Breastfeeding and COVID-19
Houston experts spell out what all new moms need to know
In all of the what-toexpect guides for being a new mother, navigating a pandemic while taking care of a newborn was not on the list.
For Lindsay Germano, a resident of The Woodlands, her last few doctor appointments before giving birth to her first child on March 22 had increasing limitations. By the time Germano went into labor, she was only allowed one support person and one visitor.
“Things probably changed dramatically after we left,” she said.
Since then, the Germanos have, for the most part, self-quarantined, trying to limit trips to the store. She planned to nurse her baby in advance of the quarantine, and now she is especially glad that her son is getting the nutrients he needs to stay healthy.
“To the extent we can take advantage of it, we want to get our baby as many antibodies as possible,” she said.
Nutritionist Lindsey Cosyns, who focuses on the health of mothers and babies in her practice Mama Thrived Nutrition, agreed. “Never in a million years did I think this would be going on right now,” she said.
Cosyns’ baby Leo was born in November, and she has a 2-year-old toddler as well. “I already knew from a nutritional standpoint that breastfeeding can be so beneficial for a baby,” she said.
Recently, recommendations from the CDC have urged new mothers to continue breastfeeding, even if they are diagnosed with COVID-19. Even when mothers are separated from their babies due to health concerns, the CDC recommends using a breast pump and practicing hand hygiene.
“It reaffirms what we know, that breast milk is magical,” Cosyns said. “It’s the best you can do for your newborn.”
Dr. Kjersti Aagaard, professor of obstetrics and gynecology at Baylor and Texas Children’s Hospital, also recommends that moms breastfeed.
“This is in line with the CDC recommendations we have been following since mid-February and consistent with more recent evidence, which fails to detect the virus in breast milk,” she said.
Still, Suzanne Juel, president of Houston Area Lactation Consultants and Educators Association and founder of Bayou City Breastfeeding, worries that conflicting recommendations could become a source of confusion and anxiety for new moms.
The World Health Organization, Academy of Breastfeeding Medicine and Italian Society of Neonatology all recommend that moms with COVID-19 are kept with their babies so they can continue directly breastfeeding — as long as the mothers are healthy enough to care for their babies.
But when the American Academy of Pediatrics issued recommendations on April 2, calling for the separation of mothers who are positive for COVID-19 and their babies, Juel grew concerned that the guidelines would increase the rates of separation of mother and babies across the board — not just those with COVID-19.
While taking all measures to reduce exposure of new babies to COVID-19 is key, Juel said that continuing to breastfeed is equally important.
“To date, no one has found the actual COVID-19 virus to be present in breast milk,” she said. “Breastfeeding is really one of, if not the most important things to protect the baby against any kind of infection.”
Juel also pointed to research showing that helpful antibodies to pathogens that the mother has been exposed to show up in the breast milk; SARS is one example, she explained.
“Based on this research, it is reasonable to expect that we will find antibodies to COVID-19 in the breast milk as well,” she said.
Currently, the University of California San Diego School of Medicine and the Family Larsson-Rosenquist Foundation are launching studies into breastfeeding and the coronavirus.
Juel explained that if a mother has been exposed to the coronavirus, it is likely that the baby also has been exposed.
“But by reducing the likelihood of breastfeeding, we are actually denying that infant the only medicine that we have to combat this disease — antibodies specific to the disease,” she said.
Another cause of concern for Juel is that mothers may be leaving hospitals too early — and coming out without the typical breastfeeding support and education.
“In effect, we will likely have fewer mothers able to breastfeed their babies, when what we really need is to have as many mothers breastfeed as possible,” she said.
At Bayou City Breastfeeding, Juel’s staff used to be booked for weeks in advance. “Now no one is calling for help because they are afraid to see anyone,” she said. “They’re petrified of getting the baby sick. They’re in a state of fear.”
She worries that being afraid of medical facilities and clinics in general can prevent women from getting the help they need. Her staff is now offering virtual visits in addition to in-person consults for individuals who are not at high risk.
Timing is everything for new mothers who want to breastfeed, Juel added. “The first couple of weeks are critical for establishing milk supply,” she said. “There’s a hormonal shift that happens that sets up milk to develop.”
One of Juel’s clients, Santa Fe resident Aireal Mauriello, who combines breastfeeding with formula for her fourth child, is dealing with additional resource problems: She uses a specific formula that she usually sources from an Ohio boutique. Her baby cannot stomach the other options on the market.
“Normally, I have no issues, but now it’s so hard to find,” Mauriello said. “I’m spending hours and hours scouring the internet.”
Her usual resource is out of the formula, and delivery options are slow, she explained.
Mauriello said she is not the only one struggling to find formula.
“Formula is scarce, and babies depend on it,” she said. “People panic and hoard it. It’s awful.”
Mauriello urges other moms to be considerate of each other. “People need to calm down and think about other people,” she said. “There are other moms out there with babies who need to be fed.”