapy water.

If you don’t need the pump at home, then you can leave it in the car. However, for moms who need to bring the pump back into the house, I would recommend using a disinfectant/bleach wipe to clean the outside before bringing it into the house. (Personally, I wipe down the inside of my car and my work bag before I come inside!) 

If possible with your work setting, consider pumping in your car. This way, you can avoid bringing the pump inside the hospital or clinical setting.  

Give yourself grace

And it’s important to know that the added stress may be affecting your milk supply. This is a normal physiological response! Remember, no matter how many ounces you collect, your baby is getting what they need.

As a physician and breastfeeding medicine specialist, I know this is a scary time for all of us. As mothers, we want to care for everyone, especially our babies. Based on the studies and current clinical situations, I encourage all my mothers to breastfeed and/or pump milk. And please give yourselves grace. Stress, coupled with other factors, such as nutrition and time, can affect supply. But just know that you are doing the best you can. Breastmilk, no matter if given directly to your baby or via a bottle, is the best source of nutrition for most infants. And while you are doing a great job taking care of your baby, remember to take care of yourself. Remember, you cannot pour from an empty cup. 

References:

https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/faqs-management-of-infants-born-to-covid-19-mothers/

https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/covid-19-and-breastfeeding.html

https://www.bfmed.org/abm-statement-coronavirus


Dr. Natasha Sriraman is an Associate Professor of Pediatrics at Eastern Virginia Medical School, attending physician, researcher, wife and mother. Her main areas of research include breastfeeding, postpartum depression, and health disparities.

She has spoken internationally about breastfeeding and postpartum depression and has published extensively. She has won numerous awards for her teaching and research. Dr. Sriraman has been on the Board of Directors for: Academy of Breastfeeding Medicine (ABM), American Academy of Pediatrics (AAP) Section on Breastfeeding, FOR KIDS Homeless Shelter and the Eliza Hope Center for Autism.  She is currently is on the BOD of the Virginia Chapter of the AAP and serves as Honorary Chair for Postpartum Support Virginia.

She is a strong advocate for mothers as she lobbies for breastfeeding support in the workplace and PPD screening within the pediatric setting. When not working, Natasha enjoys running, yoga, boxing, traveling, and reading and going to the beach with husband and 4 kids (3 human, 1 canine). Find her on Instagram, Facebook, Twitter, or her website: www.NatashaMomMD.com.