Supporting lactation is important to human health at all times, but especially during times of emergency. As skilled lactation providers around the globe support families during the COVID-19 epidemic, ILCA is working to provide resources, guidelines, and communication tools.
Supporting Families with Relactation – Centers for Disease Control Prevention
Relactation – La Leche League International
Relactation and Adoptive Breastfeeding: The Basics – Kelly Bonyata, BS, IBCLC
Click on the map to go to a region
NOTE: Guidance for families and for those providing lactation support during COVID-19 is evolving. We at ILCA will do our best to keep this information as updated as possible. The information posted here may not reflect the latest news and practice guidance. Have updates or regional guidelines to share? Please email marketing@ilca.org with details.
9 September 21 to include CDC update: COVID-19 Vaccines While Pregnant or Breastfeeding
1 September 21 to include UNICEF position regarding close contact and breastfeeding in COVID-19 context
1 September 21 to include Counselling cards (UNICEF and USAID Advancing Nutrition)
1 September 21 to include FAQ: Breastfeeding and COVID-19 For health care workers (WHO)
1 September 21 to include Breastfeeding and COVID-19: scientific brief (WHO)
1 September 21 to include Advocacy messages on breastfeeding and COVID-19 (Global Breastfeeding Collective)
1 September 21 to include Breastfeeding Safely During the COVID-19 Pandemic
1 September 21 to include COVID-19 Clinical management: living guidance
13 April 21 to include New Coronavirus Vaccination Technical Guide (First Edition) from the National Health Commission of the People’s Republic of China
29 March 21 to include new AJOG Research on Lactation, Pregnancy and COVID mRNA Vaccines
12 February 21 to include new Hospital Infant Feeding Network (HIFN) Fact Sheet On Use of COVID-19 Vaccinations in Breastfeeding and Pregnancy
3 February 21 to include new PATH guidance on aligning best practices and addressing misinformation for optimal infant feeding during COVID-19
11 January 21 to include new LER blog post on how lactation consultants can access the COVID vaccine
11 January 21 to include new WHO Interim recommendations for use of the Pfizer–BioNTech COVID-19 vaccine, BNT162b2, under Emergency Use Listing
17 December 20 to include new statement from United States Lactation Consultant Association Statement on Vaccination for Lactation Care Providers
15 December 20 to include new statement from Academy of Breastfeeding Medicine: Considerations for COVID-19 Vaccine in Lactation
14 December 20 to include new Information on CoronaVac vaccine
14 December 20 to include new resource from Infant Risk Center: COVID-19 Vaccine in Pregnancy and Breastfeeding
14 December 20 to include new Center for Disease Control Slides: Use of Pfizer-BioNTech COVID-19 Vaccine: Clinical Considerations
14 December 20 to include new American College of Obstetricians and Gynecologists Practice Advisory: Vaccinating Pregnant and Lactating Patients Against COVID-19
8 December 20 to include new ILCA webinar: Protecting Mother-infant Contact and Breastfeeding During the COVID-19 Pandemic
18 November 20 to include CDC guidance for healthcare providers who provide care for breastfeeding people
7 September 20 to include new Virtual Practice Resources
17 August 20 Multiple updates to the Research section
11 August 20 to include updates to RCOG guidance for health care professionals
3 August 20 to include Updates to CDC “Evaluation and Management Considerations for Neonates At Risk for COVID-19”
24 June 20 to include new FAQ from the American Academy of Pediatrics (AAP)
2 June 20 to include Breastfeeding Mothers and Infants affected by COVID‐19
28 May 20 to include WHO Clinical Management of COVID-19
19 May 20 to include shareable graphics in 10 languages
30 April 20 to include new research resources from JHL
28 April 20 include new FAQ and decision tree from WHO
22 April 20 to include new SOGC Statement, WHO position paper, new UNICEF Statement, and webinar from ILCA
20 April 20 to include ILCA/USLCA joint statement and additional COVID-19 graphics
16 April 20 to include new guidelines on milk handling from HMBANA
10 April 20 to include new Canadian guidelines
9 April 20 to include CDC updates
8 April 20 to include ILCA statement now available in Japanese; additional social media resources added
7 April 20 to include new or updated guidelines from UNICEF, Italy, and US
23 March 20 to include Q&A from WHO
19 March 20 to include updates from SOGC and RCOG, our statement, and changes to the IBLCE exam schedule
18 March 20 to include tools from Lactation Education Resources
16 March 20 to include milk banking resources and virtual consult resource.
WHEN SEPARATION IS NOT THE ANSWER: BREASTFEEDING MOTHERS AND INFANTS AFFECTED BY COVID‐19
ILCA STATEMENT ON BREASTFEEDING AND LACTATION SUPPORT DURING THE COVID-19 PANDEMIC
RESOURCES FOR LACTATION SUPPORTERS PROVIDING INFANT AND YOUNG CHILD FEEDING ADVICE DURING COVID-19
The COVID-19 pandemic has resulted in Declarations of Emergency in many countries and local municipalities around the world. Skilled lactation providers are being called upon to provide evidence- and policy-based advice on the feeding of infants and young children during this emergency. The following, based on international recommendations, can help guide your recommendations.
(released 24 March 20)
SOCIAL MEDIA FRAME FOR TELEHEALTH PROVIDERS
Add this frame to your social media profile to let people know that you are a lactation consultant that provides telehealth.
ILCA AND USLCA JOINT STATEMENT IN SUPPORT OF THE WORLD HEALTH ORGANIZATION
The International Lactation Consultant Association (ILCA) and the United States Lactation Consultant Association (USLCA) stand firmly in support of the World Health Organization (WHO) and their critical work helping “mothers and children survive and thrive,” particularly during the COVID-19 pandemic.
WEBINAR: PROTECTING MOTHER-INFANT CONTACT AND BREASTFEEDING DURING THE COVID-19 PANDEMIC
ACADEMY OF BREASTFEEDING MEDICINE: CONSIDERATIONS FOR COVID-19 VACCINE IN LACTATION
Early recommendations for those who are lactating and prioritized for vaccination:
“Many lactating individuals fall into categories prioritized for vaccination, such as front-line health care workers. The Academy of Breastfeeding Medicine does not recommend cessation of breastfeeding for individuals who are vaccinated against COVID-19.”
And early information on the “biological plausibility” of vaccine harm through breastfeeding:
” . . .there is little biological plausibility that the vaccine will cause harm, and antibodies to SARS-CoV-2 in milk may protect the breastfeeding child.”
(Published 14 December 2o, accessed 15 December 20)
WHO: INTERIM RECOMMENDATIONS FOR USE OF THE PFIZER–BIONTECH COVID-19 VACCINE, BNT162B2, UNDER EMERGENCY USE LISTING
“Breastfeeding offers substantial health benefits to lactating women and their breastfed children. Vaccine efficacy is expected to be similar in lactating women as in other adults.”
“As the BNT162b2 vaccine is not a live virus vaccine and the mRNA does not enter the nucleus of the cell and is degraded quickly, it is biologically and clinically unlikely to pose a risk to the breastfeeding child.”
Access the recommendations here.
