<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



Breastfeeding women infected with Covid-19 cannot transmit the virus through breast milk, according to a peer reviewed <a href="https://www.nature.com/articles/s41390-021-01902-y" target="_blank" rel="noreferrer noopener">study</a> published in Pediatric Research Tuesday, validating a small number of more limited studies and supporting recommendations from health organizations advising mothers to continue breastfeeding after infection and vaccination. 



<h2 class="wp-block-heading">KEY FACTS</h2>



A small proportion of recently infected mothers had genetic material from the virus that causes Covid-19 in their breast milk—6% of women with either a positive test or symptomatic illness or 9% with just a positive test—according to researchers from the University of California, who analyzed samples from 110 women.&nbsp;



However, the researchers said there was “no evidence” breast milk contained infectious virus or genetic material indicating viral replication, noting they were unable to culture the virus from the samples and that the genetic material was only “transiently present.”&nbsp;



There was also “no clinical evidence” to suggest infants got infected when breastfed by a mother with Covid-19, said lead author Paul Krogstad, suggesting “breastfeeding is not likely to be a hazard.”



The study is the largest of its kind so far and provides “substantial” support for a number of smaller studies with similar findings, the researchers said, as well as bolstering guidance from health organizations like the&nbsp;<a href="https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/pregnancy-breastfeeding.html" target="_blank" rel="noreferrer noopener">Centers</a>&nbsp;for Disease Control and Prevention and&nbsp;<a href="https://www.euro.who.int/en/media-centre/sections/press-releases/2021/who-recommends-continuing-breastfeeding-during-covid-19-infection-and-after-vaccination" target="_blank" rel="noreferrer noopener">World Health Organization</a>, which recommend mothers continue breastfeeding during the pandemic.&nbsp;&nbsp;&nbsp;



<h2 class="wp-block-heading">KEY BACKGROUND</h2>



There are many benefits to breastfeeding but there are rare cases where breast milk can transmit disease. It is a well-documented route of transmission for HIV and human T cell lymphotropic <a href="https://www.who.int/news-room/fact-sheets/detail/human-t-lymphotropic-virus-type-1" target="_blank" rel="noreferrer noopener">virus</a>—which can cause a type of leukemia and a progressive nervous system condition—and <a href="https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/ebola.html" target="_blank" rel="noreferrer noopener">Ebola</a> virus has been detected in samples of breast milk. The WHO says women with Covid-19 can breastfeed if they want to do so, but warns they should take <a href="https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/pregnancy-breastfeeding.html#breastfeeding" target="_blank" rel="noreferrer noopener">precautions</a> to prevent passing on the infection by other means, including wearing a mask during feeding, washing hands before and after touching the baby and routinely cleaning surfaces they’ve touched. 



<h2 class="wp-block-heading">TANGENT&nbsp;</h2>



Vaccination coverage among pregnant and breastfeeding people is<a href="https://www.wired.co.uk/article/pregnant-people-still-not-getting-vaccinated-covid" target="_blank" rel="noreferrer noopener">&nbsp;well below</a>&nbsp;average,&nbsp; fueled by muddled public health messaging that changed as new information came in and rampant&nbsp;<a href="https://www.washingtonpost.com/technology/2021/12/23/pregnancy-apps-covid-vaccine-misinformation/" target="_blank" rel="noreferrer noopener">misinformation</a>&nbsp;baselessly&nbsp;<a href="https://www.bbc.co.uk/news/health-57552527" target="_blank" rel="noreferrer noopener">suggesting</a>&nbsp;the shots can somehow harm mother, child or both (in fact, a Covid infection can have serious, potentially lethal,&nbsp;<a href="https://www.bmj.com/content/370/bmj.m3320" target="_blank" rel="noreferrer noopener">consequences</a>&nbsp;for both). While some vaccines can transmit infection to breastfed infants—the CDC cites smallpox and yellow fever vaccines, both of which use live viruses—none of the Covid-19 vaccines in widespread use do. Nor do the vaccines themselves appear in breast milk. Antibodies from the mother are&nbsp;<a href="https://www.nature.com/articles/d41586-021-01680-x" target="_blank" rel="noreferrer noopener">passed</a>&nbsp;on in breast milk, providing some degree of protection against the virus.



<h2 class="wp-block-heading">FURTHER READING</h2>



<a href="https://www.nature.com/articles/d41586-021-01680-x" target="_blank" rel="noreferrer noopener">COVID vaccines and breastfeeding: what the data say</a>&nbsp;(Nature)



<a href="https://www.nature.com/articles/s41390-021-01902-y" target="_blank" rel="noreferrer noopener">No infectious SARS-CoV-2 in breast milk from a cohort of 110 lactating women</a>&nbsp;(Pediatric Research)



<a href="https://www.nytimes.com/2021/04/08/health/covid-vaccine-breast-milk.html" target="_blank" rel="noreferrer noopener">Vaccinated Mothers Are Trying to Give Babies Antibodies via Breast Milk</a> (NYT)



By Robert Hart, Forbes Staff

SAFRICA-HEALTH-INFANTS

Breast Milk Contains Covid Genetic Material But Infected Mothers Won’t Transmit Virus Through Breastfeeding, Study Finds

Kenya’s first human milk bank has opened at Pumwani Maternity Hospital. Moina Spooner, from The Conversation Africa, spoke to the team spearheading APHRC’s research efforts in the establishment of Kenya’s first milk bank.



