Breastfeeding and COVID-19

Breastfeeding and COVID-19
Current evidence suggests that breast milk is not likely to spread the virus to babies.
You, along with your family and healthcare providers, should decide whether and how to start or continue breastfeeding. Breast milk provides protection against many illnesses and is the best source of nutrition for most babies.
If you are breastfeeding, you can receive a COVID-19 vaccine.
Helpful tips for starting or restarting breastfeeding
You may find it harder to start or continue breastfeeding if you are not sharing a room with your newborn in the hospital. Here are some helpful tips:
● Frequent hand expression or pumping will help you establish and build milk supply if you are separated from your newborn in the hospital.
● Pump or feed every 2-3 hours (at least 8-10 times in 24 hours, including at night), especially in the first few days. This helps the breasts to produce milk and prevents blocked milk ducts and breast infections.
● If you are unable to start producing milk in the hospital after birth, or if you have to temporarily stop breastfeeding during your COVID-19 illness because you do not feel well enough, get help from a lactation support provider. Learn more about restarting breastfeeding (also called relactation).
You should always wash your hands with soap and water for 20 seconds before breastfeeding or expressing breast milk, even if you don’t have COVID-19. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
If you have COVID-19 and choose to breastfeed:
● Wash your hands before breastfeeding
● Wear a mask while breastfeeding and whenever you are within 6 feet of your baby.
If you have COVID-19 and choose to express breast milk:
● Use your own breast pump (one not shared with anyone else), if possible.
● Wear a mask during expression.
● Wash your hands with soap and water for at least 20 seconds before touching any pump or bottle parts, and before expressing breast milk.
● Follow recommendations for proper pump cleaning after each use. Clean all parts of the pump that come into contact with breast milk.
● Consider having a healthy caregiver who does not have COVID-19, is not at increased risk for severe illness from COVID-19, and is living in the same home feed the expressed breast milk to the baby. If the caregiver is living in the same home or has been in close contact with you, they might have been exposed. Any caregiver feeding the baby should wear a mask when caring for the baby for the entire time you are in isolation and during their own quarantine period after you complete isolation.
Keeping your baby safe and healthy
Do not put a face shield or mask on your baby
● Children younger than two should not wear masks.
● A face shield could increase the risk of sudden infant death syndrome (SIDS)or accidental suffocation and strangulation. Babies move around, and their movement can cause the plastic face shield to block their nose and mouth or cause the strap to strangle them.
● CDC does not recommend use of face shields as a substitute for masks.
Limit visitors to see your new baby
The birth of a new baby is a significant life event that typically brings families together to celebrate and support the baby and new mother. However, before allowing or inviting visitors into your home or near your baby, consider the risk of COVID-19 to yourself, your baby, people who live with you, and visitors (e.g., grandparents or older adults and other people at increased risk of severe illness from COVID-19).
● Bringing people who do not live with you into your home can increase the risk of spreading COVID-19.
● Some people without symptoms can spread the virus.
● Limit in-person gatherings and consider other options, like celebrating virtually, for people who want to see your new baby. If you do plan to have in-person visits, ask guests to stay home if they are sick and ask them to stay 6 feet away from you and your baby, wear a mask, and wash their hands when visiting your home. For more information, please see considerations for attending or hosting a small gathering.
Keep distance between your baby and people who do not live in your household or who are sick
● Consider the risks of spreading COVID-19 to you and your baby before you decide whether to go out for activities other than healthcare visits or child care.
● Keep 6 feet of distance between your baby and people who do not live in your household.
● Ask your child care program about the plans they have in place to protect your baby, family, and their staff from COVID-19.
Know possible signs and symptoms of COVID-19 infection among babies
● Most babies who test positive for COVID-19 have mild or no symptoms.
● Severe illness in babies has been reported but appears to be rare. Babies with underlying medical conditions and babies born premature (earlier than 37 weeks) might be at higher risk of severe illness from COVID-19.
● Reported signs among newborns with COVID-19 include fever, lethargy (being overly tired or inactive), runny nose, cough, vomiting, diarrhea, poor feeding, and increased work of breathing or shallow breathing.
● If your baby develops symptoms or you think your baby may have been exposed to COVID-19:
○ Get in touch with your baby’s healthcare provider within 24 hours and follow steps for caring for children with COVID-19.
○ If your baby has COVID-19 emergency warning signs (such as trouble breathing), call 911 or call ahead to your local emergency facility.
■ Notify the operator that you are seeking care for a baby who has or may have COVID-19.
Bring your baby for newborn visits
Ideally, newborn visits are done in person so that your baby’s healthcare provider can:
● Check how you and your baby are doing overall.
● Check your baby’s growth and feeding.
● Check your baby for jaundice (yellow color in the skin or eyes).
● Make sure your baby’s newborn screening tests were done (including a bloodspot, hearing test, and a test for critical congenital heart defects) and do any repeat or follow-up testing, if necessary.
Call and notify your baby’s healthcare provider before visiting if you think you or your baby might have COVID-19.
Ensure safe sleep for your baby
During the COVID-19 pandemic, parents may be extra stressed and tired. Making sure parents and babies get enough quality sleep, is very important. Take steps to reduce the risk of sudden infant death syndrome (SIDS) and other sleep-related deaths, by doing the following:
● Place your baby on his or her back for all sleep times—for naps and at night.
● Use a firm, flat sleep surface, such as a mattress in a crib covered by a fitted sheet.
● Have the baby share your room but not your bed. Your baby shouldn’t sleep on an adult bed, cot, air mattress, couch, or chair, whether he or she is sleeping alone, with you, or with anyone else.
● Keep soft bedding, such as blankets, pillows, bumper pads, and soft toys, out of your baby’s sleep area.
● Do not cover your baby’s head or allow your baby to get too hot. Signs your baby may be getting too hot include sweating or his or her chest feeling hot.
● Do not smoke or allow anyone to smoke around your baby.
Ensure your own social, emotional, and mental health
● Call your healthcare provider if you think you are experiencing depression after pregnancy.
● Learn about ways to cope with stress and tips for caring for yourself during the COVID-19 pandemic.