Breastfeeding support during a Pandemic continues to challenge many healthcare providers and, as a Lactation Consultant, I work to support the breastfeeding dyad by providing hands on guidance to assist the mom and baby to establish breastfeeding. This intervention is especially important in the early days to weeks after delivery and continues after the new family goes home from the hospital. However, fear of the coronavirus and social distancing has caused many Lactation Consultants to think outside the box to provide care for moms and our smallest patients.
According to both the Center for Disease Control (CDC), the World Health Organization (WHO), and the American Academy of Pediatrics (AAP), breastfeeding is still the best nutrition for most babies and should be supported especially during a pandemic. “Breast milk provides protection against many illnesses and is the best source of nutrition for most babies. We don’t know for sure if mothers with COVID-19 can spread the virus to babies in breast milk, but the current evidence suggests that this isn’t likely.” 1 (COVID-19 and Breastfeeding, 2020)
According to the WHO “Transmission of active COVID-19 (virus that can cause infection) through breast milk and breastfeeding has not been detected to date. There is no reason to avoid or stop breastfeeding.” 2 (Q&A: Breastfeeding and COVID-19, 2020)
The American Academy of Pediatrics in their 7/22/20 statement, “strongly supports breastfeeding as the best choice for infant feedings”. And for the mom who has tested positive for COVID-19 the AAP guidance “Encourages proper hand washing with soap and water prior to handling the infant and advises the mother to wear a mask while nursing. Holding the baby skin-to-skin helps with latching and hormonal responses that trigger milk release. When not nursing, the infant can be cared for by a healthy caregiver, if available, and/or maintained in a separate room or at least 6-feet away from the mother. Once the mother has met time and symptom-based criteria for being noncontagious, these precautions can be discontinued.” 3 (Breastfeeding and COVID-19, n.d.)
In an interview with Ashley Lucas, RN, Internationally Board-Certified Lactation Consultant (IBCLC) and owner of Chattanooga Lactation, Inc., “Supporting the breastfeeding dyad has never been more challenging.” Lucas stated in an interview conducted by Debora Dawson that she has found many new facets to supporting the breastfeeding family during a pandemic. Due to the isolation of the new family from other family members and peers in the interest of decreasing the spread of COVID-19, many new parents have felt the strain of reduced physical and emotional support. According to Lucas, “I have taken steps to protect the breastfeeding dyad as best that I can. Universally, both the mom and I wear a mask during the visit and if she has tested positive for COVID-19, the mom and I will both wear a N95 and I wear goggles and gloves.” Ashley shared this has provided added security for the new family while allowing hands on for breastfeeding support. 4 (A. Lucas, personal communication, September 21, 2020)
As Lactation Consultants assisting families early in the pandemic, both Lucas and I found FaceTime and Zoom calls were the preferred support method for many families seeking breastfeeding support, although it can be very challenging trying to provide guidance and support for breastfeeding virtually without physically assisting the mom and baby.
As more information has become available, families are now more open to in person visits with proper personal protective equipment (PPE), social distancing, and good handwashing practices. During the visits, the families verbalized many of the emotional challenges they have been experiencing during the pandemic and Lactation Consultants are a kindly listening ear for many of these families, and can provide guidance, direction, and referrals to other healthcare providers to support the family during this time.
Further help can be found on the many social media breastfeeding support sites which families can utilize. For example La Leche League of America has meetings that can be attended either online or in person at https://lllusa.org/ and there are also numerous Facebook breastfeeding support sites where moms who want connection, but also to maintain social distance as much as possible, can find support. Moms can search “Breastfeeding Support” on Facebook or go to: https://uslca.org/resources/find-a-lactation-consultant-map#!directory/map to locate a Lactation Consultant, or support groups near them.
Assisting families during their breastfeeding journey is a passion of mine and as much as it is important to provide in person visits, providing virtual support and referrals to virtual care are equally essential during a pandemic.
This article was submitted by Debora Dawson, RN, BSN, IBCLC a Clinical Implementation Coordinator for OBIX
Sources
1 COVID-19 and Breastfeeding. (2020, September 11). Center for Disease Control. Retrieved September 11, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fpregnancy-breastfeeding.html
2 Q&A: Breastfeeding and COVID-19. (2020, May 7). The World Health Organization. Retrieved September 9, 2020, from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-on-covid-19-and-breastfeeding
3 Breastfeeding and COVID-19. (n.d.). American Academy of Pediatrics. Retrieved September 29, 2020, from https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/breastfeeding-guidance-post-hospital-discharge/
4 Lucas, A. (2020, September 21). Personal communication.