(Published 8 January 2021; accessed 11 January 2021)
INTERNATIONAL CONFEDERATION OF MIDWIVES OFFICIAL STATEMENT; WOMEN’S RIGHTS IN CHILDBIRTH MUST BE UPHELD DURING THE CORONAVIRUS PANDEMIC
“The International Confederation of Midwives (ICM) is concerned that the human rights of women, their babies and their midwives are being violated by the introduction, in many countries, of inappropriate protocols for management of pregnancy, birth and postnatal care in response to the Covid-19 pandemic. These inappropriate protocols are not based in current reputable evidence and are harmful to women and their babies.
Breastfeeding women should not be separated from their newborns, as there is no evidence to show that respiratory viruses can be transmitted through breastmilk. The mother can continue breastfeeding as long as the necessary precautions below are applied.”
Find the full precautions and the full statement here, available in English, French, and Spanish.
(dated 29 March 20, accessed 6 April 20)
COVID-19 Clinical management: living guidance
See section 21 starting on page 55
“Breastfeeding protects against morbidity and death in the post-neonatal period and throughout infancy and childhood. The protective effect is particularly strong against infectious diseases that are prevented through both direct transfer of antibodies and other anti-infective factors and long-lasting transfer of immunological competence and memory. See WHO Essential newborn care and breastfeeding (241). Therefore, standard infant feeding guidelines should be followed with appropriate precautions for IPC.”
WHO FAQ & DECISION TREE: BREASTFEEDING AND COVID-19 FOR HEALTH CARE WORKERS
“The interim guidance and FAQ reflect:
i. the available evidence regarding transmission risks of COVID-19 through breastmilk;
ii. the protective effects of breastfeeding and skin-to-skin contact, and,
iii. the harmful effects of inappropriate use of infant formula milk.The FAQ also draws on other WHO recommendations on Infant and Young Child Feeding and the Interagency
Working Group Operational Guidance on Infant and Young Child Feeding in Emergencies. A decision tree shows
how these recommendations may be implemented by health workers in maternity services and community
settings, as part of daily work with mothers and families.”
(Dated 28 April 20, Accessed 28 April 20)
WORLD HEALTH ORGANIZATION (WHO) INTERIM GUIDANCE ON CLINICAL MANAGEMENT OF SEVERE ACUTE RESPIRATORY INFECTION (SARI) WHEN COVID-19 DISEASE IS SUSPECTED:
“Infants born to mothers with suspected, probable, or confirmed COVID-19 should be fed according to standard infant feeding guidelines, while applying necessary precautions for IPC.”
“As with all confirmed or suspected COVID-19 cases, symptomatic mothers who are breastfeeding or practising skin-to-skin contact or kangaroo mother care should practise respiratory hygiene, including during feeding (for example, use of a medical mask when near a child if the mother has respiratory symptoms), perform hand hygiene before and after contact with the child, and routinely clean and disinfect surfaces with which the symptomatic mother has been in contact.”
“Breastfeeding counselling, basic psychosocial support, and practical feeding support should be provided to all pregnant women and mothers with infants and young children, whether they or their infants and young children have suspected or confirmed COVID-19.”
“In situations when severe illness in a mother with COVID-19 or other complications prevents her from caring for her infant or prevents her from continuing direct breastfeeding, mothers should be encouraged and supported to express milk, and safely provide breastmilk to the infant, while applying appropriate IPC measures.”
“Mothers and infants should be enabled to remain together and practise skin-to-skin contact, kangaroo mother care and to remain together and to practise rooming-in throughout the day and night, especially immediately after birth during establishment of breastfeeding, whether they or their infants have suspected, probable, or confirmed COVID-19.”
“Parents and caregivers who may need to be separated from their children, and children who may need to be separated from their primary caregivers, should have access to appropriately trained health or non-health workers for mental health and psychosocial support.”
Download the document “Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected” here.
(interim guidance dated 13 March; accessed 14 March 20)
WORLD HEALTH ORGANIZATION (WHO) GUIDANCE ON BREASTFEEDING WITH SUSPECTED COVID-19 WITH MILD SYMPTOMS
“Considering the benefits of breastfeeding and the insignificant role of breast milk in the transmission of other respiratory viruses, a mother could can [sic] continue breastfeeding. The mother should wear a medical mask when she is near her baby and perform hand hygiene before and after having close contact with the baby. She will also need to follow the other hygiene measures described in this document.”
Download the document “Home care for patients with suspected novel coronavirus (COVID-19) infection presenting with mild symptoms, and management of their contacts” in Chinese, English, French and Spanish here.
(interim guidance dated 4 February; accessed 12 March 20)
WHO Q&A ON COVID-19, PREGNANCY, CHILDBIRTH, AND BREASTFEEDING
“Can women with COVID-19 breastfeed?
Yes. Women with COVID-19 can breastfeed if they wish to do so. They should:
Practice respiratory hygiene during feeding, wearing a mask where available;
Wash hands before and after touching the baby;
Routinely clean and disinfect surfaces they have touched.”
(Q&A dated 18 March 20; accessed 23 March 20)
WHO POSITION PAPER - COVID-19 AND BREASTFEEDING (2020)
“Breastmilk is the best source of nutrition for infants, including infants whose mothers have confirmed or suspected coronavirus infection. As long as an infected mother takes appropriate precautions—outlined in this paper—she can breastfeed her baby. Breastmilk contains antibodies and other immunological benefits that can help protect against respiratory diseases. A growing body of evidence supports the importance of breastfeeding for a child’s growth, development, and health, as well as for helping them avoid obesity and noncommunicable diseases later in life.”
(Accessed 22 April 20)
UNICEF GUIDANCE FOR PARENTS
“To support implementers on how to prepare and respond to the COVID-19 pandemic, a series of evidenceinformed guidance briefs will be produced and updated every ten (10) days as new information and evidence emerges.”
Access the 30 March 20 version here.
(dated 30 March 20; accessed 6 April 20)
“All mothers in affected and at-risk areas who have symptoms of fever, cough or difficulty breathing, should seek medical care early, and follow instructions from a health care provider. Considering the benefits of breastfeeding and the insignificant role of breastmilk in the transmission of other respiratory viruses, the mother can continue breastfeeding, while applying all the necessary precautions. For symptomatic mothers well enough to breastfeed, this includes wearing a mask when near a child (including during feeding), washing hands before and after contact with the child (including feeding), and cleaning/disinfecting contaminated surfaces – as should be done in all cases where anyone with confirmed or suspected COVID-19 interacts with others, including children. If a mother is too ill, she should be encouraged to express milk and give it to the child via a clean cup and/or spoon – all while following the same infection prevention methods.”
Find UNICEF’s page on Coronavirus disease (COVID-19): What parents should know: How to protect yourself and your children here.
(accessed 12 March 20)
“Evidence is overwhelmingly in support of breastfeeding. The transmission of COVID-19 through breastfeeding or by giving breastmilk has not been detected. Breastfeeding and skin-to-skin contact and early, exclusive breastfeeding helps your baby to thrive and provides lifelong health benefits.”
Find the article from UNICEF here: Breastfeeding safely during the COVID-19 pandemic
(published 29 July 2021; accessed 1 September 2021)
UNICEF UK BABY FRIENDLY INITIATIVE STATEMENT ON INFANT FEEDING ON NEONATAL UNITS DURING THE CORONAVIRUS (COVID-19) OUTBREAK
This document provides guidance on use of breastmilk and breastfeeding, supporting close and loving relationships, practical considerations, and donor breastmilk.
