Breastfeeding continues to be encouraged during the pandemic, but that doesn’t mean new parents don’t have COVID-19 concerns. Photo: Becky Litz Photography

Breastfeeding during the pandemic: what we know and don’t know

There’s still little research to show if breastmilk transmits COVID-19

Frances Jones thought she might run out of breastmilk.

When the provincial COVID-19 lockdown began in March, Jones realized donations to the milk bank at BC Women’s Hospital in Vancouver were drying up.

The service provides donor milk to approximately 4,000 infants per year, according to Jones, who runs the milk bank as well as the hospital’s lactation service. Most of those babies are born premature, with an illness, or three-to-five weeks before their due date when mothers haven’t begun expressing milk.

But two weeks into the lockdown, she says, the milk began to flow back to the bank.

“We’re not necessarily seeing mothers not wanting to breastfeed,” says Jones. “We’re probably seeing more mothers definitely asking is there a risk? ‘Is there a problem if I get COVID?’”

It’s not yet clear if infected mothers can transmit the virus to infants via breastfeeding.

In July, Italian researchers examined 31 pregnant women and found traces of the virus in breastmilk, but also noted the presence of antibodies in the milk as well.

Another study also released in July examined 120 infants born in New York hospitals between March 22 and May 17 by mothers who had tested positive for COVID-19. None of their babies, however, were found to have COVID-19 in the 24 hours after birth.

Of the 116 mothers taking part, 64 were still breastfeeding five-to-seven days after birth. The majority of babies were also tested twice more, at five-to-seven days and 14 days of life, and none were positive for the virus.

The World Health Organization (WHO) and Canada’s chief public health officer Dr. Theresa Tam both recommend mothers breastfeed even if they have or are suspected to carry the virus.

At the milk bank, donors are screened and the milk is pasteurized before being provided to families. According to Jones the benefits of breastmilk, which contains antibodies that protect infants from infections, outweigh the unproven risk of COVID-19 transmission.

“They need more research to be able to say clearly it’s not a problem,” explains Jones. “But all the experts currently recommend breastfeeding. We haven’t noticed mothers saying, ‘Well, I’m not going to breastfeed because of COVID.’ It tends to be they’re going to breastfeed, but they just have questions regarding COVID.”

“Everything we know today might change tomorrow”

COVID-19 is the third pandemic Dr. Marie Tarrant has experienced during her career.

Tarrant, who is now director of the School of Nursing at the University of British Columbia’s Okanagan Campus, was a maternal health researcher in Hong Kong when the SARS spread to the city in early 2003.

Twelve pregnant women reporting having contracted SARS in Hong Kong between Feb. 1 and July 31, 2003, according to the American Journal of Obstetrics and Gynecology.

Of those women, three died, four miscarried in the first term, and four others delivered their babies preterm. The infants who lived tested negative for SARS.

“In general, SARS was serious for everyone,” says Tarrant. “You know, it was less widespread, it was not as easy to transmit. But if you got it, it was a much more serious disease. So the few pregnant women who did get it had very poor outcomes, both maternal outcomes and neonatal outcomes.”

Tarrant was also in Hong Kong during the 2009 outbreak of H1N1. That influenza virus, she says, led to some mothers having premature births.

A recent study in New York found no evidence breastmilk transmits COVID-19 to infants. Photo: Becky Litz Photography

COVID-19, like influenza viruses, is a respiratory disease that is transmitted by contact and droplets. The difference, according to WHO, is that influenza spreads faster, but COVID-19 symptoms can be more severe.

Tarrant, whose research has focused on breastfeeding and maternal influenza vaccines, suspects the breastmilk of infected mothers provides COVID-19 antibodies to infants.

But she also warns maternal COVID-19 research is still scant.

“Everything we know today might change tomorrow, right? Or at least a lot of what we know today could change tomorrow. It’s continuously evolving.”

For now, Tarrant suggests, increasing mental health support for women before and after they give birth. The virus mostly prevents in-person support services, which in turn leads to social isolation for families who may need assistance.

Reaching out for help

Jocelyn Bouchard believes in the bonding potential of breastfeeding.

Before the pandemic, Bouchard led breastfeeding groups in Castlegar as a lactation consultant with the Nelson-based Apple Tree Maternity, which provides pregnancy, birth and newborn care to families in the West Kootenay. The groups gave parents the chance to meet and learn from each other.

Since March, however, Bouchard’s groups have been replaced by one-on-one appointments, which she says has led to increased anxiety among her clients.

“Families are more isolated and they don’t have as much support necessarily from their friends and family,” says Bouchard. “[New parents] maybe aren’t able to travel to see them or maybe they don’t want to expose the baby to that many people because they’re anxious about the virus.”

According to Bouchard the families she works with aren’t concerned about breastfeeding in the pandemic. What they need is free access to counselling. Apple Tree Maternity has two mental health workers visiting families, but Bouchard says that service is a luxury many rural communities don’t have.

Parents who have questions about breastfeeding or taking care of their new additions need to feel as though they can connect with others even during a global pandemic.

“Even more so than before it’s normal and expected to need support and ask for help, and in our culture, we don’t always promote asking for help and we think that we should be able to do it on our own and do it independently.

“It’s normal to need support and need some extra help.”

Related:

How to have a baby in Nelson during a pandemic

Precious delivery: B.C. families welcome babies during COVID-19 restrictions

Pregnant in a pandemic: Expectant B.C. moms change birth plans due to COVID-19

@tyler_harper | tyler.harper@nelsonstar.com

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