How can a Covid-positive mother nurse her baby?

Doctors respond to this question as breastfeeding moms worry over vaccination after-effects

Amid the pandemic and Covid-19 vaccination drives, concerns about breastfeeding are rising among mothers.

August is the ‘Breastfeeding Awareness Month’, and so Metrolife took some concerns about vaccination and breastfeeding among women who have tested positive for the coronavirus to the experts.

Can breastfeeding women take the Covid-19 vaccine?

Dr Ravneet Joshi, MD (paediatric) and lactation physician, says it is safe for breastfeeding women to get inoculated. “A new mother might have concerns about taking the vaccine in the first year, its possible side-effects and breastfeeding. Mothers of one-year-olds and above, when getting inoculated, are often seen quitting breastfeeding altogether,” she says.

“At both these stages, we show them studies and research about breastfeeding and vaccines. The Federation of Obstetric and Gynaecological Societies of India, central government, and WHO have come out with guidelines about how breastfeeding is safe after vaccination,” Dr Ravneet says.

Dr Preeti Prabhakar, senior consultant-obstetrician-gynaecologist, says the vaccines are recommended across all trimesters of pregnancies, as well as to new mothers. “Pregnant patients are counselled as well as post-delivery mothers are encouraged to take the vaccines at the earliest,” she says.

There have been no reports of malformations or teratogenic effects on babies when pregnant mothers have taken the vaccine. “It’s always a safer option to take the vaccine, and survive a minor infection (if one is still infected) rather than battle a severe one,” Dr Preeti says.

“Counselling is important to help them understand the risks of being unvaccinated,” she adds.

Is it safe to breastfeed during the pandemic?

Yes. Covid-19 doesn’t transmit through breast milk, Dr Ravneet clarifies and goes onto say, “Breast milk provides antibodies that give babies a healthy boost and protect them against infections. Antibodies and bio-active factors in breastmilk can fight against Covid-19 infection if a baby is exposed.”

Can a suspected/Covid-positive mother breastfeed?

Breastfeeding can be continued with appropriate safety measures, says Dr Ravneet. “The mother must wear a medical mask if available, wash hands with soap and water or with an alcohol-based hand rub before and after touching her baby. And routine cleaning and disinfecting surfaces touched by her must be done,” she explains.

The mother’s chest only needs to be cleaned if she coughed on it. “Otherwise, the mother’s breasts don’t need to be cleaned before every feeding,” she adds.

Ruth Patterson, a lactation expert, says precautions must be strictly followed, so as to not infect the child. “Crowding in the room should be avoided. If the mother is sneezing continually or has a severe cold, the child must not be placed on the same bed, but into a nearby crib,” she adds.

Breastfeeding must continue, even if the newborn child is Covid-positive.

“The virus can pass through the placenta and not breastfeeding the child can turn fatal for the newborn,” she adds.

Dr Preeti says if the mother is in a critical condition or ICU, then breastfeeding is not the main concern. “Stabilising the patient is the main concern then. The severity of the situation leads to the decisions of separating or rooming-in the child and mother with guidelines,” she adds.

If a Covid-positive mother is too unwell to breastfeed…

Dr Ravneet says keeping the severity of her condition and safety measures in mind, the mother can express milk. “If the mother is hospitalised, then she can express the milk and the father could transport it,” she says.

In case of using a pump, it must be cleaned and sterilised carefully and should be handed over to a healthy caregiver. “While expressing milk, the mother must maintain hand hygiene,” she adds.

Breastfeeding-related issues in Covid-positive mothers

Ruth says that while breastfeeding is highly encouraged at the hospital, there were cases of Covid-positive mothers having to stay away from their child, once back home.

“After a woman gives birth, relatives often offer to come over and help. But they also refuse to step inside the room if she’s Covid-positive. Family members then advise about separating the child and mothers,” she says.

Since breastfeeding doesn’t happen then, the production of breastmilk diminishes. “After a month or so (post quarantine), when the mother tries to breastfeed, enough milk is not produced. In such a case, after counselling, relactation is done,” she adds.

Relactation is also done for mothers who were severely ill, where medication had suppressed their breastmilk production, Ruth adds.