Breastfeeding and COVID-19
The following information has been compiled from the Centers for Disease Control and Prevention’s website and represents the information available as of March, 25, 2020. This content is for informational purposes only and does not constitute medical advice. Please contact your healthcare provider if you should have any questions or health concerns regarding breastfeeding and COVID-19.
Q: What is COVID-19?
A: COVID-19 is a new disease and we are still learning how it spreads, the severity of the illness it causes, and to what extend it may spread. We recommend going to the CDC for the most accurate information
Q: Can breastfeeding mothers still breastfeed if they have COVID-19?
A: Yes, see the CDC guidelines below.
Q: What are the guidelines on breastfeeding for mothers with confirmed COVID-19 or under investigation for COVID-19?
A: The CDC recommends a mother with confirmed COVID-19 or who is a symptomatic person under investigation (PUI) should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone else, who is well, feed the expressed breast milk to the infant.
Q: What if the breastfeeding mother feels too sick to breastfeed?
A: If you are a breastfeeding mother or talk to a breastfeeding mother who feels really bad, strongly encourage them to call their healthcare provider. Ask if the mother has help or explore ways to get help for yourself to support breastfeeding. If help is available, the mother can hand express or pump their breast milk and have someone else feed the baby. Before expressing, it is important to wash hands thoroughly with soap and water. If using a breast pump, it is important to ensure proper cleaning is followed. See more information about pump cleaning detailed below.
Q: Will the breastfeeding mother’s milk supply decrease?
A: Some mothers notice a supply drop when they are sick. If this happens refer the mothers to a designated breastfeeding expert or medical provider. Before taking any medications, including over the counter medication, call your doctor to find out what medication is safe to take while breastfeeding.
Q: How can a breastfeeding mother reduce of spreading virus to the baby?
A: Here’s what the CDC and the World Health Organization (WHO) say:
Even if you don’t have symptoms of COVID-19, there are things we can all do in order to minimize the chances of spreading COVID-19 to others. For example, it is important to:
- Wash your hands often using soap and water or an alcohol-based hand sanitizer.
- Cover your mouth and nose with a bent elbow or tissue when coughing or sneezing, and immediately throwing away any used tissues.
- Avoid close contact with anyone who has cold or flu-like symptoms.
- Contact your doctor if you have a fever, cough or feel like it is hard to breathe.
Q: Does COVID-19 transmit to the breast milk?
A: Much is unknown about how COVID-19 is spread. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory pathogens spread. In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk. However, we do not know whether mothers with COVID-19 can transmit the virus via breast milk.
Below are the CDC’s Recommendations on How to Clean Your Breast Pump:
Before Each Pump Use:
- Wash hands. Wash your hands well with soap and water for 20 seconds.
- Washing hands is the first line of defense against contamination of your breast pump kit and the breast milk itself. Washing with soap and water is preferable to the use of alcohol hand sanitizer so as not to introduce alcohol to the breast or breast milk 3. However, when used correctly, hand sanitizershould not pose a risk to your breast milk and can be used if soap and water are not readily available.
- Assemble clean pump kit.
- Inspect whether the pump kit or tubing has become moldy or soiled during storage. If your tubing is moldy, discard and replace immediately. 3,4,5
- A 1979 outbreak of Klebsiella bacteremia in a newborn intensive care unit was linked to contaminated breast pump tubing.6
- Clean if using a shared Clean pump dials, power switch, and countertop with a disinfectant wipe.
- The outer surfaces of shared pumps can have unsafe bacteria which may carry into the pumped breast milk.
After Every Pump Use:
- Store milk safely. Cap milk collection bottle or seal milk collection bag, label with date and time, and immediately place in a refrigerator, freezer, or cooler bag with ice packs.
- If milk collection container will be stored at a hospital or childcare facility, add name to the label.
- Clean pumping area. Especially if using a shared pump, clean the dials, power switch, and countertop with disinfectant wipes. The outer surfaces of shared pumps can have unsafe bacteria that can get into pumped breast milk. 6
- Take apart and inspect pump kit. Take apart breast pump tubing and separate all parts which come in contact with breast/breast milk (for example, flanges, valves, membranes, connectors, and milk collection bottles).
- Rinse pump kit. Rinse breast pump parts which come into contact with breast/breast milk under running water to remove remaining milk.
