Breastfeeding during coronavirus
An interview with nutrition expert at UNICEF South Asia
Isolating during this outbreak of coronavirus (COVID-19) has been stressful for most. But for parents with babies and young children, there is an added concern. How can they best protect their babies? We talked to Harriet Torlesse, a nutrition expert at UNICEF’s South Asia Office, on what parents can do to ensure that their babies are protected and well-nourished during this crisis.
What are some of your most pressing concerns regarding infants and their nutrition?
Governments across the South Asia region have put in place measures to stop the spread of coronavirus and have been advising people to keep at least one metre away from others. We’re worried that this message will mean that mothers are afraid to breastfeed their babies.
All the evidence suggests that it’s safe for mothers to breastfeed. So, we encourage all mothers continue to breastfeed their infants and young children up to at least two years. Breastmilk offers the best protection and nourishment for your child. It contains vital antibodies and other nutrients that can help the baby’s immune system to fight infections.
What if a breastfeeding mother is sick and has symptoms of coronavirus?
A mother can breastfeed, even if she develops symptoms of coronavirus infection such as fever or a cough. The benefits of breastfeeding far outweigh the risks of infection. At the same time, it is really important that the mother follows all the recommended practices to prevent her from spreading the infection to her baby or anyone else in the household. That includes washing her hand with soap for at least twenty seconds, wearing a facemask and cleaning any surfaces that she touches. If the mother does not have a facemask, she should still continue to breastfeed because the benefits are greater than the risk of infection.
What if the mother is too ill to breastfeed?
Women with young babies are generally at lower risk of severe illness because of their age. However, we do know that the virus can make you feel very unwell, and some people can become severely sick. If a mother feels too unwell to breastfeed, wherever possible, she can express milk. Then the mother or someone else can feed the milk to the baby with a clean cup and spoon. If that is not possible, another breastfeeding woman can breastfeed her baby, if this is culturally appropriate. If neither of these options are possible, the best course of action is to seek advice and support from a health worker.
What is important to know is that cow’s milk or any form of formula or growing up milk [powdered milks] are not a good option for most babies and young children. Cow’s milk is not suitable for any baby less than 12 months of age because it does not have the right balance of nutrients. Formula milk is risky because it is expensive, and difficult to prepare safely. Sometimes families dilute it too much to make it last longer, and don’t have clean water to mix it with. Their babies may then fall sick with diarrhea or become malnourished. And once a mother reduces or stops breastfeeding, her milk production can decline quickly. This can make it difficult for her to resume breastfeeding when she wants to. Giving infant formula is the last resort while a mother is recovering from COVID-19, and until exclusive breastfeeding can be established or reestablished.
Many families in South Asia are poor and struggling. How can these families support breastfeeding mothers?
It is so important that breastfeeding mothers feel supported. Having a young baby can be stressful even in normal times. And now parents have additional worries about money, food and what the future holds.
Mothers are better able to breastfeed when they have the support of their families though positive encouragement and the sharing of household responsibilities. Regardless of coronavirus, it’s also important that breastfeeding mothers get good nutrition. I know that families are struggling to put food on the table at this time. But look at it this way: it is much better to spend money to buy foods for the mother, than it is to spend that money on alternative milks for an infant. Breastmilk and breastfeeding are always the best option for infants and young children. It’s also true that almost all mothers, even those who are underweight or not able to eat the most nutritious foods, can breastfeed successfully. They should know that they can provide good breastmilk for their babies.
What about older babies and young children who need other foods?
For any child less than six months, exclusive breastfeeding is the best option. But once children reach six months of age, they need a variety of other nutritious food to grow up strong and healthy, in addition to breastmilk. Eggs, meat, fish and poultry are very good sources of nutrients for children. We know they can be expensive and that some families are vegetarian, so other good sources of nutrients are pulses, such as dhal and chickpeas, dairy products such as yoghurt, and fruits and vegetables.
This is a really difficult time for families, both in terms of their income and their access to markets. But if families have access to markets and if they have a choice, a range of these foods will provide the best possible nutrients for a young child.
There is one worrying trend. We are noticing that families are consuming less fresh foods and more packaged foods because it is difficult or impossible to go to shops and markets. Some of these packaged foods are a poor source of nutrition for all family members and especially for children. Biscuits, chips, candies, instant noodles and other packaged foods are often very high in salt, sugar and fat, and low in vitamins and minerals. They’re not appropriate for children. Neither are sugar sweetened beverages, such as sweetened fruit juices, flavoured milks and soda. It is best to avoid giving these foods to children.
What if a baby or a young child gets sick with coronavirus?
As every parent knows, young children can often get sick in their early years and this is always a worrying time. The good news is that young children seem to get mild coronavirus infections.
When your child is sick, they’re at much more risk of getting thin and weak. The important thing to remember is that when your child gets sick – with coronavirus or any other illness – nutritious food can help them recover. They’ll get better quicker if they get extra breastmilk, as much breastmilk as they will take. Breastmilk and breastfeeding is often comforting to a sick child. If they are six months and above, they will also need extra nutritious food.
Children can sometimes refuse food when they are not feeling well. If this is the case, it is best to try to offer them their favourite foods. And when they are feeling better, give them extra nutritious foods so they replace any weight they may have lost.
Are there any foods that can prevent you getting infected?
We’ve picked up lots of misinformation about certain foods or supplements offering protection against infection. These claims are not true. No food or supplement will prevent you catching COVID-19, and we don’t want families, especially those on a low income, to spend money on these products.
The most effective protection against infections is hand washing regularly, keeping at least one meter away from others, if that is possible, and wearing a mask if you are infected. These are the most important actions to prevent infection.
But good nutrition is very important for a healthy immune system. So a healthy diet that contains a range of different foods will boosts your immune system and makes it easier for your body to fight infection.
Can the virus be transferred through food preparation? Can parents and other caregivers who have coronavirus prepare food for their children?
Again, good hygiene is crucial. Just follow these simple rules:
Before preparing food, wash your hands with soap and water for 20 seconds and clean any surfaces where you will be preparing food. Before feeding your children, wash your own hands as well as your child’s hands. And if possible, feed the child with their own bowl and spoon so that there is no danger that other people will touch their food.
If the mother or the caregiver has any signs of infections, they should wear a face mask while feeding or caring for the child.