How long has it taken to open? What were the biggest obstacles?



The process of establishment of human milk banking in Kenya started in 2016. It was spearheaded by the NGO&nbsp;<a href="https://www.path.org/">PATH</a>, in partnership with APHRC and Kenya’s Ministry of Health, among other partners. It was rolled out in two phases.



During phase one we assessed people’s perceptions and acceptability of using donated human milk. We also looked at how feasible it would be to set a bank up. The results were encouraging. About 90% of participants were positive about it, 80% would donate their breast milk, and about 60% indicated that they would allow their children to be fed with donated human milk.



A committee was also set-up to provide oversight and guidance on human milk bank work in Kenya. They were sent to South Africa to learn more about the human milk banking process. Finally, local strategies were developed.



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We are now in phase two of the project: the establishment of a pilot human milk bank in Pumwani Maternity Hospital. This includes the launch of a research project which examines its feasibility, effectiveness, acceptability and aims to estimate the cost of establishing an actual human milk bank in Kenya.



There have been challenges. Being a new concept, there have been some logistical challenges, for instance some of the equipment wasn’t locally available so it took longer to get it all done and installed.



There have also been concerns by some community members and health workers over the safety and quality of the donor human milk.



However, we’ve had support from the government which has been critical in addressing the logistical challenges. Advocacy and communication activities are also being rolled out to create awareness on human milk banking and address any concerns.



What is a milk bank and how does it work?



Human milk banks are facilities that systematically collect, pasteurise, test, store, and distribute donated breast milk.



An effective system has many operational processes to ensure it provides safe, high quality donor milk. They start with screening and recruiting donors who must be healthy mothers with surplus milk beyond the needs of their own child’s. Donors must undergo health checks including tests that screen for HIV, syphilis, and hepatitis B and C. Diseases could be passed to children through breastmilk.



READ MORE | <a href="https://www.forbesafrica.com/focus/2019/02/04/kenyan-approach-holds-promise-for-boosting-early-childhood-education/" target="_blank" rel="noreferrer noopener" aria-label="Kenyan Approach Holds Promise for Boosting Early Childhood Education (opens in a new tab)">Kenyan Approach Holds Promise for Boosting Early Childhood Education</a>



Donors must then express milk in hygienic conditions, after which the milk is pasteurised. This involves heating the milk in a water bath at 62.5°c for 30 minutes followed by rapid cooling.



At the bank, the milk is frozen and stored at -20c. When needed, it’s thawed to room temperature and issued to children who don’t have access to their own mothers’ milk. A prescription by a qualified health professional is needed for this.



Why are they needed?



Although breastfeeding is the most natural and best way to feed infants, many babies may lack access to their mother’s milk. This could’ve happened for many reasons – maybe the mother is sick, hasn’t got enough breast milk or is dead.



From our formative research, 44% of newborns in urban health facilities were separated from their mothers for varying periods of time. This ranged from less than an hour to more than 6 hours and even days after birth. Of these infants, only 14% were fed on mother’s own milk during separation. 36% of the newborns weren’t fed on anything during this period and an additional 23% were fed on formula or cow’s milk.



When breastfeeding is not an option, the World Health Organisation (WHO) recommends donated human milk as a lifesaving alternative. Particularly for babies that were born early, have low birth weight, are orphaned, malnourished or are severely ill.



Evidence paints a very strong picture in favour of donated human milk over infant formula. It’s more effective in reducing the risk of disease and infections – like inflammatory bowel disease, leukemia and respiratory tract infections – in newborn babies and is better tolerated by babies that are born prematurely.



In the US and Brazil, the use of donated human milk was reported to reduce the length of hospital stay for sick infants and save on the cost of health care.



Given the benefits of using donated human milk over infant formula, the WHO has called for the global scale-up of human milk banks. These are expected to increase access to safe donor human milk.



Is this the first of many?



Although WHO recommends that the milk banks be set up, Kenya is just the second, after South Africa, to establish a human milk bank in sub-Saharan Africa – even though it is a pilot.



We hope that human milk banking will be scaled up in Kenya and the rest of sub-Saharan Africa, using the evidence we generate from our research.



-The Conversation



-Elizabeth Kimani-Murage; Research Scientist at the African Population and Health Research Center and Adjunct Assistant Professor, Brown University



-Milka Wanjohi, Taddese Zerfu, Esther Anono and Eva Kamande from the African Population and Health Research Center contributed to the writing of this article.



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Tag: breast milk

FORBES AFRICA SOCIAL MEDIA

Breast Milk Contains Covid Genetic Material But Infected Mothers Won’t Transmit Virus Through Breastfeeding, Study Finds

Kenyan Hospital Opens Human Milk Bank – A Rarity In Sub-Saharan Africa