Resources for skilled lactation providers on COVID-19

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. Please watch here for additional resources as they become available.

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 media@myilca.org with details.

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UPDATES:

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.

14 March 20 to include new WHO guidance: Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected

ILCA RESOURCES

Article in Maternal & Child Nutrition New article with authors including Cecelia Tomori (recent ILCA speaker on COVID-19) and Aunchalee Palmquist, a member of the Breastfeeding Collective.

“All international world health guidelines agree: Breastfeeding should continue and be supported during the COVID-19 epidemic, with appropriate precautions.”

(released 18 March 20)

Find Our Statement Here

English 

Japanese

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)

Find Our Resource Guide Here

Add this frame to your social media profile to let people know that you are a lactation consultant that provides telehealth.

Find Instructions Here

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.

Find Our Statement Here

INTERNATIONAL RESOURCES

“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)

See section 19, starting on page 42

“We recommend that mothers with suspected or confirmed COVID-19 should be encouraged to initiate and continue breastfeeding. From the available evidence, mothers should be counselled that the benefits of breastfeeding substantially outweigh the potential risks of transmission.”

“Mother infant contact at birth: Mothers should not be separated from their infants unless the mother is too sick to care for her baby.”

(Dated 27 May 2020, Accessed 28 May 2020)

“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.”

Access the FAQ here. 

(Dated 28 April 20, Accessed 28 April 20)

“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)

“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)

“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.”

Find the Q&A here.

(Q&A dated 18 March 20; accessed 23 March 20)

“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.”

View the paper here

(Accessed 22 April 20)

UNICEF Infant and Young Child Feeding in the Context of COVID-19

“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)

Is it safe for a mother to breastfeed if she is infected with coronavirus?

“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)

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.”

Find the statement here 

(Updated 2 April 20, Accessed 22 April 20)

“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:

  • Symptomatic mothers well enough to breastfeed should wear a mask when near a child (including during feeding), wash hands before and after contact with the child (including feeding), and clean/disinfect contaminated surfaces.
  •  If a mother is too ill to breastfeed, she should be encouraged to express milk that can be given to the child via a clean cup and/or spoon – while wearing a mask, washing hands before and after contact with the child, and cleaning/disinfecting contaminated surfaces.

Provision of mental health and psychosocial support for affected individuals, families, communities and health workers is a critical part of the response.”

Find the statement here

And the related press release here

(statement dated 5 March 2020; accessed 12 March 20)

“Publications and resources from organisations related to the Coronavirus disease (COVID-19) and breastfeeding.”

Access the resources here.

(Accessed 4 September 20)

REGIONAL RESOURCES

Alphabetical by Country of Origin

Australia

“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)

Find the related call to action and petition here.

Canada

“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)

“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)

  • “Management in the post-partum period should be guided by a patient-centred discussion about the available evidence and its limitations.
  • We do not recommend universal isolation of the infant from either confirmed of suspected infection in the mother. However, depending on a family’s values and availability of resources they may choose to separate infant from mother until isolation precautions for the mother can be formally discontinued.
  • Women should practice good handwashing before and use of a mask while engaging in infant care.
  • Women who choose to breastfeed should be allowed to do so after appropriate handwashing and while wearing a mask. It is possible that the mother can transmit antibodies to the infant through breastmilk; however, there is limited evidence of this transmission and the potential benefits are unclear.”

Find the statement here. 

(dated 13 March 20; accessed 22 April 20)

“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.”

View the statement here

(dated 27 March 20; accessed 22 April 20)

“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)

Italy

“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.”

Find the information here.

(dated 5 March 20; accessed 13 March 20)

“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)

United Kingdom

  • “Pregnant women do not appear to be more susceptible to the consequences of coronavirus than the general population and there is no evidence that the virus can pass to a baby during pregnancy
  • As a precautionary approach, pregnant women with suspected or confirmed coronavirus when they go into labour are being advised to attend an obstetric unit for birth but their birth plan should be followed as closely as possible
  • At the moment there is no evidence that the virus can be carried in breastmilk, so it is felt the benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk. ”

Access the national guidance here.

