The World Health Organisation and its sister agency, UNICEF, have encouraged women to continue to breastfeed during the pandemic, even if they have confirmed or suspected COVID-19 infection.

The UN agencies on Wednesday in a statement released via its website said that evidence indicates that it is unlikely that COVID-19 would be transmitted through breastfeeding.

The UN agencies made the submission after it released a new report on the status of the use of breast-milk substitutes across the world.

The report, “Marketing of breast-milk substitutes: National implementation of the International Code – Status report 2020”, provides updated information on the status of country implementation, including which measures have and have not been enacted into law.

The new report released by WHO, UNICEF, and the International Baby Food Action Network (IBFAN) reveals that despite efforts to stop the harmful promotion of breast-milk substitutes, countries are still falling short in protecting parents from misleading information.

It noted that the monitoring and enforcement of the Code is inadequate in most countries and most of the companies are beginning to take advantage of the pandemic to push their products to the market.

“The numerous benefits of breastfeeding substantially outweigh the potential risks of illness associated with the virus,” the authors find.

Breast milk is the only accepted food recommended for infants for the first six months of their lives.

Breastmilk saves children’s lives as it provides antibodies that give them a healthy boost and protect them against many childhood illnesses.

The COVID-19 scare has made some suspected and confirmed COVID-19 female patients stop breastfeeding and resulted in the use of breast milk substitutes.

However, WHO and UNICEF said it is yet to be proven that children can contract the virus through breast-milk.

Breastfeeding and COVID-19

WHO and UNICEF said active COVID-19 virus has not, to date, been detected in the breastmilk of any mother with confirmed or suspected COVID-19.

“It appears unlikely, therefore, that COVID-19 would be transmitted through breastfeeding or by giving breastmilk that has been expressed by a mother who is confirmed or suspected to have COVID-19.

“Women with confirmed or suspected COVID-19 can therefore breastfeed if they wish to do so,” they stated.

Red alert

The agencies lamented that breastfeeding is under threat as health systems are stretched thin.

UNICEF said babies who are exclusively breastfed are 14 times less likely to die than babies who are not breastfed.

“However, today, only 41 per cent of infants 0–6 months old are exclusively breastfed, a rate WHO Member States have committed to increasing to at least 50 per cent by 2025.

“Inappropriate marketing of breast-milk substitutes continues to undermine efforts to improve breastfeeding rates and the COVID-19 crisis is intensifying the threat,” it said.

WHO also said the pandemic is having a negative effect on the health care services aimed at supporting mothers to breastfeed, including counselling and skilled lactation.

“Infection prevention measures, such as physical distancing make it difficult for community counselling and mother-to-mother support services to continue, leaving an opening for the breast-milk substitute industry to capitalise on the crisis, and diminish confidence in breastfeeding.”

Code

Also, WHO and UNICEF called on governments to urgently strengthen legislation on the ban of all breast milk substitutes during the COVID-19 pandemic.

The agencies urged governments and civil society organisations not seek or accept donations of breast milk substitutes in emergency situations.

The Code bans all forms of promotion of breast-milk substitutes, including advertising, gifts to health workers and distribution of free samples. Labels cannot make nutritional and health claims or include images that idealise infant formula. Instead, labels must carry messages about the superiority of breastfeeding over formula and the risks of not breastfeeding.

Patti Rundall, of IBFAN’s Global Council, said the fear of COVID-19 transmission is eclipsing the importance of breastfeeding – and in too many countries mothers and babies are being separated at birth – making breastfeeding and skin to skin contact difficult if not impossible. All on the basis of no evidence, he said.

Meanwhile the baby food industry is exploiting fears of infection, promoting and distributing free formula and misleading advice – claiming that the donations are humanitarian and that they are trustworthy partners.

Of the 194 countries analysed, 136 including Nigeria, have in place some form of legal measures related to the International Code of Marketing of Breast-milk Substitutes and subsequent resolutions adopted by the World Health Assembly.

Meanwhile, UNICEF’s Chief of Nutrition, Victor Aguayo, said as the COVID-19 pandemic progresses, health workers are being diverted to the response and health systems are overstretched.

“At such time, breastfeeding can protect the lives of millions of children, but new mothers cannot do it without the support of health providers.

“We must, more than ever, step up efforts to ensure that every mother and family receive the guidance and support they need from a trained health care worker to breastfeed their children, right from birth, everywhere,” he said.

Guidelines

Guidelines for suspected or confirmed COVID-19 mothers who want to breastfeed their babies were also released. They include:

Wash hands frequently with soap and water or use alcohol-based hand rub and especially before touching the baby;

Wear a medical mask during any contact with the baby, including while feeding;

Sneeze or cough into a tissue. Then dispose of it immediately and wash hands again;

Routinely clean and disinfect surfaces after touching them.

Even if mothers do not have a medical mask, they should follow all the other infection prevention measures listed, and continue breastfeeding.