Key points to remember about COVID-19 and breastfeeding

So far, there is no evidence of mothers passing on COVID-19 to babies through breastmilk.

• breastfeeding protects babies from getting sick and helps protect them throughout their infancy and childhood
• breastfeeding is very effective against infectious diseases because it strengthens babies' infection-fighting system (immune system)
• breastfeeding directly transfers antibodies from mother to baby
• if you have COVID-19, you can still breastfeed your baby
• so far, there is no evidence of passing on COVID-19 to babies through breastmilk
• the main risk of breastfeeding is close contact between you and your baby
• take precautions if you are breastfeeding and you have COVID-19 (confirmed or suspected)

How does breastfeeding protect my baby from infectious diseases?

Breastfeeding is very effective against infectious diseases. It strengthens your baby's infection-fighting system (immune system).

Breastfeeding protects babies from getting sick. It also helps protect them right through infancy and childhood. Breastfeeding is very effective against infectious diseases because it strengthens your baby's infection-fighting system (immune system). Breastfeeding directly transfers antibodies from you to your baby.

[1]

Can I breastfeed my baby if I have COVID-19?

Yes, you can breastfeed if you have confirmed or suspected COVID-19. Continuing to breastfeed benefits your baby.

[2] [3]

What precautions do I take if I'm breastfeeding and have or might have COVID-19?

Take precautions if you are breastfeeding and you have confirmed or suspected COVID-19, or any symptoms of COVID-19.

Make sure you take precautions if you are breastfeeding or practising skin-to-skin contact with your baby and you have either:

• confirmed or suspected COVID-19
• any symptoms of COVID-19

Precautions:

• wash hands before and after contact with your baby (including feeding)
• wear a surgical mask during breastfeeds
• avoid coughing or sneezing on your baby
• avoid kissing and touching your baby's face, and your own face
• clean and disinfect any surfaces you touch

If you become unwell and you are breastfeeding your baby, keep breastfeeding. It's important not to interrupt breastfeeding. Your baby will already have had exposure to COVID-19 and will benefit from continued breastfeeding.

If you are too unwell to breastfeed, express your milk and give it to your baby by bottle (taking the same precautions).

Your baby will also be considered a 'close contact' and your public health unit will give you more advice.

[4]

What if I am breastfeeding and in self-isolation after possible exposure to COVID-19?

Exclusive breastfeeding gives the best protection for babies, so if your baby is less than 6 months old, aim for exclusive breastfeeding. This means only breastfeeding, and not feeding any other sorts of food until 6 months. Even if your baby is older than 6 months, remaining with you and continuing your breastfeeding relationship is good for both of you.

Other countries (such as Italy and the UK) report that babies usually stay well if they stay with a mother who has mild COVID-19 symptoms and who takes precautions around breastfeeding.

If you are in self-isolation after possible exposure to COVID-19, keep your baby with you so you can keep breastfeeding.

Wash your hands before touching your baby, avoid touching their face and coughing or sneezing on them. 

What happens straight after birth if I have COVID-19?

If you have COVID-19, staff in your maternity unit will talk with you about your options straight after birth. They will involve you in shared decision-making.

Can I touch and hold my newborn baby if I have COVID-19?

Yes. Close contact and early, exclusive breastfeeding will help your baby to thrive. Your care providers should support you to:

• breastfeed safely - taking precautions
• hold your newborn skin-to-skin
• share a room with your baby

What precautions should I take if I'm breastfeeding and have COVID-19?

• wash hands before and after contact with your baby (including feeding)
• wear a surgical mask during breastfeeds
• avoid coughing or sneezing on your baby
• avoid kissing and touching your baby's face, and your own face
• clean and disinfect any surfaces you touch

What are the chances of my baby developing COVID-19?

Other countries (such as Italy and the UK) report that babies usually stay well if they stay with a mother who has mild COVID-19 symptoms and who takes precautions around breastfeeding.

How long should I stay in the maternity unit?

If you have COVID-19, it's best you stay at least 48 hours after birth in the maternity unit. But, if you are well, you may be able to go home and receive care from your midwife.

Your stay in the maternity unit will be longer if:

• you need close monitoring
• your baby needs close monitoring
• your baby is in the neonatal intensive care unit (NICU) or specialist care baby unit (SCBU) for a short stay

What if I become quite unwell and need treatment for COVID-19?

If you become quite unwell and need to transfer to a medical area or intensive care unit for your own treatment, the best option is for your baby to be with a well family member. If you are well enough to do so, you can still express breastmilk for your baby. 

How do I get help with breastfeeding my baby if I need it?

If you are still receiving care from your midwife, she will support you with feeding and can answer your questions. If your midwifery care has finished and you have some breastfeeding concerns, or need support or information, there are options available. In-person consultations are unlikely during the COVID-19 pandemic but online consultations are available. You will find this information at the bottom of the College of Midwives frequently asked questions for pregnant women and whānau [5]. You can also call PlunketLine on 0800 933 922.

Can I start breastfeeding again if I have recently stopped?

Yes, in some circumstances women can start breastfeeding again, either fully or partially - this is called relactation. It depends on a number of factors such as when you stopped breastfeeding your baby, the reason why you stopped breastfeeding, your baby's age, and your baby's willingness to return to your breast.

The easiest way to bring back a milk supply is through your baby suckling at your breast. The more often your baby suckles at your breast, the more likely your breasts will make milk. You will need to make sure you:

• offer your breast very frequently
• drink plenty of fluids
• eat a healthy diet
• rest

Talk to your midwife or Well Child nurse, or call PlunketLine on 0800 933 922 for more information on re-establishing your breastmilk supply if this is something you would like to do. 

You can also find more information about relactation at the Australian Breastfeeding Association website [6] and the Association of Breastfeeding Mothers (UK) website [7].

The content on this page is supported by The New Zealand College of Midwives.