COVID-19 and breastfeeding

SARS-CoV2 is a novel coronavirus, causing a highly infectious respiratory illness, COVID-19. It has led to at least 4.5 million confirmed cases and over 300,000 deaths globally. Governments around the world, including the UK, have taken unprecedented measures to limit the spread and this has a had significant effect on everyone, including pregnant and postnatal women.

There is an urgency to understand the effects of COVID-19 on maternal and infant health, including breastfeeding. Evidence to support the safety of breastfeeding is limited, current World Health Organisation (WHO) and National Health Service (NHS) guidances suggest the benefits of breastfeeding outweigh the risk and recommend women to continue to breastfeed. But there are concerns about (a) the safety of medications for breastfeeding among women with COVID-19 , (b) how infant feeding hygiene practices can be optimised, and (c) what factors are important for the initiation and continuation of breastfeeding during this time.

The aim of the three living systematic reviews listed below is to answer these research questions. As living systematic reviews, we will search relevant databases monthly to identify new evidence which will be added to an evidence table accessed from this webpage. When relevant new findings become available, an updated review will be submitted for publication.

Research questions:

• Safety of prescription-only medications for breastfeeding in women who took or were administered them for diagnosed or suspected COVID-19 infection: a living systematic review. Link to PROSPERO protocol.
• What are the barriers and facilitators to optimizing parents’, carers’ and healthcare workers’ infant feeding hygiene practices to prevent transmission of respiratory infectious diseases, including COVID-19? A living systematic review. Link to PROSPERO protocol.
• What factors that are associated with breastfeeding initiation, duration and exclusivity of breastfeeding during the SARS-Cov2 pandemic? A living systematic review. Link to PROSPERO protocol

Keywords: COVID-19; breastfeeding; SARS-CoV2; medication; prescription-only; safety; hygiene, initiation of breastfeeding; continuation of breastfeeding; breast milk; infant feeding.

The review team comprises international experts in midwifery, infant and maternal health, nursing, obstetric, pharmacology, primary care, public health, and systematic reviewing:

• Professor Debra Bick, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, United Kingdom - link to profile
• Dr Joanne Fisher, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, United Kingdom - link to profile
• Dr Yan-Shing Chang, Child and Family Health Department, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, United Kingdom - link to profile
• Dr Abimbola Ayorinde, Warwick Centre for Applied Health Research & Delivery (W-CAHRD), University of Warwick, United Kingdom - link to profile
  
• Dr Yuh-Lih Chang, Faculty of Pharmacy, National Yang-Ming University; Department of Pharmacy, Taipei Veterans General Hospital, Taiwan - link to profile
• Dr Ejaz Cheema, School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom - link to profile
• Professor Li-Yin Chien, Institute of Community Health Care, School of Nursing, National Yang-Ming University, Taiwan - link to profile
• Dr Sarah Hillman, Unit of Academic Primary Care, Warwick Medical School, University of Warwick, United Kingdom - link to profile
• Dr Paul Sutcliffe, Warwick Evidence, Warwick Medical School, University of Warwick, United Kingdom - link to profile