Maternal Transmission of SARS-CoV-2: Safety of Breastfeeding in Infants Born to Infected Mothers

Hayder M Al-Kuraishy; Ali I Al-Gareeb; Francis O Atanu; Mona A El-Zamkan; Hassan M Diab; Ahmed S Ahmed; Thabat J Al-Maiahy; Ahmad J Obaidullah; Sultan Alshehri; Mohammed M Ghoniem; Gaber E Batiha

doi:10.3389/fped.2021.738263

Maternal Transmission of SARS-CoV-2: Safety of Breastfeeding in Infants Born to Infected Mothers

Front Pediatr. 2021 Dec 9:9:738263. doi: 10.3389/fped.2021.738263. eCollection 2021.

Affiliations

¹ Department of Clinical Pharmacology and Medicine, College of Medicine, AL-Mustansiriyah University, Baghdad, Iraq.
² Department of Biochemistry, Faculty of Natural Sciences, Kogi State University, Anyigba, Nigeria.
³ Department of Food Hygiene and Control (Milk Hygiene), Faculty of Veterinary Medicine, South Valley University, Qena, Egypt.
⁴ Department of Animal and Poultry Health and Environment, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt.
⁵ Department of Gynecology and Obstetrics, College of Medicine, Mustansiriyah University, Baghdad, Iraq.
⁶ Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
⁷ Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
⁸ Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah, Saudi Arabia.
⁹ Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt.

Abstract

Coronavirus disease 2019 (COVID-19) is a recent epidemic disease caused by severe acute respiratory syndrome virus type 2 (SARS-CoV-2). In pregnancy, SARS-Cov-2 infection creates additional alarm due to concerns regarding the potential for transmission from the mother to the baby during both the antenatal and postpartum times. In general, breastfeeding is seldom disallowed because of infection of the mother. However, there are few exceptions with regards to certain infectious organisms with established transmission evidence from mother to infant and the link of infection of a newborn with significant morbidity and mortality. It is confirmed that pregnant women can become infected with SARS-CoV-2, although the debate on the possible vertical transmission of SARS-CoV-2 infection during pregnancy is still open. In this regard, the literature is still poor. On the contrary, the information on the safety of breastfeeding even during infections seems reassuring when the mother takes the necessary precautions. However, there are still answered questions regarding the precautions to be taken during breastfeeding by COVID-19 patients. This paper reviews the existing answers to these and many other questions. This review therefore presents a summary of the present-day understanding of infection with SARS-CoV-2 and discusses the answers around the maternal transmission of COVID-19 and the potential threat of breastfeeding to babies born to infected pregnant mothers. In conclusion, intrauterine transmission of SARS-CoV-2 infection is less likely to occur during pregnancy. Most studies suggest that COVID-19 is not transmitted through breast milk. Correspondingly, COVID-19-infected neonates might acquire the infection via the respiratory route because of the postnatal contact with the mother rather than during the prenatal period. International organizations encourage breastfeeding regardless of the COVID-19 status of the mother or child as long as proper hygienic and safety measures are adhered to so as to minimize the chance of infant infection by droplets and direct contact with the infected mother. Pasteurized donor human milk or infant formula as supplemental feeding can be quite beneficial in the case of mother-infant separation till breastfeeding is safe.

Keywords: COVID-19; breast milk; infectious disease; maternal transmission; pandemic.

Publication types

Review