Breast milk protects infants from many illnesses and is the best food for most infants.
During the coronavirus disease 2019 (COVID-19) pandemic, mothers who may be exposed or infected might be unsure about feeding their infant breast milk. Mothers, along with their family and health care professionals, should decide whether and how to start or continue breastfeeding. We do not know if mothers with COVID-19 can spread the virus to infants through breast milk, but it is unlikely based on what we do know. Women who have had COVID-19 have high amounts of antibodies to the virus in their breast milk, which coat the inside of infants’ noses and mouths, helping to block infection. Fresh (not frozen) milk is ideal because it is has live infection-fighting cells and offers the most protection.
If you test positive for COVID-19 and want to breastfeed or express breast milk, follow these guidelines: (1) Wash your hands before and after touching your infant or any pump or bottle parts. (2) Avoid using a pump that is shared by others. (3) Wear a mask or cloth face covering during breastfeeding or pumping. (4) Follow manufacturer instructions for proper pump cleaning after each use, cleaning all parts that come into contact with skin or breast milk. (5) If possible, pumped breast milk should be fed to the infant by a healthy caregiver who does not have COVID-19, is not at high risk for severe illness from COVID-19, and is living in the same home.
If you are breastfeeding and may have been exposed to COVID-19 and/or work in a setting with increased risk of exposure to the virus, such as a health care professional or first responder, limiting duties or isolating from your family are not currently recommended. As always, your employer should provide access to a private, nonbathroom space for you to pump milk. Clean your hands routinely, whether breastfeeding or pumping milk. Clean all pump and collection kit parts as directed by the manufacturer. Some women may wish to follow the guidelines above for those who have COVID-19, in addition to these suggestions: (1) Upon returning home, you may choose to take off shoes, immediately wash work clothing, and shower. (2) You can continue your usual work while following workplace guidelines. (3) You may wish to work with supervisors to limit high-risk situations, especially with people testing positive for COVID-19. (4) You may wish to clean areas that are touched a lot in work lactation rooms when you go in and out of the room. (5) Cleaning the outside of milk bottles or bags is not currently recommended. (6) If your infant has risk factors such as age younger than 2 months, born early, heart defect, severe lung disease, or severe immune problems, you may wish to isolate from your infant while providing your milk (see above guidelines for those who have tested positive for COVID-19).
As we learn more about COVID-19 and breastfeeding, this advice may change. For now, we know protecting breastfeeding and breast milk is best.
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Published Online: October 26, 2020. doi:10.1001/jamapediatrics.2020.3341
Conflict of Interest Disclosures: None reported.