(dated 9 March 20; accessed 13 March 20)

The impact of new evidence and changes in policy on the published guidance is reviewed on a weekly basis.
“Women and their healthy babies, who do not otherwise require maternal critical care or neonatal care, should be kept together in the immediate postpartum period.”
“Women with suspected or confirmed COVID-19 should be supported and enabled to remain together with their bablies and to practice skin-to-skin/kangaroo care, if the newborn does not require additional medical care at this time.”
“In light of the current evidence, we advise that the benefits of breastfeeding outweigh any potential risks of transmission of the virus through breastmilk.”
“Specific recommendations on minimising the risk of transmission when feeding the baby were developed with experts from RCPCH and RCM, and from their guidance.”
(Published/revised 24 July 20, accessed 11 August 20. This version replaces the version published on ILCA’s COVID resources on 19 March 20)

United States

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.

Access the information here

Published 16 November 20, Accessed 17 November 20

Provides “Updated guidance on mother-neonate contact, emphasizing the importance of maternal autonomy in the medical decision-making process.”
“Rates of SARS-CoV-2 infection in neonates do not appear to be affected by mode of delivery, method of infant feeding, or contact with a mother with suspected or confirmed SARS-CoV-2 infection.”
“Early and close contact between the mother and neonate has many well-established benefits. The ideal setting for care of a healthy, term newborn while in the hospital is in the mother’s room, commonly called “rooming-in.” Current evidence suggests the risk of a neonate acquiring SARS-CoV-2 from its mother is low. Further, data suggests that there is no difference in risk of SARS-CoV-2 infection to the neonate whether a neonate is cared for in a separate room or remains in the mother’s room.”
(Published/revised 3 August 20; accessed 3 August 20)
“Families can now be informed that evidence to date suggests that the risk of the newborn acquiring infection during the birth hospitalization is low when precautions are taken to protect newborns from maternal infectious respiratory secretions. This risk appears to be no greater if mother and infant room-in together using infection control measures compared to physical separation of the infant in a room separate from the mother.”
“The AAP strongly supports breastfeeding as the best choice for infant feeding. Several published studies have detected SARS-CoV-2 nucleic acid in breast milk. It is not yet known whether viable, infectious virus is secreted in breast milk, nor is it yet established whether protective antibody is found in breast milk. Given these uncertainties, breastfeeding is not contraindicated at this time.” (edited) 
(Published/revised 22 July 20; accessed 23 July 20)

“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.”

Access the information here.

(Published/revised Wednesday 10 February 20; accessed 13 March 20)

“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.”

Access the information here.

(Published/revised 4 April 20; accessed 9 April 20)

“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. …”

Access the statement here.

(Published/revised Tuesday 10 March 20; accessed 13 March 20)

“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.””

Access the information here.

(Published/revised Thursday 27 February 20; accessed 13 March 20)

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)

“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.”

Find the guidance here.

(dated 29 July 20, accessed 4 September 20)

“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)

“[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)

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:

      • acknowledging that everyone’s concerns are valid
      • sharing our own experiences and reactions
      • explaining proven public health responses
      • promoting the evidence 
      • dispelling the myths
      • modelling healthy behaviors

“Use the resources listed here to support your efforts.”

Access the resources here.

(Accessed 4 September 20)

“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)

“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.”

Access the resources here.

(Updated 14 August 20, Accessed 4 September 20)

MILK BANKING RESOURCES

Find HMBANA’s statement here.

(guidance issued 6 March 20, accessed 16 March 20)

Find the guidance and infographic here.

(dated 14 April 20; accessed 16 April 20)

Find EMBA’s statement here.

(dated 25 February 20; accessed 13 March 20)

VIRTUAL PRACTICE RESOURCES

(Updated March 2020 With COVID-19 Guidelines) by Annie Frisbie, IBCLC

“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)

From Lactation Education Resources

(Resource shared 18 March 20; accessed 19 March 20)

Add a Telehealth Frame To Your Facebook Profile

(Resource shared 25 March 20, Accessed 7 September 20)

How to add virtual practice to your Find A Lactation Consultant Profile

(Shared 7 September 20, accessed 7 September 20)

Please share this social media post to help families find telehealth providers.

Share on Facebook

Repost on Instagram here

(Resource posted 25 April 20, accessed 7 September 20)

SOCIAL MEDIA AND COMMUNICATIONS RESOURCES

The World Health Organization has created a series of graphics that can be shared:

Find infographics from the US based National Perinatal Association here.

UPDATES FROM THE INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS

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.

RESEARCH RESOURCES

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.