“There is a wealth of evidence that breastmilk and breastfeeding reduces the risk of babies developing infectious diseases.”
(Updated 2 April 20, Accessed 22 April 20)
UNITED NATIONS POPULATION FUND (UNFPA) STATEMENT ON PREGNANCY (INCLUDES INFORMATION ON LACTATING FAMILIES)
“Breastfeeding women should not be separated from their newborns, as there is no evidence to show that respiratory viruses can be transmitted through breast milk, according to UNICEF. The mother can continue breastfeeding, as long as the necessary precautions below are applied:
Provision of mental health and psychosocial support for affected individuals, families, communities and health workers is a critical part of the response.”
And the related press release here
(statement dated 5 March 2020; accessed 12 March 20)
WORLD ALLIANCE FOR BREASTFEEDING ACTION (WABA) CORONAVIRUS DISEASE (COVID-19) AND BREASTFEEDING
“Publications and resources from organisations related to the Coronavirus disease (COVID-19) and breastfeeding.”
(Accessed 4 September 20)
PATH GUIDANCE ON ALIGNING BEST PRACTICES AND ADDRESSING MISINFORMATION FOR OPTIMAL INFANT FEEDING DURING THE COVID-19 PANDEMIC
“During the COVID-19 pandemic, there is also an overabundance of information, an infodemic, circulating about the virus and infant feeding. This brief provides accurate information regarding breastfeeding and COVID-19 and addresses ways for protecting yourself from mis- or disinformation.”
(Published January 2021; accessed 3 February 2021)
BREASTFEEDING AND COVID-19: SCIENTIFIC BRIEF (WHO)
“WHO recommends that mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue to breastfeed. Mothers should be counselled that the benefits of breastfeeding substantially outweigh the potential risks for transmission.
Mother and infant should be enabled to remain together while rooming-in throughout the day and night and to practice skin-to-skin contact, including kangaroo mother care, especially immediately after birth and during establishment of breastfeeding, whether they or their infants have suspected or confirmed COVID-19.”
(published 23 June 2020; accessed 1 September 2021)
FREQUENTLY ASKED QUESTIONS: BREASTFEEDING AND COVID-19 FOR HEALTH CARE WORKERS (WHO)
Answers key questions for health care workers.
(published 12 May 2020; accessed 1 September 2021)
COUNSELING CARDS CARDS (UNICEF AND USAID ADVANCING NUTRITION)
Infant and Young Child Feeding Recommendations When COVID-19 is Suspected or Confirmed.
Access the counseling cards here.
(accessed 1 September 2021)
ADVOCACY MESSAGES ON BREASTFEEDING AND COVID-19 (GLOBAL BREASTFEEDING COLLECTIVE)
Find messages for families, health care providers, and governments.
(Published 8 May 2020; accessed 1 September 2021)
UNICEF POSITION REGARDING CLOSE CONTACT AND BREASTFEEDING IN COVID-19 CONTEXT
“In the context of COVID19, there is no evidence that the illness can be transmitted through the breastmilk, hence the recent guidance is that women with COVID-19 are recommended to continue breastfeeding (early exclusive breastfeeding from birth to 6 months and then continuing up to 2 years of age and beyond), but they should take precautions, including practicing respiratory hygiene during feeding, including wearing a mask covering mouth and nose, washing hands with soap and water for 20 seconds before and after touching the baby and, routinely cleaning and disinfecting surfaces they have touched. “
Access the press release here.
(published 10 April 2020; 1 September 2021)
Grouped by World Health Organization Regions
VACCINATION OVERVIEW
Available Vaccines as of 1/11/21: AstraZeneca, CoronaVac
Cadernos de Saúde Pública: “January 11, 2021: Most of the trials have been done in populations over 18 years of age, so the vaccines cannot be used in children, adolescents, or pregnant and breastfeeding women.”
(Published 11 January 2021; accessed 4 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 3/1/21: AstraZeneca, Pfizer, Moderna
Government of Canada: “NACI recommends that a complete vaccine series with a COVID-19 vaccine may be offered to pregnant individuals in the authorized age group if a risk assessment deems that the benefits outweigh the potential risks for the individual and the fetus, and if informed consent includes discussion about the absence of evidence on the use of COVID-19 vaccine in this population. (Discretionary NACI Recommendation).”
(Published 1 March 2021; accessed 18 February 2021)
CBC News: “After careful review, women who are pregnant and breastfeeding will no longer be excluded from receiving COVID-19 vaccinations. They will be able to make an informed decision for themselves after consulting with a health-care provider about the benefits and risks.”
(Published 8 January 2021; accessed 18 February 2021)
PUBLIC HEALTH AGENCY OF CANADA (PHAC) CASE MANAGEMENT IN THE HOME AND CO-LIVING SETTINGS (SELF-ISOLATION)
“For breastfeeding mothers: considering the benefits of breastfeeding and the insignificant role of breast milk in transmission of other respiratory viruses, breastfeeding can continue. If the breastfeeding mother is a case, she should wear a surgical/procedure mask when near the baby, practice respiratory etiquette, and perform hand hygiene before and after close contact with the baby.”
Find the interim guidance here in English and here in French.
(guidance issued 3 March 20; accessed 12 March 20)
BRITISH COLUMBIA CENTRE FOR DISEASE CONTROL (BCCDC) INTERIM GUIDANCE: PUBLIC HEALTH MANAGEMENT OF CASES AND CONTACTS ASSOCIATED WITH NOVEL CORONAVIRUS (COVID-19) IN THE COMMUNITY
“For breastfeeding mothers: considering the benefits of breastfeeding and the insignificant role of breast milk in transmission of other respiratory viruses, breastfeeding can continue. If the breastfeeding mother is a case, she should wear a surgical/procedure mask when near the baby, practice respiratory etiquette, and perform hand hygiene before and after close contact with the baby.”
Access the interim guidance here.
(guidance issued 10 March 20; accessed 13 March 20)
UPDATED SOGC COMMITTEE OPINION – COVID-19 IN PREGNANCY
(dated 13 March 20; accessed 22 April 20)
REVISED SOGC INFECTIOUS DISEASE COMMITTEE STATEMENT ON HEALTH CARE WORKERS DURING THE COVID-19 PANDEMIC
“For these reasons, pregnant women in essential services, including HCW, can continue to work during the COVID-19 pandemic. In situations where a worker may be exposed to a person who is suspect or confirmed to have COVID-19, appropriate personal protective equipment should be used. No additional PPE measures are required for pregnant HCW beyond those that are advised for non-pregnant HCW. Given that the data on COVID-19 during pregnancy is in its infancy, where staffing allows, avoiding unnecessary exposure to patients with suspected or known COVID-19 should be considered.”
(dated 27 March 20; accessed 22 April 20)
CANADIAN PAEDIATRIC SOCIETY’S PRACTICE POINT: BREASTFEEDING WHEN MOTHERS HAVE SUSPECTED OR PROVEN COVID-19
“Mothers with suspected or proven COVID-19 and their infants should not be completely separated. Mothers and infants should be allowed to remain together, after potential risks and benefits of rooming-in have been discussed and allowing for shared decision-making with families and their health care providers.”
