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I’m a mum and I have COVID-19… what next?

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COVID-19 has rapidly become a part of our everyday life, and catching the virus seems to be a very real possibility. But what if you test positive and you’re a breastfeeding mum?

Postpartum doula, podcaster and author Anna Cusack recently posted helpful information on Instagram to guide breastfeeding mums and lactating people through this challenging time.

Is it safe to breastfeed when I’ve tested positive?

Fortunately, there seems to be little chance of spreading the virus through your breast milk. The Centers for Disease and Prevention (USA) states that “current evidence is that breast milk is not likely to spread the virus to babies”. The World Health Organization (WHO), NSW Health and Australian Breastfeeding Association (ABA) agree that long-term benefits of breastfeeding your baby outweigh the long-term risks of stopping. Plus, if you’ve been vaccinated or have the virus, there are immune factors present in breast milk, so even more benefits to keep supplying your child with milk.

How can I reduce risk of transmission when feeding my baby?

According to NSW Health, you should take these special precautions when feeding your baby, expressing breast milk, having skin to skin contact, or when closer than 1.5 metres from your baby:

  • Wash your hands frequently with soap and water or using alcohol-based hand rub especially before touching your baby, pumps or bottles.
  • Wear a surgical mask yourself (single use, replace it as needed, and don’t touch it). Don’t put a mask on your baby as it’s a suffocation risk.
  • Sneeze or cough into your elbow or a tissue. Dispose of the tissue immediately then use alcohol-based hand rub or wash your hands with soap and water.
  • Regularly clean and disinfect surfaces and feeding utensils if expressing breast milk or preparing bottles.

Should I pump instead?

While some parents might think it safer to pump milk rather than feed off the breast, Anna suggests that there’s no need to do this unless you’re too sick to feed or you and your baby are separated. Pumping can be tricky and time consuming, and bottles and pump parts are still open to contamination. Besides, WHO still recommends feeding at the breast over any other human milk substitutes.

What if I’m too sick to feed my baby?

If you’re too ill to feed your baby, Anna suggests trying to express milk and find someone who could help feed your baby a bottle of expressed milk. The ABA offers information on how to manage this and maintain a good supply. Meanwhile WHO recommend feeding options in this order:

  • direct feeding at the breast or chest
  • expressed milk from the parent
  • human donor milk
  • wet nursing.

Will COVID-19 affect my supply?

There’s no evidence to suggest that COVID-19 effects milk supply, but supply can be impacted when you’re sick, especially if you have a fever and are dehydrated. It’s recommended that you keep up your fluids and seek medical attention. It might also be helpful to contact ABA to be put in touch with a lactation consultant for a video chat.

What if my baby gets sick too?

Fortunately, COVID-19 is usually mild in children (of course, it can also be severe in some rarer cases). The most common symptoms are fever, cough, runny nose, diarrhoea, nausea, vomiting and stomach ache. In this situation, Anna suggests feeding as much as your baby wants, bearing in mind that it might take longer or be more frequent when they have a stuffy nose.

If your baby is in hospital then you should continue to express. If you don’t have a pump, you may be able to borrow one from the hospital, hire one from the ABA, or hand express. And if you’ve tested positive yourself, the hospital will have procedures in place for the safe expressing, transporting and feeding of milk.

How do I know if my baby is sick?

According to NSW heath, poor feeding and lethargy are often signs that a baby is ill. In this case, you should follow up immediately with your health care professional. If you have any concerns at all, contact your GP, child and family health nurse or nearest emergency department.

Paediatric consultant Dr Niamh Lynch suggests looking out for the following red flags and acting immediately:

  • persistent high temperature
  • coughing so much that it interferes with feeding
  • rapid breathing, such as >60 breaths per minute in a six-month-old
  • dry nappies
  • working hard to breathe – wheezing, chest wall sucking in each breath
  • lethargy – drowsiness, lack of interest in surroundings.

How do I care for myself?

It goes without saying that you need to look after yourself too. Stay hydrated, take painkillers when needed (Panadol is safe in pregnancy), and try to rest as much as you can.

Don’t be afraid to ask for help from friends and family – they may not be allowed in the house, but they can drop off food or order groceries to help out.

If you’re pregnant or have another chronic health condition, you’re encouraged to speak to your GP (and in NSW, call NSW Health’s COVID-19 Care at Home Support Line on 1800 960 933).

If you develop severe symptoms – such as severe headaches or dizziness, shortness of breath, chest pressure or pain – call 000 straightaway and tell the ambulance staff that you have been diagnosed with COVID-19.

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