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Posted By: Susan M. Tiso, DNP, APRN, FNP-BC
June 19, 2020
One of the challenging features of COVID-19 is its ability to sweep through families. In my experience, this is more prevalent in multigenerational family living situations.
I recently tested a young, symptomatic mom of a 15-month-old toddler and a 26-day-old infant. Her elderly father-in-law was also living in their home and was the first household member to become infected with COVID-19. The patient (mom) tested positive for SARS-CoV-2 by polymerase chain reaction about 7 days after her father-in-law developed symptoms. She had upper respiratory symptoms, cough, and fever, but was able to stay at home, as she was only moderately ill and saturating well. Her spouse was managing to take care of everyone, allowing the mom and the father in law to self-isolate, rest, and recuperate. Because the patient (mom) was breastfeeding, she continued to pump but was discarding the breast milk since she feared it would put the infant at risk for the virus. I discussed the American Academy of Pediatrics (AAP) recommendations for breastfeeding with the patient and her spouse, given their circumstances.
To date, SARS-CoV-2 has not been found in breast milk, and breastfeeding can help protect infants from infections; additionally, breastfed infants are less likely to develop severe respiratory symptoms, according to AAP. Recommendations guide moms to pump and have another caretaker feed the breastmilk to the infant until it has been 7 days from the onset of symptoms and the mom has been afebrile for 72 hours without using antipyretics. For cases in which the mom wants to have close contact with the infant or breastfeed directly, she should be masked and follow strict handwashing precautions.
In this particular family, the toddler, newborn, and spouse all became ill about a week after the onset of COVID-19 in the mom; the children tested negative but the dad tested positive, requiring additional family to provide support. However, by the time the dad became ill, the mom had significantly improved, and she was feeding breastmilk to the infant, following guidelines. Virtual telehealth visits were set up to follow the family closely and provide interval assessments, support, and education.
- Wyckoff AS. AAP issues guidance on breastfeeding during COVID-19 pandemic. www.aappublications.org/news/2020/04/23/covid19breastfeeding042320. Accessed June 18, 2020.