“Mothers can practice skin-to-skin care and breastfeed while in hospital with some modifications to usual processes.”
“Currently, the Public Health Agency of Canada (PHAC) and the World Health Organization (WHO) recommend that mothers with suspected or proven COVID-19 continue to breastfeed. The U.S. Centers for Disease Control (CDC) recommends that mothers and their health care providers discuss the benefits and risks of breastfeeding, given the uncertainty around transmission of SARS-CoV-2, and come to a shared decision.”
“The current evidence available to inform decision-making is limited. A 2003 study describes the experience of 12 women with SARS and the outcomes of their newborns. None of the infants who were breastfed went on to develop SARS. Similarly, a recent small-sample-size study that tested breast milk directly found no positive tests for SARS-CoV-2, suggesting that the virus does not pass into breast milk. Importantly, maternal antibodies to SARS-CoV-2 are likely passed to the newborn and offer a protective benefit, as was documented for SARS.”
“At this point, the primary concern is that the virus will be transmitted from mother to infant through respiratory droplets during breastfeeding. Women who choose to breastfeed should wear a mask (if available), wash their hands, and clean their breast area with soap and water before each feeding. Mothers may also choose to pump—ensuring that they wash their hands, and clean all equipment–and then feed their infant expressed breastmilk. At home, frequently touched household surfaces should also be disinfected regularly. Symptomatic individuals should not be allowed to visit with mother and baby.”
Find the full practice point here.
(dated 6 April 20; accessed 10 April 20)
VACCINATION OVERVIEW
Available Vaccines: AstraZeneca, Pfizer, CoronaVac
Ministerio de Salud: “In the case of breastfeeding women, it should be analyzed whether the benefits of vaccination against COVID-19 outweigh the risks of inoculation, being able to choose to receive the vaccine after receiving counseling on the lack of evidence on the safety and efficacy of the vaccine. COVID-19 vaccine in that group.”
(Accessed 12 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/22/21: Pfizer, CanSino, CoronaVac, AstraZeneca, Sputnik
Secretaria de Salud & Centro Nacional Para La Salud de la Infancia y la Adolescencia: “Se subraya, que pueden vacunarse las mujeres que lactan a su bebé y no se recomienda suspender la lactancia al bebé ni antes, ni después de que se aplique este biológico a sus madres.”
(Accessed 22 February 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/22/21: Pfizer, Sinopharm
Ministerio de Salud:
“For this first phase, the Sinopharm laboratory vaccine will be applied, which has emergency approval and is an inactivated version of the coronavirus (SARS-CoV-2). Who should not get vaccinated with the Sinopharm vaccine?
People who are allergic to any component (active and excipients) of this product, or those who have already had allergic reactions to this vaccine.
People who have serious chronic illnesses or a history of hypersensitivity.
Vaccination should be postponed if individuals have a fever or during an acute phase of illness.
Fertility, pregnancy and lactation It is not known whether the vaccine can harm the fetus when administered to a pregnant woman or affect reproductive capacity.
The vaccine should only be given to pregnant women who really need it.”
(Accessed 22 February 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/12/21: Pfizer, Moderna, Johnson&Johnson
Centers for Disease Control and Prevention: “There are neither data on the safety of COVID-19 vaccines in lactating women nor on the effects of mRNA vaccines on the breastfed infant or on milk production/excretion. mRNA vaccines are not thought to be a risk to the breastfeeding infant. People who are breastfeeding and are part of a group recommended to receive a COVID-19 vaccine, such as healthcare personnel, may choose to be vaccinated.”
(Published 12 February 2021; accessed 18 February 2021)
AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS PRACTICE ADVISORY: VACCINATING PREGNANT AND LACTATING PATIENTS AGAINST COVID-19
“COVID-19 vaccines should be offered to lactating individuals similar to non-lactating individuals when they meet criteria for receipt of the vaccine based on prioritization groups outlined by the Advisory Committee on Immunization Practices (ACIP).”
Access the practice advisory here.
Published 13 December 20, Accessed 14 December 20
CENTER FOR DISEASE CONTROL SLIDES: USE OF PFIZER-BIONTECH COVID-19 VACCINE: CLINICAL CONSIDERATIONS
Published 12 December 20, Accessed 14 December 20
INFANT RISK CENTER: COVID-19 VACCINE IN PREGNANCY AND BREASTFEEDING
“Similar to other medications, pregnant and/or breastfeeding women have not been included in studies to determine how well COVID vaccines work or how safe they are. Based on what we understand from similar vaccines, we believe the risks that come with vaccination will probably be low. Therefore, while we wait for more information, each mother and provider should discuss what choice fits their situation best.”
Find an explanation of how the vaccine works here and why IFC says “it is our opinion that most of the COVID-19 vaccines are probably going to be quite safe for breastfeeding mothers and their infants.”
Accessed 14 December 20
UNITED STATES LACTATION CONSULTANT ASSOCIATION STATEMENT ON VACCINATION FOR LACTATION CARE PROVIDERS
“While USLCA recognizes the need for a strategized distribution of the vaccine based on risk, we strongly urge for lactation care providers working directly with lactating parents and babies be included in the same dissemination tier as birth workers, including, but not limited to: OB/GYN physicians, OB and NICU nurses, and midwives, regardless of work setting.”
Published 14 December 20, accessed 17 December 20
LER: HOW CAN LACTATION CONSULTANTS ACCESS THE COVID VACCINE?
“Lactation consultants provide healthcare to patients, with a level of direct exposure to patients equal to or higher than many of the personnel listed. While the list does not explicitly include lactation consultants, it names a number of similar professions and states that it is not limited to only the roles named.”
(Published 5 January 2021; accessed 11 January 2021)
AJOG RESEARCH ON LACTATION, PREGNANCY AND COVID MRNA VACCINES
“COVID-19 mRNA vaccines generated robust humoral immunity in pregnant and lactating women, with immunogenicity and reactogenicity similar to that observed in non-pregnant women. Vaccine-induced immune responses were significantly greater than the response to natural infection. Immune transfer to neonates occurred via placenta and breastmilk.”
(Published 25 March 2021; accessed 29 March 2021)
CDC: COVID-19 VACCINES WHILE PREGNANT OR BREASTFEEDING
“COVID-19 vaccination is recommended for all people 12 years and older, including people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.
“Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing. These data suggest that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy.”
(Published 11 August 2021; accessed 9 September 2021)
UNITED STATES CENTERS FOR DISEASE CONTROL (CDC): INTERIM GUIDANCE FOR HEALTHCARE WORKERS ON CARE FOR BREASTFEEDING WOMEN
Provides information for “for healthcare providers and lactation specialists who care for breastfeeding people as well as infants and children who receive breast milk feeds during the COVID-19 pandemic.”
Includes infection prevention and control measures for visits in both the healthcare and home settings.
Published 16 November 20, Accessed 17 November 20
UPDATES TO THE CDC "EVALUATION AND MANAGEMENT CONSIDERATIONS FOR NEONATES AT RISK FOR COVID-19"
AMERICAN ACADEMY OF PEDIATRICS FAQS: MANAGEMENT OF INFANTS BORN TO MOTHERS WITH SUSPECTED OR CONFIRMED COVID-19
UNITED STATES CENTERS FOR DISEASE CONTROL (CDC) INTERIM GUIDANCE ON BREASTFEEDING FOR A MOTHER CONFIRMED OR UNDER INVESTIGATION FOR COVID-19
“Breast milk is the best source of nutrition for most infants. However, much is unknown about COVID-19. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and healthcare providers. A mother with confirmed COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.”
