Covid-19 adds an extra layer of worry for pregnant and breastfeeding moms. Registered dietician and lactation consultant Carey Haupt answers some of your most pressing questions.
Covid-19 is everywhere in our social media, on every channel and radio station, as it swiftly moves across the globe infecting as many people as it can. We are in lockdown, which will help to slow down the spread of the disease. This is to protect our country’s most vulnerable: people with immune compromise, asthma, any lung conditions and pregnancy.
As a mom who is pregnant or with a little one, this can be very unsettling. How do you get the support around breastfeeding that you normally would have?
The good news is that healthcare workers are still around to assist you. Many lactation consultants are still seeing clients, and some are even doing virtual consults. I highly recommend the virtual consults if you are pregnant, so that you can prepare yourself with as much knowledge around latching, getting your milk supply and how to increase your milk supply. It is also comforting to know your lactation consultant before you give birth. This way you will know her and be able to find help if you need it.
During pregnancy
Research is now showing that if a pregnant women contracts Covid-19 it increases her risk for severe illness and delivering her baby prematurely. Therefore, social distancing and self-isolation are important while pregnant.
While it is one of the best ways to reduce your risk of contracting Covid-19, this can make this time exceedingly difficult, because baby showers and special visits from family are all part of the way we, as society, support pregnant women. We need to change how we will celebrate these milestones, and I am sure in a few months we will see “welcome to the world” parties instead of baby showers. I had these for both of my children, who were premature, and they were so special, as we got to celebrate new life.
We need to start thinking of different ways to support pregnant women, like food deliveries, online purchases as baby shower gifts, WhatsApp calls and FaceTime support. The time will come when we can catch up and hold the baby. Even though family may not be able to be at her side, we still need to remember her and chat to her about her progress, hopes and fears. She needs to know that she is not alone.
Some encouraging news from the CDC, is that in the few cases where mothers tested positive for Covid-19, they had not passed it on to their infants. In fact, new research has found that babies born to mothers with Covid-19 have evidence of immune cells against the virus in their own blood. This is thought to be a further protection for the baby against getting the disease. Women’s bodies are just so amazing!
During breastfeeding
There have also been a few studies on the mother’s amniotic fluid and breast milk, and no virus was found in either. In general, the CDC recommends that mothers with general flu, or flu-like symptoms continue to breastfeed their infants. We know that breast milk is the best source of nutrition for most infants, because it helps the infant’s immature immune system by supplying antibodies from the mom.
CDC interim guidelines for mothers who have tested positive for Covid-19 suggest that the mother, her family and health care team need to decide how she will feed her baby. It is very important that she does everything in her ability to not infect her baby with the virus by washing her hands before touching her baby, wearing a mask (if direct feeding) and, if using a breast pump, making sure that it is sterilised correctly. Keep an eye on the CDC’s website, as they do update information as new research comes to light.
By using an FDA approved closed system pump, you will be able to prevent possible contamination from your pump motor or tubing moving back into the freshly pumped breast milk. If expressing, you may even decide to have someone else, who is uninfected, care for your baby and feed the expressed breast milk.
What will this look like in practice for women who have tested positive for Covid-19? It will all depend on the general health of the mother. If she is well enough to breastfeed or express, she can continue to do so. However, if the mother is not able to express due to serious hospitalisation then the infant can be given donor breastmilk or formula.
Once the baby is born, it they will need to be placed into temporary isolation and be treated as a “person under investigation”. The new recommendation is that babies should be given frequent and uninterrupted access to breastfeeding, and the mother will need to practise skin-to-skin and have her baby rooming in with her. This will all depend on the mother’s health status and her ability to care for her baby.
This mom will need extra breastfeeding support from a lactation consultant and a hospital grade breast pump is most likely required. You will need additional support to get your breastfeeding started and your milk supply up. Once you are well you will be able to continue breastfeeding directly.
What about vaccination?
At the time of publishing the Johnson & Johnson vaccination had just been launched as part of a research protocol in South Africa. This vaccine is unavailable to pregnant women during this initial stage, which is a common practice when vaccines are not yet fully licensed, such as during clinical trials. This is done as a precaution as there is little information on the safety of the Johnson & Johnson vaccine in pregnancy.
However, it is highly expected that the jab will be found to be safe for pregnant women and that pregnant women will become eligible for vaccination in the coming months. Keep your eyes open and follow the updates.
Similar vaccines to the Johnson & Johnson Covid-19 vaccine have shown no safety concerns in pregnancy.
Being pregnant, giving birth and breastfeeding is an incredibly emotional rollercoaster, nevermind adding a pandemic too. As we understand more and more about this virus, it makes it somewhat easier to navigate. I personally wouldn’t have been able to breastfeed without the help of a lactation consultant, so I’m really thrilled that they’ve diversified and found ways to help.
