Program for Education in Global and Population Health

Should Women Breastfeed if They Have COVID-19? Reviewing the Changing Guidance and Evidence for Policy Recommendations for the Ministry of Health of Armenia

Denice Arnold

Name: Denice Arnold
School: Vagelos College of Physicians and Surgeons, Class of 2023
Mentor: Kim Hekimian, PhD

Samantha Marosis

Name: Samantha Marosis
School: Vagelos College of Physicians and Surgeons, Class of 2023
Mentor: Kim Hekimian, PhD

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Abstract

Throughout the COVID-19 pandemic, providers and expecting parents seek information regarding SARS-CoV-2 viral transmission from mother to baby and the safety of breastfeeding when COVID-19-positive. Our goal is to understand the changing guidance by the WHO, CDC, AAP, and others since the start of the pandemic and to create health education materials for mothers that reflect current recommendations. We performed a literature review to assess the evidence for current guidelines regarding breastfeeding and postpartum practices for mothers who are COVID-19-positive. We interviewed experts in the US and Armenia about current practices. As new literature is being published, national and international health guidelines are shifting. Initial recommendations encouraged infected mothers to separate from their baby until they were no longer contagious. This reflected a lack of evidence about both mode of transmission and risk to the neonate. However, skin-to-skin contact and

breastfeeding within the first hour of birth are essential for newborn development and maternal lactation. Recent evidence indicates that risk of vertical transmission is low and can be diminished with respiratory protection. Therefore, current guidance supports mothers who choose to breastfeed while infected with the support of their healthcare team. Unfortunately, the changing guidance has led to confusion and many are still hesitant about which recommendations to follow. We developed a series of health education materials - flyers, posters, and social media posts - that describe the current recommendations in language that is accessible to the lay population. These materials are being translated, printed, and distributed in Armenia.