(Published/revised Wednesday 10 February 20; accessed 13 March 20)
UNITED STATES CENTERS FOR DISEASE CONTROL (CDC) INTERIM CONSIDERATIONS FOR INFECTION PREVENTION AND CONTROL OF 2019 CORONAVIRUS DISEASE 2019 (COVID-19) IN INPATIENT OBSTETRIC HEALTHCARE SETTINGS
“The many benefits of mother/infant skin-to-skin contact are well understood for mother-infant bonding, increased likelihood of breastfeeding, stabilization of glucose levels, and maintaining infant body temperature and though transmission of SARS-CoV-2 after birth via contact with infectious respiratory secretions is a concern, the risk of transmission and the clinical severity of SARS-CoV-2 infection in infants are not clear.
The determination of whether or not to separate a mother with known or suspected COVID-19 and her infant should be made on a case-by-case basis using shared decision-making between the mother and the clinical team. Considerations in this decision include: . . . a desire to feed at the breast.”
“If temporary separation is undertaken, mothers who intend to breastfeed should be encouraged to express their breast milk to establish and maintain milk supply. If possible, a dedicated breast pump should be provided. Prior to expressing breast milk, mothers should practice hand hygiene.1 After each pumping session, all parts that come into contact with breast milk should be thoroughly washed and the entire pump should be appropriately disinfected per the manufacturer’s instructions. This expressed breast milk should be fed to the newborn by a healthy caregiver.”
“If a mother with known or suspected COVID-19 and her infant do room-in and the mother wishes to feed at the breast, she should put on a face mask and practice hand hygiene before each feeding.”
(Published/revised 4 April 20; accessed 9 April 20)
ACADEMY FOR BREASTFEEDING MEDICINE (ABM) STATEMENT ON CORONAVIRUS 2019 (COVID-19)
“Breast milk provides protection against many illnesses. There are rare exceptions when breastfeeding or feeding expressed breast milk is not recommended. CDC has no specific guidance for breastfeeding during infection with similar viruses like SARS-CoV or Middle Eastern Respiratory Syndrome (MERS-CoV) also both Corona viruses. In a similar situation to COVID-19, the CDC recommends that a mother with flu continue breastfeeding or feeding expressed breast milk to her infant while taking precautions to avoid spreading the virus to her infant. Given low rates of transmission of respiratory viruses through breast milk, the World Health Organization states that mothers with COVID-19 can breastfeed.”
The complete statement also includes guidance for both home and hospital.
“…In Hospital:
The choice to breastfeed is the mother’s and families. If the mother is well and has only been exposed or is a PUI with mild symptoms, breastfeeding is a very reasonable choice and diminishing the risk of exposing the infant to maternal respiratory secretions with use of a mask, gown and careful handwashing is relatively easy. If the mother has COVD-19, there may be more worry, but it is still reasonable to choose to breastfeed and provide expressed milk for her infant. Limiting the infant’s exposure via respiratory secretions may require more careful adherence to the recommendations depending on the mother’s illness. …”
(Published/revised Tuesday 10 March 20; accessed 13 March 20)
ACADEMY FOR BREASTFEEDING MEDICINE (ABM) BREASTFEEDING AND RESPIRATORY ANTIVIRALS: CORONAVIRUS AND INFLUENZA – BREASTFEEDING MEDICINE
“The short answer to questions regarding drug therapy for COVID-19 is that currently there is no antiviral agent proven to be effective against this new infection. However, one investigational drug so far, remdesivir, appears promising to treat COVID-19, and it is in phase 3 clinical trials in patients. Dr. Anderson notes: “Nothing is known about the passage of remdesivir into breastmilk.””
(Published/revised Thursday 27 February 20; accessed 13 March 20)
ACADEMY FOR BREASTFEEDING MEDICINE (ABM) NEWS RELEASE: CORONAVIRUS TREATMENT AND RISK TO BREASTFEEDING WOMEN — MARY ANN LEIBERT INC. PUBLISHERS
Arthur I. Eidelman, MD, Editor-in-Chief of Breastfeeding Medicine, states: “Given the reality that mothers infected with coronavirus have probably already colonized their nursing infant, continued breastfeeding has the potential of transmitting protective maternal antibodies to the infant via the breast milk. Thus, breastfeeding should be continued with the mother carefully practicing handwashing and wearing a mask while nursing, to minimize additional viral exposure to the infant.”
Access the press release here.
(Published/revised Tuesday 4 March 20; accessed 13 March 20)
AMERICAN ACADEMY OF PEDIATRICS BREASTFEEDING GUIDANCE POST HOSPITAL DISCHARGE
“This guidance was developed to support pediatricians providing direct care for breastfeeding families after discharge from the newborn hospital stay. Breastfeeding concerns during the first few weeks are associated with a decreased duration of breastfeeding (especially concerns about sore nipples/difficulties latching, low milk supply, and medications). A mother with significant coronavirus disease 2019 (COVID-19) illness may have been separated from her newborn infant after birth or experienced other events that have affected breastfeeding. The American Academy of Pediatrics (AAP) strongly supports breastfeeding as the best choice for infant feeding. Several published studies have detected SARS-CoV-2 nucleic acid in human milk. It is not yet known whether viable, infectious virus is present in human milk nor is it yet established whether protective antibody is found in human milk. In light of the established short- and long-term benefits of breastfeeding, physicians should advocate for and encourage breastfeeding. Postdischarge guidance and education are essential to support families, ensure the health of mothers and infants, and ensure mothers are able to reach their breastfeeding goals.”
(dated 29 July 20, accessed 4 September 20)
AMERICAN SOCIETY OF OBSTETRICIANS AND GYNECOLOGISTS (ACOG) PRACTICE ADVISORY: NOVEL CORONAVIRUS 2019 (COVID-19)
“The CDC has developed Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation for COVID-19. There are rare exceptions when breastfeeding or feeding expressed breast milk is not recommended. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and health care practitioners. Currently, the primary concern is not whether the virus can be transmitted through breastmilk, but rather whether an infected mother can transmit the virus through respiratory droplets during the period of breastfeeding. A mother with confirmed COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while breastfeeding. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant. In limited case series reported to date, no evidence of virus has been found in the breast milk of women infected with COVID-19; however, it is not yet known if COVID-19 can be transmitted through breast milk (ie, infectious virus in the breast milk).”
Access the practice advisory here.
(Published/revised Tuesday 10 March 20; accessed 13 March 20)
INITIAL GUIDANCE: MANAGEMENT OF INFANTS BORN TO MOTHERS WITH COVID-19, AMERICAN ACADEMY OF PEDIATRICS COMMITTEE ON FETUS AND NEWBORN, SECTION ON NEONATAL PERINATAL MEDICINE, AND COMMITTEE ON INFECTIOUS DISEASES
“[For mothers with COVID-19 or PUI] the likely benefits of temporary maternal and newborn separation at birth for decreasing the risk of newborn infection should be discussed with the mother, optimally prior to delivery.
