Breastfeeding during COVID-19

We understand how stressful it can be to navigate life as a new parent. With the added anxiety brought on by COVID-19, we want to share trusted information to breastfeeding mothers who are COVID-19 positive or suspected positive, on whether their milk is still safe and beneficial for their baby.

COVID-19 is a new disease and researchers are still studying how the disease spreads. However, breast milk remains the best source of nutrition for most infants.

Current guidance from the Centers for Disease Control states that a mother who has been confirmed or suspected to have COVID-19 should take all precautions to avoid spreading the virus to her infant. These steps include:

  • Washing hands with soap and water for 20 seconds before touching the infant, pumping equipment or feeding supplies.
  • Wear a face mask when breastfeeding, pumping or handling the baby.
  • If using a breast pump, washing hands before touching the pump and following CDC recommendations for cleaning the pump after each use.
  • Follow current CDC guidelines for proper breastmilk handling and storage.
  • If bottle feeding pumped breast milk, have someone who is well feed the baby, if possible.

“Although there’s limited research available on whether COVID-19 is transmitted via breastmilk, studies on similar viruses did not find the virus in the milk,” said Dr. Reshmi Basu, a CHOC pediatrician. “A mother’s milk does contain specially made antibodies, produced by the mother’s body to protect her and her child from various viruses. These antibodies are transferred in breastmilk.”

Cindy Baker-Fox, registered nurse and certified lactation consultant at CHOC, explains how these antibodies make breastmilk a good source of nutrition for infants.

“Lifesaving antibodies in breastmilk protect babies from many illnesses and are one of the many unique properties found in human breast milk, making it not only a good source of nutrition but also valuable medicine for newborns and infants.”

If you have specific questions about breastfeeding and your baby, contact your pediatrician.

This article was updated August 5, 2020.

How to support someone who is breastfeeding

Laura Mize, registered nurse, international board-certified lactation consultant at CHOC Children’s

Each year, World Breastfeeding Week is celebrated in early August  to raise awareness of the benefits of  breastfeeding. This year’s theme,  “Empower Parents, Enable Breastfeeding” was chosen to be inclusive of all types of parents in today’s world. Breastfeeding is a team effort and involves more than just the baby’s mom.

Here at CHOC, we want to help empower parents and enable breastfeeding by providing support if your child is in the hospital. We understand that having a child in the hospital is stressful, and we know that our pumping and breastfeeding moms may need extra support during this time. Your baby’s bedside nurse and the lactation team will work together to help your family achieve feeding goals.

The mom’s support person is an important part of the team too! Helping mom takes many forms and families come in many different varieties. The mom’s support person may be the baby’s dad or mom’s partner, or it may be a friend or family member. The support person has a unique role that provides needed help to mom and increases the support person’s bond with the baby. The CHOC team provides education and guidance for mom and her support person.

Here are some examples of how the support person can help on a day-to-day basis:

  • Skin-to-Skin with baby is not just for moms! The support person can also do skin-to-skin, as tolerated by baby. Ask your nurse for details.
  • Diaper changes and temperature taking at care time if it is ok with baby’s bedside nurse.
  • Serve as a gatekeeper for family and friends. Everyone wants to know how baby is doing! The support person can provide updates and guide family and friends that want to help.
  • Help mom by keeping track of when it is time to pump or breastfeed.
  • Make sure the pumping/breastfeeding mom is getting proper hydration and nutrition. Ask your bedside nurse about meals available for  pumping and breastfeeding moms.
  • Getting mom and baby into breastfeeding position can feel awkward and challenging at first. The support person can help guide mom and baby. CHOC lactation consultants can teach you what you can to do to help.
  • Wash pump parts so they will be clean and ready for next pump session.
  • Love the baby! Babies can never have too much love.

The support person plays a valuable and important role that benefits both mom and baby. Please ask your bedside nurse what you can do to support mom and baby during their hospitalization.

