The Unicef UK Baby Friendly Initiative has received a number of queries regarding best practice for infant feeding during the Covid-19 outbreak. We suggest that all practitioners follow latest updates from the UK governments and the World Health Organization (WHO) as these could change as more information becomes available.
There is a wealth of evidence that breastfeeding reduces the risk of babies developing infectious diseases. There are numerous live constituents in human milk, including immunoglobulins, antiviral factors, cytokines and leucocytes that help to destroy harmful pathogens and boost the baby’s immune system. Considering the protection that human milk and breastfeeding offers the baby and the minimal role it plays in the transmission of other respiratory viruses, it seems sensible to do all we can to continue to promote, protect and support breastfeeding.
To facilitate breastfeeding, mothers and babies should be enabled to stay together as much as possible, to have skin-to-skin contact, to feed their baby responsively and to have access to ongoing support when this is needed.
When mothers are partially breastfeeding they can be encouraged to maximise the amount of breastmilk they are able to give or, if they choose, to be supported to return to full breastfeeding. If mothers are considering stopping breastfeeding it is worth having a sensitive conversation about the value of continuing during the Covid-19 outbreak.
Public Health England (PHE) guidance
If you are breastfeeding while infected
There is currently no clinical evidence to suggest that the virus can be transmitted through breastmilk. Infection can be spread to the baby in the same way as to anyone in close contact with you. The benefits of breastfeeding outweigh any potential risks of transmission of the virus through breastmilk or by being in close contact with your child, however, this will be an individual decision and can be discussed with your midwife, health visitor or GP by telephone. If you wish to breastfeed, take precautions to limit the potential spread of Covid-19 to the baby by:
washing your hands before touching the baby, breast pump or bottles
avoiding coughing or sneezing on the baby while feeding at the breast
cleaning any breast pump as recommended by the manufacturer after each use
considering asking someone who is well to feed your expressed breastmilk to the baby
If you are feeding with formula or expressed milk, sterilise the equipment carefully before each use. You should not share bottles or a breast pump with someone else.
Parents should be encouraged to continue adhering to current guidance on washing and sterilizing equipment. Parents should be supported to bottle feed responsively, including pacing feeds and limiting the number of people who feed their baby.
Accessing infant formula – information from First Steps Nutrition Trust
There are reports of parents being unable to purchase infant formula. We have been informed that retailers do have stock and continued supplies of infant formula at this time. The main reason shelves have been bare in some shops is because of stockpiling. The British Retail Consortium have said that the major retailers will now limit purchases of infant formula to 2-4 tins per customer (retailers may vary in the number restricted) to ensure that there is fair distribution (BRC communication, 16th March 2020).
Local stores, pharmacies and corner shops do not seem to be experiencing the same empty shelves that the main supermarkets have had. Many pharmacies will order products for their customers if asked. Parents should be advised that stage 1 / first infant formula should be used for infants in the first year of life:
If you are unable to get your usual brand of first infant formula, don’t worry – you can use any first infant formula as all preparations have a similar nutritional composition to comply with legislation.
Don’t use stage 2 follow on formula for any baby under 6 months – only use first infant formula.
If you are using follow on formula for a baby older than 6 months and cannot access this, then use first infant formula.
If you are using other milks such as anti-reflux milk, comfort milk, etc. and can’t access these, then use first infant formula.
Always make up infant formula as per manufacturers guidance – do not be tempted to add more water to make it last longer as diluting the milk could endanger your baby’s health.
Information on infant formula can be found at: https://www.firststepsnutrition.org/parents-carers
Supporting close and loving relationships
Regardless of feeding method, it is essential that babies’ needs for emotional attachment with their parents / primary caregiver continues to be considered. Keeping babies close and responding to their need for food, love and comfort are all essential for babies’ health, wellbeing and development. In addition, this will enhance mothers’ mental wellbeing in the postnatal period.
A range of Baby Friendly resources on infant feeding and supporting close and loving relationships can be found at: Unicef UK Baby Friendly Initiative
Information on infant formula can be found at: First Steps Nutrition Trust