Below is a selection of recent research on the ongoing coronavirus (Covid-19) crisis. For resources and guidance to help health professionals continue to provide care for babies, their mothers and families during the outbreak, visit our response to Covid-19 page.
COVID-19 Vaccine in Pregnancy and Breastfeeding
This US paper addresses how pregnant and/or breastfeeding women have not been included in studies to determine how well COVID-19 vaccines work or how safe they are. The authors believe the risk and benefit of the vaccine should be compared to each mother’s individual risk for getting COVID-19 as well as how well she is expected to tolerate the disease.
Breastmilk Harbors Antibodies to SARS-CoV-2
This article discusses the abundance of immunoglobulin antibodies, and a paucity of viral RNA, in breastmilk which offer evidence that women can safely continue breastfeeding during the pandemic.
Marketing of breastmilk substitutes during the COVID-19 pandemic
This article addresses how the infant formula industry has been actively exploiting concerns about COVID-19 to increase sales, in violation of the WHO International Code of Marketing of Breastmilk Substitutes and national law across the globe. These infant formula companies and large manufacturers of breastmilk substitutes have inappropriately positioned themselves as sources of public health expertise, and suggested various unnecessary hygiene measures, the use of expressed breastmilk, and the separation of mothers from their babies. Such recommendations undermine breastfeeding and thus increase the risk of infant death. Baby Milk Action and the International Baby Food Action Network have documented numerous infringements of both the Code and laws associated with COVID-19.
van Tulleken C, Wright C, Brown A, McCoy D, Costello A. Marketing of breastmilk substitutes during the COVID-19 pandemic [published online ahead of print, 2020 Oct 8]. Lancet. 2020;396(10259):e58. doi:10.1016/S0140-6736(20)32119-X
Breastfeeding support during Covid-19
This article addresses the removal of breastfeeding support services and the rise of misinformation related to breastfeeding safety during the coronavirus pandemic. To ascertain families’ experiences of breastfeeding, the authors of this article surveyed women who were breastfeeding their baby when lockdown changes started to occur in the UK about their experiences of breastfeeding support at this time. A total of 1360 mothers completed the survey between May and June 2020, with key findings including that the most common reasons for stopping breastfeeding were insufficient professional support, physical issues such as difficulties with latch, exhaustion, insufficient milk and pain. Seventy per cent of respondents said a lack of face to face support led to their decision to stop breastfeeding and 21% had been worried about the safety of breastfeeding during the pandemic. A further 4% had been told by a health professional that breastfeeding may not be safe during COVID-19.
NGOs defend breastfeeding as COVID-19 misinformation rages
This article discusses recent announcements by NGOs that the misinformation about the safety of breastfeeding during the coronavirus pandemic has led to decreases in the practice by women who fear it could harm babies.
Experiences of breastfeeding during COVID‐19: Lessons for future practical and emotional support
This article explores the effects of the Covid-19 pandemic on women’s breastfeeding experiences in the UK. An online survey of 1219 breastfeeding mothers in the UK with a baby 0-12 months old showed varying results: 41.8% of mothers felt that breastfeeding was protected due to lockdown, however 27.0% of mothers struggled to get support and had numerous barriers stemming from lockdown, with some stopping breastfeeding before they were ready. Mothers reported certain challenges, including lack of support, feelings of isolation and being confined to home. Additionally, mothers with a lower education, with more challenging living circumstances and from Black and minority ethnic backgrounds were more likely to find the impact of lockdown challenging and stop breastfeeding.
Mistakes from the HIV pandemic should inform the COVID-19 response for maternal and newborn care
Researchers discuss efforts by governments, professional organisations, and health facilities to institute policies that isolate newborns from their mothers which prevent breastfeeding in order to prevent infants being infected with Covid-19. Policy makers and practitioners are urged to learn from the mistakes of the HIV pandemic and not undermine breastfeeding; it is clear that in order to maximise infant health and wellbeing, COVID-19 policies should support skin-to-skin contact, maternal proximity, and breastfeeding.
Gribble, K., Mathisen, R., Ververs, M. et al. Mistakes from the HIV pandemic should inform the COVID-19 response for maternal and newborn care. Int Breastfeed J 15, 67 (2020). https://doi.org/10.1186/s13006-020-00306-8
Visitation restrictions: is it right and how do we support families in the NICU during COVID-19?
