Welcome to World Breastfeeding Week!

World Breastfeeding Week is celebrated every year from August 1 – 7 to commemorate the Innocenti Declaration. This milestone document was signed in August 1990 by government policymakers, WHO, UNICEF and other organizations to fortify a global movement to protect, promote and support breastfeeding.

This movement has seen its share of challenges in the COVID-19 era. Therefore, this year, perhaps more than any other, we are pleased to share with you some things to celebrate this week.

A major concern for parents and providers over the past few months has been uncertainty around potential transmission of COVID-19 from an infected mother to her newborn infant. Because of that uncertainty, some authorities had recommended separation of mother and newborn.

Now, a study published last week in The Lancet, as well as new guidance from the CDC and AAP, put much of these concerns to rest.

Lancet Study Finds Perinatal Transmission Unlikely to Occur if Correct Hygiene Precautions Are Taken

The authors of the Lancet study identified 120 neonates of mothers who had tested positive for COVID-19, 82 of which completed follow-up and were included in the final analysis. To date, this is the largest US cohort of neonates born to SARS-CoV-2-positive mothers and evaluated with serial testing.

The mothers could practice skin-to-skin care and breastfeed in the delivery room but had to wear a surgical mask when near their neonate and practice proper hand hygiene and breast cleansing before skin-to-skin contact, breastfeeding, and routine care. 83% of the infants roomed in with their mothers. These infants were kept in a closed isolette, six feet apart from their mother unless feeding.

None of the infants tested at 5-7 days and then again at 14 days contracted COVID-19.

CDC and AAP Update Guidance for Rooming In

In addition to the Lancet article, the Center for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) have each revised their guidance on how to care for newborns at risk for maternal exposure to COVID-19. These revisions were not issued because of the Lancet article, although they are clearly related and mutually supportive.

The revised CDC guidance emphasizes that “early and close contact between the mother and neonate has many well-established benefits” and that “the ideal setting for care of a healthy, term newborn while in the hospital is in the mother’s room.” It further states that “current evidence suggests the risk of a neonate acquiring SARS-CoV-2 from its mother is low,” and “data suggests that there is no difference in risk of SARS-CoV-2 infection to the neonate whether a neonate is cared for in a separate room or remains in the mother’s room.”

The CDC suggests a series of considerations for discussions with families on whether a neonate should remain in the mother’s room and recommends specific measures to minimize the risk of transmission if the neonate remains in the room with a mother who has suspected or confirmed COVID-19.

Similarly, the revised AAP guidance, based on “months of national and international experience with babies whose mothers tested positive for SARS-CoV-2,” states that “mothers and newborns may room-in” when “precautions are taken to protect newborns from maternal infectious respiratory secretions.”

The AAP also provides a set of recommended precautions for care of mothers with confirmed or suspected COVID-19 and their well newborns.

Helpful Clarification

We hope this new information helps to clarify how to best proceed with this critical component of the Baby-Friendly protocol.

The entire team at Baby-Friendly USA sends our deepest gratitude to all healthcare providers, staff and first responders for the heroic work you are doing to provide incredible care to your patients. And we wish everyone a happy and safe World Breastfeeding Week.