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EDUCATIONAL INSIGHTS: Pearls from a Practicing Pediatrician - “Coronavirus COVID-19 in Infants, Children and Breastfeeding Babies”

Posted: Mar 17, 2020
Comments: 0
Author: UCA Admin

Content provided by Thomas W. Tryon, MD, MBA, FAAP; UCA Pediatric Section Chair

This winter, cold and flu season seems unending.  On top of having one of the worst influenza seasons I have seen in my almost 30-year career, we now are concerned about the worldwide pandemic of the novel Coronavirus COVID-19 and how much of an impact it will make on children and adults here in the United States.

To this point for infants and children the news appears to be good.  Coronavirus seems to be an infection that impacts adults much more than children.  In addition, information from China on children who were infected with the virus seems to indicate that they had a rather mild infection that mimicked the common cold with a runny nose, cough and fever.  Only one child was reported to have had vomiting or diarrhea.  The risk of severe illness, hospitalizations and death appears to be very low.  

The American Academy of Pediatrics (AAP) along with the Center for Disease Control in conjunction with other government agencies and state and local health departments are closely monitoring the situation.  The AAP is particularly monitoring the impact this will have on children and advocating with the federal government to ensure that children and healthcare providers for children have adequate resources to care for any children who become afflicted, and to work to ensure the safety of the healthcare workforce.

With many questions remaining about the virus and its impact on infants and children, Dr. Ann-Christine Nyquist, M.D., FAAP who is a member of the AAP Committee on Infectious Diseases urged healthcare providers, parents and patients to seek information only from trusted sources – the AAP, CDC and state and local health departments. 

She also provided the following advice:


As for breastfeeding infants, currently, approximately 85% of mothers initiate breastfeeding at birth.  We don’t have good information of the risk to the babe of continued breastfeeding with a mother who is infected or may be infected with the Coronavirus.  We do know that in the past two Coronavirus pandemics with MERS and SARS, the CDC reports that there was never any virus found in breastmilk and never a report of a baby being infected from breastfeeding.  However, there was one report of antibodies to SARS that were found in breastmilk of an infected mother.

Recently, the Academy of Breastfeeding Medicine (www.bfmed.org), an evidence-based breastfeeding science organization in the U.S. recently released this statement from Dr. Eidelman, Editor-in-Chief of Breastfeeding Medicine:  “Given the reality that mothers infected with coronavirus have probably already colonized their nursing infant, continued breastfeeding has the potential of transmitting protective maternal antibodies to the infant via the breast milk. Thus, breastfeeding should be continued with the mother carefully practicing handwashing and wearing a mask while nursing, to minimize additional viral exposure to the infant.”


As of this week, here is the latest information from the CDC regarding breastfeeding mothers who are “persons under investigation” (PUI) for Coronavirus COVID-19:  ”Breast milk is the best source of nutrition for most infants. However, much is unknown about COVID-19. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and healthcare providers.  A mother with confirmed COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast.  If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.”

My hope is, like we typically see with influenza, we will see Coronavirus burn out as we approach Spring and warmer weather.  Best wishes to stay healthy, rest as much as you can, and continue to practice good hand hygiene.   


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