Amy Brown is a professor of child public health in the College of Human and Health Sciences. Her research explores how we can better support new parents to feed their baby, particularly concerns and questions they might have around breastfeeding.
This has taken on a whole new dimension during the current Coronavirus pandemic, so Professor Brown has put together answers to the top questions we have been receiving over the last few weeks to try and help.
Caring for babies can be stressful at the best of times, not least during a global epidemic. It’s only natural that many parents are concerned and are seeking reassurance. Thankfully, global health organisations, researchers and breastfeeding organisations are already on the case in helping answer your top concerns.
1. Can I still breastfeed my baby?
Yes absolutely. The World Health Organisation, UK Department of Health, Royal College of Obstetricians and Gynaecologists, Unicef UK Baby Friendly Initiative and more have also issued clear guidance saying that mum and baby should be kept together where possible, they should still have lots of skin to skin contact, and be supported to breastfeed.
Although at the moment research is limited (due to how quickly this epidemic has progressed), research from mothers in China who were diagnosed with Coronavirus found no transmission of the virus into their milk. We also know that there was no evidence of transmission during similar viruses such as SARS.
Importantly, we have lots and lots of research that breastmilk can help protect babies. It is full of live immune properties that helps boost their immune system at the best of times, but also, we know that when a mother becomes ill with an infection she can produce antibodies in her milk against that infection which she then passes to her baby. It is too soon to know definitively whether this is the case with Coronavirus but it is highly likely it is true. Again, in previous epidemics such as SARS, women who were infected were found to produce antibodies in their milk.
2. Can I still breastfeed my baby if I become unwell
Again yes. If you are well enough to feed your baby, you can carry on breastfeeding them. It is likely that if you have been exposed to a virus, your baby will have to. Given you are most likely now producing antibodies to the virus in your milk, continuing to breastfeed them if possible is the best idea. If you are too unwell to feed them directly, consider whether you can express some milk for your baby for someone else to give to them.
If you have been diagnosed with the virus (or have any symptoms) take particular care with washing your hands, wear a mask during feeding, and try not to cough or sneeze directly over them.
3. How do I breast or formula feed my baby safely?
As is the advice to the general population, keep washing your hands! Make sure before you feed your baby you have washed them. Also make sure anything you use to feed your baby – a breast pump, bottles or teats is sterilised. The virus can live on surfaces, so it is important that anything you use is properly cleaned.
It is also important to make sure, if you are using formula that you make the bottles up according to instructions taking particular care. Do not be tempted to dilute bottles; it’s really important feeds are made up correctly.
The Local Infant Feeding Information Board have excellent factsheets here specifically in relation to Coronavirus if you are breast or formula feeding your baby http://lifib.org.uk/update-March-2020/. The Breastfeeding Network and La Leche League International also have reassuring information.
4. I am struggling to find formula milk for my baby
Unfortunately, there have been lots of shortages in the shops of formula milk due to people hoarding more than they need. Be reassured that this is not an issue with formula supply, but panic buying. Shops are now restricting how much anyone can buy at once.
If your usual formula milk is not available, you can try a different one. There is very little difference between formula milks and unless your baby needs a medically prescribed version, you can try any first stage formula milk for your baby. Do not be tempted to buy follow on or toddler milks for a baby under one year old; first stage formula is the most nutritionally complete for your baby and if they are older than 12 months, they can be given cows milk instead.
If you cannot find a first stage formula, ask at a pharmacist. Many will order them in for you, but it might take a little longer and be a little more expensive. If you are struggling with any price increase, talk to your midwife or health visitor.
If you have any questions about formula feeding your baby, the charity First Steps Nutrition Trust and the Unicef UK Baby Friendly Initiative both provide lots of information on their website including how to choose an infant formula, how to prepare it safely and where to get more support.
Finally, if you are currently both breast and formula feeding, you might like to consider whether you can increase your breastmilk supply during this time, so you do not need to rely on formula milk. Although this might not be possible for everyone, if you feed your baby more frequently (or express your milk) you may find your milk supply starts to increase. Try to offer your baby the breast more frequently, cutting down on formula feeds slowly, and keeping an eye on how many nappies your baby is producing. The Association of breastfeeding mothers have a great factsheet here.
5. I am worried about getting feeding support
There is excellent support still available from the main breastfeeding organisations. Each has a website with lots of leaflets and information. You can also contact their helplines with any feeding related question, including of course information on giving formula milk.
The numbers are:
• National Breastfeeding Helpline 0300 100 0212.
• Association of Breastfeeding Mothers 0300 330 5453.
• La Leche League GB 0345 120 2918.
• National Childbirth Trust (NCT) 0300 330 0700.
If you have a query about a medication and breastfeeding, an excellent source of advice is the Breastfeeding Network Drugs in breastmilk service. They have a range of leaflets for different medications and procedures and you can contact a specialist pharmacist if needed.
The Association of Breastfeeding Mothers are also offering their ‘Team Baby’ module for free at the moment. This short course helps you and your partner, or anyone else supporting you learn more about breastfeeding.
If you would like further one to one support from a lactation consultant (someone who is highly trained in breastfeeding support and able to solve more complex queries), many are offering sessions via skype and similar programmes. You can find a full list of qualified lactation consultants on the Lactation Consultants of Great Britain website.
Although face to face breastfeeding support and baby groups will now have temporarily shut, many will have an online Facebook group, which may be moderated by peer supporters or local health professionals. If you cannot find one, ask your midwife or health visitor. There are also lots of great resources online (and too many to list here!), but do make sure what you are reading is accurate. One excellent source of reliable, moderated information on Facebook is the ‘breastfeeding yummy mummies’ group. The website KellyMom also has evidenced based answers to lots and lots of questions. We also offer lots of evidence based information about feeding your baby on our website.
Most of all, look after yourself and stay safe.