No study to date has demonstrated the presence of SARS-CoV-2 in breast milk (Table 1). [Mothers with COVID-19 or PUI] may express breast milk (after appropriate breast and hand hygiene) and this milk may be fed to the infant by designated caregivers. Breast pumps and components should be thoroughly cleaned in between pumping sessions using standard center policies that must include cleaning the pump with disinfectant wipes and washing pump attachments with hot soapy water.
In addition to the known benefits of breastfeeding, mothers’ milk may provide infant protective factors after maternal COVID-19. Promoting breast milk feeding and supporting establishment of maternal milk supply may offer additional benefits to well and sick newborns.”
Find the initial guidance here.
(dated 2 April 20, accessed 6 April 20)
NATIONAL PERINATAL ASSOCIATION COVID-19 RESOURCES
“As our community prepares to face a new and novel virus we need to be prepared – not just for the virus but for people’s anxieties and fears.
“One of the most important things we can do as providers and advocates is to empower people with information. When we all have the facts it’s easier for us to make informed decisions.
“We can help address anxieties and fears by:
“Use the resources listed here to support your efforts.”
(Accessed 4 September 20)
NATIONAL PERINATAL ASSOCIATION SHARED DECISION MAKING JOINT POSITION STATEMENT
“The National Association of Neonatal Nurses (NANN) and the National Perinatal Association (NPA) fully support the incorporation of a shared-decision model between the mother and the clinical team to determine the best care for the mother-newborn dyad.
“NANN and NPA encourage the ideal scenario, which is to keep mother and newborn together while respecting the unique challenges individual institutions may encounter.
“While we recognize the myriad uncertainties in understanding the best evidence-based practice for the mothernewborn dyad during the postpartum period, we encourage families and clinicians to remain diligent in learning up-to-date evidence and ultimately working in partnership for the safest and best practice for all parties involved.
“NANN and NPA acknowledge the potential trauma and exacerbation of postpartum mental health issues that may negatively impact the fourth trimester.
“We encourage healthcare providers to assist the mother to recognize the ideal versus realistic scenarios, acknowledge the uncertainty and grief over changing expectations, and consider higher-touch care in the weeks following delivery.”
Access the position statement here.
(Accessed 4 September 20)
UNITED STATES BREASTFEEDING COMMITTEE: INFANT AND YOUNG CHILD FEEDING IN EMERGENCIES, INCLUDING COVID-19
“Why is your action today so important? The COVID-19 pandemic has created seismic shifts in the infant and young child feeding landscape with dangerous compromises to the initiation and establishment of breastfeeding.
“To document how breastfeeding families have been impacted, the USBC is publishing a series of documents titled “Voices from the Field: COVID-19 and Infant Feeding.” These publications aim to demonstrate the impact of the pandemic and associated policy responses on the infant feeding experience.”
(Updated 14 August 20, Accessed 4 September 20)
VACCINATION OVERVIEW
Available Vaccines as of 2/16/2021: Johnson&Johnson, AstraZeneca
Messages for Mothers: “February 16, 2021: Yes, there are no risks for the baby if a breastfeeding mother gets vaccinated against COVID-19. There may be benefits for the baby if the mother is vaccinated. However, breastfeeding mothers have not so far been identified as a priority group for vaccination, and so they will have to wait their turn to be vaccinated unless they fall into a priority group (such as health care workers).”
(Published 16 February 2021; accessed 12 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 1/14/21: Oxford-AstraZenica (Covishield), Covaxin
Government of India, Ministry of Health & Family Welfare: “As of Jan 14, 2021 the Ministry of Health and Family Welfare has informed all states and union territories that women who are breastfeeding or pregnant are not allowed to take the COVID vaccine as they have not been part of any anti-coronavirus vaccine clinical trial so far.”
(Published 14 January 2021; Accessed 17 February 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/11/21: CoronaVac
Netral News: “The National Immunization Expert Advisory Committee has submitted a study that Covid-19 vaccination can be given to the age group of 60 years and over, comorbid, Covid-19 survivors and breastfeeding mothers.”
(Published 11 February 2021; accessed 17 February 2021)
VACCINATION OVERVIEW
Available Vaccines: Pfizer, Moderna, AstraZeneca
Initiative Österreich Impft.: “Breastfeeding mothers can get vaccinated. The vaccine does not pass into breast milk. Source: AGES, MedUni Vienna.”
(Accessed 8 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/28/21: Pfizer, Moderna, AstraZeneca, Johnson&Johnson
The Brussels Times: “February 28, 2021: Vaccination prevents severe forms of COVID-19 and premature births as well as maternal and perinatal mortality,” they noted further. “Moreover, the antibodies are passed on during pregnancy and breastfeeding, which protects the baby.”
On the other hand, the CSS does not object to the systematic vaccination of women of child-bearing age or those who wish to be pregnant. It also says that all nursing mothers should be given the vaccine.”
(Published 28 February 2021; accessed 11 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 3/9/2021: Pfizer, Moderna, AstraZeneca, Johnson&Johnson
Danish Health Authority: “If you are pregnant or breastfeeding, you should not be vaccinated, except in exceptional circumstances – for example, if you suffer from severe illness.”
(Publish 9 March 2021; accessed 10 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/8/21: Pfizer, Moderna, AstraZeneca, Johnson&Johnson
France 24: “No adverse side effects were reported in pregnant women who took part in the clinical trials, be it with regard to the pregnancy itself or in the development of the foetus during the preclinical trials led by Pfizer and Moderna on animals. However, pregnant women are currently excluded from the vaccination campaign while targeted studies are conducted. According to the European Medicines Agency, vaccination will only be considered once the expected benefit exceeds the potential risk. As far as breastfeeding is concerned, there is not yet data on the vaccine’s potential to transfer into breastmilk after the mother is inoculated.”
(Published 8 February 2021; Accessed 12 March 2021)
VACCINATION OVERVIEW
Available Vaccines: Pfizer, Moderna, AstraZeneca, Johnson&Johnson
VACCINATION OVERVIEW
Available Vaccines: Pfizer, Moderna, AstraZeneca
VACCINATION OVERVIEW
Available Vaccines: BIBP, Pfizer, Moderna, AstraZeneca, Sputnik
VACCINATION OVERVIEW
Available Vaccines as of 3/14/21: Pfizer, Moderna, AstraZeneca, Johnson&Johnson
Our Health Service: “There’s no evidence that COVID-19 vaccination is unsafe if you’re pregnant. There is also no known reason to avoid breastfeeding if you are vaccinated. The vaccines were not widely tested on pregnant or breastfeeding women so the evidence available at this time is limited. If you are a healthcare worker or at high risk and you are pregnant, you should talk to your obstetrician or GP about getting your COVID-19 vaccine.”
(Published 14 March 2021; Accessed 11 March 2021)
VACCINATION OVERVIEW
Ministry of Health: “Israel’s Health Ministry and council for gynecological health updated its guidance to recommend the coronavirus vaccine for pregnant and lactating women, especially those with preexisting health issues or who work in close contact with the public.”
