Research on infant feeding & mother–infant contact policies in the context of COVID-19

Research discussing the rising concerns of mother–infant transmission of SARS-CoV-2 through breastfeeding and close contact has been published, citing how insufficient available evidence has contributed to differing guidelines and recommendations from public health agencies and national health authorities.

The study concludes that deaths among infants affected by a policy of separation and non-breastfeeding would be at least 67 times greater than mortality potentially attributable to COVID-19.

Authors used the Lives Saved Tool to examine the different approaches taken by public health agencies and how these might affect infant mortality, taking into consideration key factors including risk, child survival, lifelong health, development, maternal health and the latest available evidence. The authors conclude:

Five further key conclusions are made on the basis of available evidence, reading:

1. “The state of evidence and balance of risk estimates support mother–infant close contact and breastfeeding by mothers with confirmed SARS-CoV-2 infection while still implementing infection prevention and control measures, including handwashing and wearing face masks. The survival benefits of breastfeeding substantially outweigh the very low reported CFRs among infants with COVID-19.
2. Public health authorities should consider the full scope of evidence and implications for all-cause child mortality and other health outcomes and ensure that resultant policy and associated messaging are coherently communicated to health-care workers and communities.
3. Research will populate the evidence gaps and future estimations should adopt a comprehensive child survival and health framing to avoid oversimplification. Animal models would be helpful for elucidating infectivity of viruses through breastfeeding.
4. In the COVID-19 pandemic, breastfeeding counselling and support and other interventions and approaches should focus on how to reduce the small risk of transmission and effect through respiratory spread.
5. Public health authorities and legislators should proactively address the deliberate exploitation and seeding of doubt about breastfeeding by commercial interests.”

The approach put forward by this paper presents a useful framework for planning “globally-consistent” advice pertaining to the risks and benefits associated with breastfeeding in the context of coronavirus or a future epidemic.

Citation:

N. Rollins, et al. (2021). A public health approach for deciding policy on infant feeding and mother–infant contact in the context of COVID-19, The Lancet Global Health, ISSN 2214-109X. https://doi.org/10.1016/S2214-109X(20)30538-6.