This article addresses how the Covid-19 pandemic has affected levels of care provided in hospitals and neonatal intensive care units around the globe and discusses the various new methods of supporting families both in-hospital and at home. The authors explore the ethical dilemma of separating parents and infants, particularly in regard to severely limited family visitation privileges.
Murray, P.D., Swanson, J.R. Visitation restrictions: is it right and how do we support families in the NICU during COVID-19?. J Perinatol 40, 1576–1581 (2020). https://doi.org/10.1038/s41372-020-00781-1
Breastfeeding link to COVID-19 is negligible, says World Health Organization
The World Health Organization (WHO) announced in August 2020 that the risk of Covid-19 infection from breastfeeding is negligible and has never been documented, and that the benefits of exclusive breastfeeding for six months for the infant and mother far outweigh any risk from Coronavirus. The organisation notes that not using mother’s own milk is linked to 820,000 child deaths a year and a cost of $300 billion to the global economy.
Implications of the COVID-19 Pandemic Response for Breastfeeding, Maternal Caregiving Capacity and Infant Mental Health
This article discusses the variable support for breastfeeding and the mother–infant dyad in policies and guidance developed in response to the coronavirus pandemic. Authors outline the benefits of breastfeeding during the pandemic, the current scientific understanding of any relationship between coronavirus and infants/human milk, and the current national guidance for newborn care in this context. Policies that are causing separation of mothers and babies and parallels to the HIV pandemic are also described.
Gribble, K., Marinelli, K., et al. (2020). Implications of the COVID-19 Pandemic Response for Breastfeeding, Maternal Caregiving Capacity and Infant Mental Health. https://doi.org/10.1177/0890334420949514
Covid-19 and maternal and infant health: Are we getting the balance right? A rapid scoping review
The purpose of this study was to summarise the evidence of the clinical and psychological impacts of Covid-19 on perinatal women and their infants. Results of the study found that despite the lack of evidence, many maternity services have been imposing severe restrictions on aspects of maternity care previously acknowledged as vital to optimum health (including birth companionship, breastfeeding, and contact between mother and baby).
Optimising mother-baby contact and infant feeding in a pandemic
Unicef UK Baby Friendly were delighted to be involved in a rapid analytic review by the RCM advisory group. The review offers evidence-based recommendations for midwives and maternity teams on optimising mother-baby contact and infant feeding during Covid-19 and explores the implications of the pandemic on breastfeeding and infant health, including the wearing of face masks.
When Separation is not the Answer: Breastfeeding Mothers and Infants affected by COVID‐19
This article discusses separation of mothers and babies affected by Covid-19, saying that separation causes cumulative harms and disrupts breastfeeding, thus preventing the ability to pass on protection against infectious disease. Authors also discuss the risk of “replaceability of breastfeeding” that is caused by separation of mothers and babies and therefore minimised rates of breastfeeding. According to the authors, separation does not ensure lower viral exposure and instead increases the burden on strained healthcare services. Health services are called to consider the short‐and‐long‐term impacts of separating mothers and infants in their policies.
Navigating pregnancy during the coronavirus disease (COVID-19) pandemic
This helpful article addresses the fear, uncertainty and anxiety that expectant mothers may be facing during the outbreak of the coronavirus disease (COVID-19). Unicef spoke with Franka Cadée, President of the International Confederation of Midwives to discuss common questions women may be having, including whether prenatal checkups are considered safe, if Covid-19 can be passed to the baby and whether giving birth in a hospital or healthcare clinic is still considered a good option. The interview covers a range of additional topics, including whether expecting mothers can have a partner or family member nearby during birth, how to protect a newborn from Covid-19 and more.
Maintaining safety and service provision in human milk banking: a call to action in response to the COVID-19 pandemic
This article calls on global policy leaders and funding agencies to recognise and prioritise the need to address four high-impact areas: (1) ensuring neonatal nutrition is an essential focus during emergencies; (2) funding research to optimise human milk bank systems in response to new infectious threats; (3) investing in innovation across all aspects of milk banking processes to improve the responsivity, access, and quality of donor milk provision; and (4) supporting the integration of learnings and innovations by the global milk bank community during COVID-19 into newborn, nutrition, and emergency response planning for future emergencies. The author notes that this is the best chance to keep infants healthy is to promote breastfeeding and a human milk diet and it is vital to avoid further straining the health system during the COVID-19 pandemic.