(Published 28 January 2021; Accessed 19 February 2021)
L’EPIDEMIOLOGIA PER LA SANITÀ PUBBLICA – ISTITUTO SUPERIORE DI SANITÀ (ITALIAN NATIONAL INSTITUTE OF HEALTH) COVID-19: PREGNANCY, DELIVERY AND BREASTFEEDING
“The clinical, organizational and logistical management of mothers and infants represents a challenge for health services already overloaded with emergency management. Moreover, different institutions and authors seem to apply the precautionary principle differently, in light of the same limited evidence. Whenever possible, it is essential to preserve the physiology of childbirth, the mother-child relationship and breastfeeding that, even in uncertainty, guarantee a protective potential for the newborn, widely documented in the literature, including previous SARS or MERS epidemics.
In this state of uncertainty, providing convincing and undisputable recommendations for SARS-COV-2 positive mothers and/or for those with Covid-19 clinical symptoms is challenging. Therefore, a multidisciplinary case-by-case assessment is desirable and recommended. Notably, the best care approach can be reached by taking into account the maternal exposure time to the coronavirus, the gestational age, the ongoing treatment, the individual immune response situation and all the variables that can influence the clinical condition.”
(dated 5 March 20; accessed 13 March 20)
AD INTERIM INDICATIONS OF THE ITALIAN SOCIETY OF NEONATOLOGY ENDORSED BY THE UNION OF EUROPEAN NEONATAL & PERINATAL SOCIETIES
“If a mother previously identified as COVID‐19 positive or under investigation for COVID‐19 is asymptomatic or paucisymptomatic at delivery, rooming‐in is feasible and direct breastfeeding is advisable, under strict measures of infection control.
On the contrary, when a mother with COVID‐19 is too sick to care for the newborn, the neonate will be managed separately and fed fresh expressed breast milk, with no need to pasteurize it, as human milk is not believed to be a vehicle of COVID‐19.”
Find the Ad interim indications here.
(dated 3 April 20; accessed 6 April 20)
VACCINATION OVERVIEW
Available Vaccines as of 3/15/21: Pfizer, Moderna, AstraZeneca, Johnson&Johnson
National Institute for Public Health and the Environment: “Can I breastfeed after being vaccinated? Yes, you can. There are no indications the vaccine enters breast milk or reaches the child through breastfeeding.”
(Published 15 March 2021; accessed 11 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/16/21: Pfizer, Moderna, AstraZeneca
Medicover: “The vaccine has been tested on a group of over 43,000 individuals aged 16-65. In certain patient groups, its safety has not been tested. Therefore, vaccination is not recommended for: children and youths under 16 years of age; pregnant women and women who plan to get pregnant (they should not get pregnant for at least two months after taking a second dose of the vaccine); breastfeeding women.”
(Published 16 February 2021; accessed 12 March 2021)
VACCINATION OVERVIEW
Available Vaccines: Pfizer, AstraZeneca, Moderna
VACCINATION OVERVIEW
Available Vaccines: Pfizer, Moderna, AstraZeneca, Johnson&Johnson
VACCINATION OVERVIEW
Available Vaccines as of 3/16/21: Pfizer, Moderna
Schweizerische Eidgenossenschaft: “(Translated by the Family Larsson-Rosenquist Foundation) Can a mother get vaccinated after giving birth and during lactation? According to current knowledge, a mother can get vaccinated immediately after giving birth to her baby. A risk for the breastfed infant due to the vaccination of the mother is unlikely.”
(Published 16 March 2021; Accessed 11 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 1/8/21: Pfizer, Moderna, AstraZeneca
The BMJ: “The Royal College of Obstetricians and Gynaecologists (RCOG) said that the new guidance meant that pregnant women who were frontline health or social care workers could discuss the option of vaccination. It also meant that frontline health and care workers who were breastfeeding should be offered vaccination.”
(Published 8 January 2021; Accessed 8 March 2021)
HOSPITAL INFANT FEEDING NETWORK (HIFN) FACT SHEET ON USE OF COVID-19 VACCINATIONS IN BREASTFEEDING AND PREGNANCY
“In the UK there have been some changes surrounding the use of Covid-19 vaccinations in breastfeeding and pregnancy, which has led to confusion for some. This factsheet will outline the current position (January 2021) and some background information.”
(Published January 21; accessed 12 February 21)
ROYAL COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS (RCOG) NATIONAL GUIDANCE ON MANAGING CORONAVIRUS INFECTION IN PREGNANCY
Access the national guidance here.
(dated 9 March 20; accessed 13 March 20)
ROYAL COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS (RCOG) CORONAVIRUS (COVID-19) INFECTION IN PREGNANCY: INFORMATION FOR HEALTH CARE PROFESSIONALS
VACCINATION OVERVIEW
Available Vaccines as of 2/14/21: Sinopharm, Sputnik
Ahram Online: “February 14, 2021: According to guidelines issued by the WHO, the following categories are not allowed to take the COVID-19 vaccine due to either adverse reactions or insufficient research results:
(Published 14 February 2021; Accessed 1 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/6/21: BIBP, CanSino, AstraZeneca, Sputnik
SAMAA: “Feb 6, 2021: SinoPharm Specific: The COVID-19 vaccine is not recommended for pregnant and breastfeeding women because clinical trials worldwide did not involve this group and therefore it is difficult to predict safety.”
(Published 6 February 2021; accessed 6 April 2021)
Government of Pakistan, Ministry of National Health Services: “April 1, 2021: Sputnik Specific: Breastfeeding • It is unknown whether Sputnik V is excreted in human milk. It should be avoided.”
(Published 1 April 2021; accessed 6 April 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/22/21: Pfizer
Ministry of Health: “Initially, women who are pregnant or breast-feeding will not receive COVID-19 vaccinations because they were not included in the clinical trial studies that were conducted to receive approval from the regulatory authorities. This recommendation may change as more research and information becomes available.”
(Published 21 January 2021; Accessed 4 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 1/13/21: Sinopharm, Pfizer-BioNtech, Sputnik
Khaleej Times: “January 13, 2021: Dr Nusarat Tadkod, an obstetrician and a gynecologist, who is attached to Prime Medical Centre at the Barsha Heights branch, said: “Women planning pregnancy should consider carefully about taking the jab. Women planning to take vaccines should avoid pregnancy for the next three months.”She added: “The vaccines are still not considered safe for women, who are pregnant or breastfeeding their babies. Lactating mothers should continue breast feeding to ensure good immunity of their babies. They can take the jab after six months of child birth.” She added, “For lactating mothers, passive transfer of antibodies may be beneficial. However, we don’t know the immune response of a lactating mother to this new vaccine.””
(Published 13 January 2021; Accessed 2 March 2021)
Goverment of Dubai: Novel Covid Awareness for Expectant Mothers
(Accessed 2 March 2021)
WORLD BREASTFEEDING TRENDS INTITIATIVE AUSTRALIA’S POSITION STATEMENT: INFANT AND YOUNG CHILD FEEDING IN EMERGENCIES
“But, in October 2020, despite the horrendous bushfire season in 2019-20 and the current COVID-19 pandemic, Australian mothers and infants are at risk of being left without adequate policies and support for infant and young child feeding in emergencies.”
Find the Position Statement here.