- Clean pump kit. As soon as possible after pumping, clean pump parts which come into contact with breast/breast milk in one of the following ways.
- Clean by hand:
- Use a wash basin. Place pump parts in a clean wash basin used only for washing infant feeding equipment. Do not place pump parts directly in the sink, because germs in sinks or drains could contaminate the pump. Many germs can easily grow in sink drains and spread to other surfaces. Outbreaks in hospitals have been linked to germs from sink drains. 7,8,9,10
- Add soap and water. Fill wash basin with hot water and add soap. 11,12
- Scrub items according to pump kit manufacturer’s guidance. If using a brush, use a clean one that is used only to clean infant feeding items. 11,12
- Rinse by holding items under running water, or by submerging in fresh water in a separate basin that is used only for cleaning infant feeding items.
- Allow to air-dry thoroughly. Place pump parts, wash basin, and bottle brush on a clean, unused dish towel or paper towel in an area protected from dirt and dust. Do not use a dish towel to rub or pat items dry because doing so may transfer germs to the items.
- Research in a neonatal intensive care unit setting found Proteus bacteria at the bottom of a milk bottle. The study concluded that breast pump kits should be dried thoroughly to not allow for any water to remain where bacteria can multiply. 13
- Clean in a dishwasher (if recommended by pump kit manufacturer).
- Place disassembled pump parts in dishwasher. Be sure to place small items into a closed-top basket or mesh laundry bag so they don’t end up in the dishwasher filter. If possible, run the dishwasher using hot water and a heated drying cycle (or sanitizing setting); this can help kill more germs.
- Remove from dishwasher. Wash your hands with soap and water before removing and storing cleaned items. If items are not completely dry, place items on a clean unused dish towel or clean paper towel to air-dry thoroughly before storing. Do not use a dish towel to rub or pat items dry because doing so may transfer germs to the items.
- A systematic review concluded that a number of different methods for cleaning and disinfecting a breast pump kit appear to be acceptable, including thoroughly washing with warm water and soap, using a dishwasher, and boiling 14,15. The authors did conclude that whatever method is used, the most important steps are thoroughly washing with warm water and soap to remove all traces of milk, rinsing to remove the soap, and then thoroughly drying before storing.
- Clean wash basin and bottle brush. If you use a wash basin or bottle brush when cleaning your pump parts, rinse them well and allow them to air-dry after each use. Consider washing them every few days, either in a dishwasher with hot water and a heated drying cycle, if they are dishwasher-safe, or by hand with soap and warm water.
Available Links to Support Breast Pump Cleaning:
- How to Keep Your Breast Pump Kit Clean: The Essentials (English/Spanish)
- How to Keep Your Breast Pump Kit Clean, Print Version- English
- How to Keep Your Breast Pump Kit Clean, Print Version- Spanish
Available Links to Human Milk Storage Guidelines:
COVID-19 Breastfeeding Support Resources:
- Academy of Breastfeeding Medicine-Statement on Coronavirus
- American Academy of Pediatrics-Critical Updates on COVID-19
- American College of Obstetricians and Gynecologists-Novel Coronavirus 2019 (COVID-19)
- CDC-Coronavirus (COVID-19)
- CDC- Disaster Planning: Infant and Child Feeding
- CDC-COVID-19, Pregnancy and Breastfeeding
- Carolina Global Breastfeeding Institute- COVID-19 Resources
- Human Milk Banking Association of North America- Milk Banking and COVID-19
- The Milk Bank- COVID-19 Statement
- National Perinatal Association -COVID-19
- Nevada Health Response: COVID-19
- Society for Maternal Fetal Medicine-Coronavirus (COVID-10)
- UNICEF- Coronavirus Disease (COVID-19): What Parents Should Know
- United Nations Population Fund-UNFPA Statement on Novel Coronavirus and Pregnancy
- United States Breastfeeding Committee- Infant and Young Child Feeding in Emergencies
- United States Department of Agriculture, Food and Nutrition Service- Response to COVID-19
- WHO-Coronavirus Disease (COVID-19) Pandemic
- WIC Breastfeeding Support
- World Alliance for Breastfeeding Action- Coronavirus Disease (COVID-19) and Breastfeeding
Adapted from materials provided by the Washington WIC Program.
For a printable PDF in English, please click here.
For a printable PDF in Spanish, please click here.