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Breastfeeding: A Foundation for Life

By Alana Salcido, registered nurse and lactation consultant at CHOC Children’s

If you were to ask me back in nursing school what kind of nurse I wanted to be, I guarantee I never would have said I wanted to become a lactation consultant. I honestly didn’t even know this was a specialty at that time. Helping other moms succeed with breastfeeding is my way of giving back and my way of changing the world, one couple at a time.

World Breastfeeding Week 2018

Today kicks off World Breastfeeding Week, an annual observance to bring awareness to the importance of human milk and to offer education and encouragement to mothers, health care providers, and the community.

Breast milk is constantly changing

A mother’s milk is constantly changing. Her milk will actually change from feeding to feeding, day to day, month to month as her baby grows. For example, the first milk, known as colostrum, is rich in components that prevent and protect the newborn from common and potentially serious infections. Breastfeeding not only provides exceptional nutrition but it also promotes lifelong health benefits.

Benefits of breastfeeding: preventing disease

Breastfeeding is the most economical solution to the biggest threat against children’s health worldwide: malnutrition and preventable diseases. In developing countries, human milk can mean the difference between life or death in children under five because a mother’s milk provides necessary nourishment for babies.

Breast milk-fed infants have significantly lower rates of illness—even in industrialized countries. The longer a mother breastfeeds, the more infection fighting antibodies are passed to her infant through her milk. Just as the womb protected and nourished the developing child during pregnancy, the body was preparing to protect and nourish her baby after birth by stimulating milk production as early as 12-14 weeks gestation.

Lifelong benefits of breastfeeding

Research has shown that babies who receive breast milk have a lower risk of hypertension, type 1 and type 2 diabetes, allergies, cancer, asthma, intestinal and respiratory infections, and obesity both during childhood and adulthood. Health benefits occur not only for the baby, but for the mother as well. Breastfeeding helps reduce the maternal risks of diseases such as hypertension, type II diabetes, high cholesterol, osteoporosis, breast cancer, and even Alzheimer’s Disease. Research has shown that the health benefits, for both mom and baby, are dose dependent. This means that the longer a woman breastfeeds the greater the health benefits she and her baby receive. Because of this, the WHO (World Health Organization) recommends breast milk in a child’s diet for the first two years of life (with the addition of appropriate complimentary solid foods beginning at 6 months of age).

Lactation consultants can help mothers provide the benefits of breastfeeding

Some mothers who wish to breastfeed their babies face challenges. Statistically, 75 percent of moms in the U.S. start out breastfeeding. By the time babies are six months old, only 44 percent are breastfed.

CHOC Children’s has a team of registered nurses who are international board-certified lactation consultants. We work closely with medical teams to provide support to mothers who need assistance in producing lifesaving breast milk for children. We can also help them achieve their lactation goals which may be different for each mother and could include pumping milk for the first six months, or it might be to exclusively breastfeed until the baby is a year old. We want every child at CHOC to receive optimal nutrition. For the newborn, infant and young child, we support breastfeeding and breast milk use. We firmly believe it when we tell our families that breast milk Is medicine.

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Frozen Breastmilk Safety 101

By Caroline Steele, board-certified lactation consultant, board-certified specialist in pediatric nutrition, and registered dietitian at CHOC Children’s

Caroline Steele, director of clinical nutrition and lactation at CHOC Children’s

CHOC has board-certified lactation consultants as well as certified lactation educators available to assist breastfeeding or pumping moms. Many of our other staff members, including nurses, dietitians and developmental specialists, can also assist families with breastfeeding and pumping, and many have specialty lactation training.

Because nutrition is one of the most important factors in a baby’s health, CHOC Children’s provides lactation services to mothers who wish to breastfeed or pump while their baby is in the hospital.

Here are answers to some of the most common questions we receive on frozen breast milk safety.

Can breastmilk be frozen?

Yes, breastmilk can be frozen and should be frozen if it won’t be used right away (similar to what you would do with other foods).

What is the safest way to freeze breastmilk?

