Breastfeeding and COVID-19 | Live Broadcast

Pediatrician Lilit Marutyan answers the questions about breastfeeding that concern mothers.

UNICEF Armenia
Mother is breastfeeding her one year old boy.
UNICEF Armenia/2020/Grigoryan
10 August 2020

Can breastfeeding be continued if the mother and/or the baby are infected with COVID-19?

- The WHO position has initially encouraged mother and child to be together, regardless of infection. From the first hours of life, the child should receive the best food, if there are no objective reasons to prevent it. This approach is explained as follows: the risks of quitting breastfeeding are much more serious and undesirable than the possible risks of being infected with COVID -19.

In the early months of the spread of coronavirus, the American Pediatric Association advocated the need to separate the baby from a mother infected with the coronavirus. Now the picture has changed. The mother is the decision-maker: if she wants to keep the baby by herself and breastfeed, then the baby should stay with the mother and be fed; in compliance with safety rules: clean hands, a mask, enough distance when there is no need to be close to the baby.


What is exclusive breastfeeding?

- The word EXCLUSIVE says it all. Breast milk fully meets almost all the needs of the organism, growth and development of a baby until 6 months. Why almost? Because there is an exception, the amount of vitamin D in breast milk is not enough for the baby. This is why the child receives vitamin D in the form of drops - 400-500 units per day, regardless of weather conditions. Exclusive breastfeeding also means not offering water or any other liquid to a pre-6-month-old baby. All the "miracles" that promise milk formulas and teas producing companies are just commercial tricks. No food has yet been created that can completely replace breast milk.


How to understand if the quantity of breast milk is enough for the needs of the baby? What if the child stays hungry?

- Is your breast milk enough for your baby? The answer to this question is very easy to acquire. Follow the diapers. Having at least six full diapers a day indicates that your baby is getting enough food.

Night feedings are essential to ensure uninterrupted milk production during the day. At least every 2-3 hours during the night the baby should be fed, whether he demands it or not.

By the age of 6-7 months, many babies are able to stay without food or water for about 5-6 hours, and if the baby has already started sleeping for a long time, you leave him undisturbed, and do not feed him / her at night.

The belief that "my milk is not enough" is the number one reason for cutting a child off from the breastfeeding; and if it is accompanied by psychological pressure from relatives, acquaintances and strangers, the mother reaches an extreme point beyond which she no longer believes she is able to provide the best nutrition for her child and decides to move to alternative nutrition.

The reality is different: every woman is able to feed her baby. Nature has developed a fantastic mechanism by which breast milk is changed and adapted to the needs of the baby's organism. For example, during the first 5 days after birth, a colostrum is produced instead of milk, less in quantity but thicker, has a laxative effect, which helps the baby's first stool to come out more easily, has the ability to protect the intestines, and so on. Then comes the "transitional" milk and only two weeks later the baby begins to receive the "main" milk.


Can breastfeeding technique affect milk quantity?

- The first few days of a child's life are critical. If the mother is not properly educated from the beginning on how to feed the baby (position, frequency, longitude, etc.) it is likely that the mother will not be able to organize the breastfeeding process in the future. The role of staff in maternity wards is very important, as the pediatrician sees the baby only 4-5 days after birth.

It is often said that the newborn reflexively "knows" how to hold the breast and how to eat, but this is an exaggeration. Yes, the baby has the reflexes to pump out milk, but professionals have to teach how to feed properly.

Improper feeding position, infrequent feedings, and offering only one breast at each feeding, eventually leads to the breasts not being emptied completely and the brain does not get the order to produce milk. This is why it is important to empty the breasts after each feeding. Breast milk production operates on a demand-supply basis. The baby should be fed at least 8-12 times in 24 hours. During the first months, the baby should be fed whenever he demands. After a while, the mother and the baby will "find" their feeding pattern.


What are the contraindications of breastfeeding?

- This list of contraindications below is not exhaustive:


● Some medications taken by the mother: ergotamines, statins, chemotherapy

● Herpes on the breast/nipple skin

● Child galactosemia

● Hepatitis C if there are cracks/bleeding nipples

● X-ray examinations, tooth extraction or treatment and many other interventions are compatible with breastfeeding


How to stop breastfeeding?

- Both starting and finishing breastfeeding should be done gradually. Stopping breastfeeding is a stressful process for both the mother and the baby; which is why it is important to be done gradually. In addition, abrupt interruption can lead to clogging of the ducts, so, if necessary, it is possible and necessary to pump the milk. If the interruption is a purely planned decision and there is no need to do it very quickly, then the breastfeeding should be reduced by one feeding every 2-5 days. First, you need to reduce the frequency of daytime feedings, then the nighttime ones.


You can read the article and watch the recording in Armenian here

This article is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of authors and do not necessarily reflect the views of USAID or the United States Government