(guidance issued 11 November 20; accessed 12 November 20)
VACCINATION OVERVIEW
Available Vaccines: CanSinoBio, BBIBP-CorV, Sinopharm, CoronaVac
INFORMATION ON CORONAVAC VACCINE
Preliminary information about the CoronaVac vaccine is limited and does not discuss breastfeeding. Learn more in the Lancet journal.
(published 17 November 20; accessed 14 December 20)
NEW CORONAVIRUS VACCINATION TECHNICAL GUIDE (FIRST EDITION) FROM THE NATIONAL HEALTH COMMISSION OF THE PEOPLE’S REPUBLIC OF CHINA
This document addresses the 5 manufacturers of new coronavirus vaccines approved for conditional marketing or emergency use, including:
“Although there is currently no clinical research data on the impact of new coronavirus vaccines in breastfeeding women on breastfeeding infants, based on the understanding of the safety of the vaccine, it is recommended to vaccinate breastfeeding women (such as medical staff) who are at high risk of new coronavirus infections. . Considering the importance of breastfeeding to the nutrition and health of infants and young children, with reference to internationally accepted practices, breastfeeding women are advised to continue breastfeeding after being vaccinated against the new coronavirus.”
(Published 29 March 2021; accessed 13 April 2021)
VACCINATION OVERVIEW
Available Vaccines as of 3/16/2021: Pfizer, CoronaVac
The Government of the Hong Kong Special Administrative Region: “While COVID-19 vaccination is not routinely recommended for breastfeeding women, those with high clinical need for protection against COVID-19 may be offered BioNTech or AstraZeneca vaccination. Discussion with their doctors on the potential developmental and health benefit of breastfeeding as well as on the information about absence of corresponding safety data is advised.”
(Published 16 March 2021; accessed 14 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 2/17/21: Pfizer
The Japan Times: “Feburary 17, 2021: Pregnant women are not subject to the government’s call for vaccinations due to insufficient clinical data, but if they wish to receive it, they can get the vaccines in consultation with health providers. The Japan Society of Obstetrics and Gynecology has asked for pregnant women not to be removed from the vaccination drive outright, instead recommending that they avoid the jabs during the first trimester.
(Published 17 February 2021; accessed 25 February 2021)
Centers for Disease Control and Prevention: “February 28, 2021: CDC: Discussions on the New Coronavirus Vaccine for Breastfeeding Women Revised February 12, 2021 COVID-19 vaccination considerations for people who are breastfeeding.
(Published 28 February 2021; accessed 7 March 2021)
Japan Association of Lactation Consultants: “Safety of COVID-19 vaccine in lactating women and during breastfeeding There are no data on the effects of the mRNA vaccine on infants and lactation / secretion. RNA vaccines are not considered to be at risk for breastfeeding babies. People who are breastfeeding and who belong to a group that is recommended to receive the COVID-19 vaccine, such as healthcare professionals, can choose to receive the vaccine.”
(Published 28 February 2021; accessed 7 March 2021)
VACCINATION OVERVIEW
Available Vaccines as of 3/21: Pfizer
The Immunisation Advisory Centre: “Internationally, a pregnant or lactating person may choose to be vaccinated after considering the risks and benefits and/or consulting with a healthcare professional. There is currently only limited data on the safety of COVID-19 vaccines in pregnancy and lactation. When deciding, the following points should be considered: risk of being exposed to COVID-19; risks of COVID19 to the patient and the foetus; efficacy of the vaccine; side effects of the vaccine; data available on COVID-19 vaccines during pregnancy/lactation.”
(Published March 2021; accessed 19 February 2021)
VACCINATION OVERVIEW
Available Vaccines as of 1/3/21: Pfizer, Moderna
Ministry of Health, Singapore: “For lactating women, EC19V’s (Expert Committee on Covid-19 Vaccination) recommendation is that they can get vaccinated but are recommended to abstain from breastfeeding for 5 to 7 days post-vaccination.”
(Published 1 March 2021; Accessed 19 February 2021)
VACCINATION OVERVIEW
Available Vaccines: AstraZeneca, Pfizer
VACCINATION OVERVIEW
Available Vaccines as of 3/14/21: AstraZeneca
HUMAN MILK BANKING OF NORTH AMERICA (HMBANA)
Find HMBANA’s statement here.
(guidance issued 6 March 20, accessed 16 March 20)
HUMAN MILK BANKING ASSOCIATION OF NORTH AMERICA( HMBANA) MILK HANDLING FOR COVID-19 POSITIVE OR SUSPECTED MOTHERS IN THE HOSPITAL SETTING
Find the guidance and infographic here.
(dated 14 April 20; accessed 16 April 20)
EUROPEAN MILK BANK ASSOCIATION (EMBA)
Find EMBA’s statement here.
(dated 25 February 20; accessed 13 March 20)
BLOG POST: VIRTUAL CONSULT BEST PRACTICES FOR LACTATION CONSULTANTS
“While most clinicians can agree that nothing can replace an in-person lactation consult with a family in need of help feeding their baby, virtual consults are becoming more and more popular as a way to make services more accessible. In order to meet your ethical obligations and stay within your scope of practice as an IBCLC or other lactation credential, you’ll want to keep some key factors in mind.”
Access the blog post on paperlesslactation.com here.
(resource updated March 20; accessed 16 March 20)
INFOGRAPHICS ON TELEHEALTH FOR LACTATION CONSULTANTS, LACTATION CARE IN THE COMMUNITY SETTING, AND TELEHEALTH DECISION ALGORITHM
HOW TO ADD A TELEHEALTH FRAME TO YOUR SOCIAL MEDIA PROFILE
Add a Telehealth Frame To Your Facebook Profile
(Resource shared 25 March 20, Accessed 7 September 20)
ILCA MEMBERS: HOW TO ADD VIRTUAL PRACTICE TO YOUR FIND A LACTATION CONSULTANT PROFILE
How to add virtual practice to your Find A Lactation Consultant Profile
(Shared 7 September 20, accessed 7 September 20)
HELP FAMILIES FIND TELEHEALTH PROVIDERS
Please share this social media post to help families find telehealth providers.
(Resource posted 25 April 20, accessed 7 September 20)
Shareable graphics from ILCA available here (now in 10 languages!)
Find infographics from the US based National Perinatal Association here.
The International Board of Lactation Consultant Examiners (IBLCE) has made changes to:
– the late March/early April 2020 exam date
– the deadline to apply for the September 2020
– customer support delivery
For updates, please visit their website here.
JOURNAL OF HUMAN LACTATION
Safe Handling of Containers of Expressed Human Milk in all Settings During the SARS-CoV-2 (COVID-19) Pandemic
(Please see here for questions about the controversy with this article)
International Perspectives Concerning Donor Milk Banking During the SARS-CoV-2 (COVID-19) Pandemic
COVID-19 AND LACTATION RESEARCH REPOSITORY
OTHER RESEARCH TOOLS
Letter to the Lancet Global Health Editor in response to the modeling study on the potential indirect effects of COVID-19, encouraging authors to consider the substantial morbidity and mortality repercussions from pandemic-related disruptions to breastfeeding.
International Board of Lactation Consultant Examiners® and IBLCE® are registered Service Marks, and International Board Certified Lactation Consultant® and IBCLC® are registered Certification Marks, of the International Board of Lactation Consultant Examiners and are used with permission herein.