  • For preterm or hospitalized infants, it is generally recognized that milk that will not be used within 48 hours after it is pumped, should be frozen. For healthy babies at home, it is possible to store freshly pumped milk in the refrigerator for 5 days before needing to freeze it.
  • Milk should be frozen in rigid plastic bottles or plastic bags specifically designed for breastmilk storage. Plastic bags are not recommended for hospitalized infants because they are prone to leaking and are more difficult to handle in the hospital setting.
  • Freeze milk in volumes that the baby would normally eat so that once it is thawed, none is wasted.
  • Never add freshly pumped milk to a bottle already containing frozen milk. Newly pumped milk should go into its own container.

How long can breastmilk be frozen?

  • If freezing/storing breastmilk in a combination refrigerator/freezer unit, the milk should be stored in the back of the freezer to keep it from being exposed to temperature fluctuations when opening and closing the freezer door. In this type of unit, the milk may be stored 3-6 months.
  • If freezing/storing breastmilk in a deep freezer that can maintain a temperature at or below zero degrees Fahrenheit, it may be stored for 6-12 months.
  • Once frozen milk has been thawed, it must be used within 24 hours or discarded.

I’m giving my baby frozen breastmilk. Are there any risks I should know about?

  • It is best to use the oldest pumped milk first to prevent milk from being frozen too long.
  • Some of the immune enhancing properties of breastmilk are decreased over time when milk is frozen. However, the risk of bacterial contamination of milk that has been kept in the refrigerator too long and not frozen, far outweighs the downside of freezing milk.
  • Sometimes there are slight changes in the taste and smell of milk that has been frozen due to the enzymes naturally present in breastmilk. Those changes are not harmful and don’t matter to most babies.  However, some babies do have a noticeable preference for milk that has not been previously frozen.

Get more helpful tips about lactation and breast milk

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How to Tell If Your Baby is Getting Enough Milk from Breastfeeding

By Michelle Roberts, registered nurse and certified lactation consultant at CHOC Children’s

Every year in August, we celebrate World Breastfeeding Week. This year’s focus is “Sustaining Breastfeeding Together.” As a lactation consultant, the most common question I get from parents of a breastfed infant is, “How do I know my baby is getting enough?” When we bottle feed an infant we can look at the measurements on the bottle to determine the exact amount that a baby gets. When a mom is breastfeeding, she may be concerned because she can’t see the amount taken. A common reason women give up on breastfeeding is feeling they are not producing enough milk.

Here are 5 key indicators a baby is getting enough milk directly from the breast.

  • Breastfeeding 8-10 times minimum per day. Newborn babies should be breastfed a minimum of 10 times per 24 hours. As the baby gets older and is gaining appropriate weight, they may cut back to 8 times per 24 hours. We recommend keeping a breastfeeding log. Start by downloading a template breastfeeding log.
  • Latches well and maintains latch. Babies should latch and remain latched without coming on and off throughout the feeding. It can be difficult to transfer adequate milk if they are not staying on the breast. For the most part, breastfeeding should not be painful. If you are experiencing bleeding or scabbing, the latch is not deep enough and can lead to low weight gain and low milk supply.
  • Audible swallowing. A baby’s suck pattern and frequency of swallowing will change throughout the first three to five days. When a baby is first born, they will be sucking more often than swallowing but as mom’s milk supply increases, the swallowing should increase too. Mom’s milk usually increases between Day Three and Day Five after giving birth.
  • It is important to track a baby’s diapers to make sure they are producing enough diapers based on their age. Your birth hospital or your pediatrician will provide you with a diaper log that will show you how many wet and dirty diapers are expected based on your baby’s age.
  • Weight Gain. All newborn babies lose some weight shortly after birth. Your pediatrician will determine if they lose too much weight. Once mom’s milk supply has increased in volume, the baby should gain an average of 1 oz. per day.

What do you do if you are not sure your baby is getting enough at the breast?

Your pediatrician is always a great person to help you determine whether your baby is doing well. It is also helpful to reach out to women in your life that have breastfed. Call your mom, your sister, a neighbor or a friend for support. It is also beneficial to be aware of your resources within your community. Most birth hospitals have lactation consultants that can work with you on an outpatient basis. A lactation consultant will be able to determine the amount of milk a baby transferred from your breast to your baby’s stomach by using a breastfeeding scale. They can also assist with supplementing at the breast directly.

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