New Delhi: Can an infant contract COVID-19 from its mother through breastfeeding? Evidence is inconclusive, say experts.

In a research paper published in the June 2020 issue of the health journal, The Lancet, researchers examined milk from two nursing mothers infected with COVID-19 for 26 days. Samples from one tested negative, but viral RNA was found in the milk from the second mother on days 10, 12 and 13.

Mother 1 had tested positive after delivering her baby. Her newborn had also tested positive but both had recovered. After recovering and being discharged, she again tested positive 13 days after her first diagnosis.

Mother 2, who shared the first mother’s room after delivering her baby, had tested positive eight days after delivery, and her child had tested positive three days after that.

Detection of viral RNA in milk from Mother 2 had coincided with her newborn testing positive for COVID-19. She had been following the safety precautions since the onset of symptoms when handling or feeding the neonate.

“However, whether Newborn 2 was infected by breastfeeding or other modes of transmission remains unclear,” said the research, adding that development of recommendations on whether mothers with COVID-19 should breastfeed or not would need further studies.

Earlier, an article published in the non-peer-reviewed preprint server medRxiv on June 1, 2020 evaluated the effect of breastfeeding on SARS-CoV-2 transmission based on samples from 23 pregnant women. Fourteen of these women were confirmed positive for COVID-19 while nine were suspected to be infected and eight were asymptomatic.

After delivery, all neonates tested negative for COVID-19, and no milk samples contained any viral RNA. Even though only one confirmed patient breastfed her infant, the study said

that “breastfeeding is possible for mothers with COVID-19 theoretically”. “Findings from this small number of cases suggest that there is currently no evidence for mother-to-child transmission via breastfeeding in women with COVID-19,” the research concluded.

It is dangerous to extrapolate anything from small samples and any policy guidance given at this point might have a reverse impact, said Shahid Jameel, a Delhi-based virologist and the chief executive officer of India Alliance, a charity that funds biomedical research. He said India’s reality is different: “What will rural women feed their children if not breast milk? They don’t have access to formula milk.”

What Mothers Should Do

The World Health Organization has advised mothers who are suspected or tested for COVID-19 to follow these precautions while breastfeeding:

  • If you have respiratory symptoms such as shortness of breath, use a medical mask when near your child.
  • Wash your hands thoroughly with soap or sanitiser before and after contact with your child.
  • If you are unable to continue direct breastfeeding, express milk to safely provide breastmilk to your infant.
  • If unable to do the above, consider relactation (restarting breastfeeding after a gap), wet nursing (another woman breastfeeding or caring for your child), or using donor human milk.

(Tiwari is a principal correspondent with IndiaSpend.)