Frequently Asked Questions on feeding premature babies

1. Should I still breastfeed my preterm baby if I have coronavirus?

If you have symptoms of fever, cough or difficulty breathing, you should seek medical care early and follow instructions from your health care provider. Breast milk is the best source of nutrition for most infants, though it needs to be fortified to meet the nutritional needs of preterm infants. There is currently no clinical evidence to suggest that the virus can be transmitted through breast milk. Infection can be spread to the baby in the same way as to anyone in close contact with you. UNICEF suggests that the benefits outweigh the risks and breastmilk is particularly essential for a preterm baby. It helps their immune system develop and aids in destroying harmful bacteria and infections.

Skin-to-skin contact is also important for preterm babies as they need a lot of love and connection to thrive. UNICEF suggests keeping mothers and babies together as much as possible while following necessary precautions when breastfeeding such as; washing your hands, wearing a mask and disinfecting feeding equipment. If you can’t breastfeed, consider expressing milk, asking someone who is well to feed your expressed milk to the baby.

If you have any further questions, contact your doctor.

2. Can my preterm baby contract Coronavirus while breastfeeding?

Much is unknown about how Coronavirus is spread. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory pathogens spread. In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk; however we do not know whether mothers with Coronavirus can transmit the virus via breast milk. It is suggested that that the benefits of breastfeeding outweigh any potential risks of transmission of the virus through breast milk or by being in close contact. If you are breastfeeding, you should take precautions to limit potential spread of COVID-19 to the baby:

1. Wash your hands before touching the baby, breast pump or bottles
2. Avoid coughing or sneezing on the baby while feeding at the breast
3. If you use a breast pump, clean it as recommended by the manufacturer after each use
4. Consider asking someone who is well to feed your expressed breast milk to the baby

If you have any further questions, contact your doctor

3. How to protect my preterm baby while feeding if I have COVID-19?

1. Wash your hands before touching the baby, breast pump or bottle
2. Wear a mask if you have symptoms of infection to avoid breathing, coughing or sneezing on the baby
3. Clean and sterilise all pump and feeding equipment thoroughly in accordance with your local COVID-19 guidelines
4. Consider asking someone who is well to feed your expressed breast milk to the baby
5. If needed, transport breastmilk to the NICU in a clean freezer bag and an insulated bag that is thoroughly cleaned in between use.
6. Restrict exposure to visitors

If you have any further questions, contact your doctor

4. How can I feed my preterm baby if I am not allowed into NICU due to COVID-19?

If you are unable to breastfeed your baby, you should transport breastmilk to the NICU in a clean freezer bag and an insulated bag that is thoroughly cleaned in between use.

If you are too sick to feed your preterm infant, consider a HCP feeding your expressed breast milk to your baby, if it is available you can use donor milk as a second alternative if available locally. Informal milk sharing (using/sharing milk with other mums) is never recommended, but particularly nowadays, while coronavirus – COVID-19 is such a concern. Although the virus has not been detected in breastmilk it can stay on the surface of containers and can also be passed on through close contact without the person being aware they have any of the symptoms

5. What should I do if my preterm baby has symptoms of Coronavirus?

If you have concerns about the wellbeing of yourself or your baby contact your HCP for advice as to whether or not screening for COVID-19 should be performed.