Breastfeeding during the COVID-19 pandemic

Interview with Mona Maman, UNICEF Sudan nutrition expert

Baby being held by mother
UNICEF/Aaliyah Madyun
10 August 2020

As Sudan joins the rest of the world to mark this Year’s World Breastfeeding Week starting from August 7th, under the theme “Support breastfeeding for a healthier planet”, UNICEF is calling on governments to protect and promote women’s access to skilled breastfeeding counselling, a critical component of breastfeeding support.  

UNICEF has urged mothers to continue to breastfeed their babies while observing all necessary safety and hygiene precautions during the COVID-19 pandemic. UNICEF stressed that the COVID-19 pandemic highlights the need for stronger measures to support exclusive breastfeeding.

What the link between breastfeeding and healthy parenting?

Also known as nursing, breastfeeding is the feeding of babies and young children with milk from a woman's breast. UNICEF and health professionals recommend that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. During the first few weeks of life, babies may nurse roughly every two to three hours, and the duration of a feeding is usually ten to fifteen minutes on each breast. Older children feed less often. Mothers may also pump milk so that it can be used later when breastfeeding is not possible. 

Breastfeeding has a number of benefits to both mother and baby, which infant formula lacks.

Breast milk provides the ideal nutrition for infants. It has a nearly perfect mix of vitamins, protein, and fat –everything your baby needs to grow. And it's all provided in a form more easily digested than infant formula. Breast milk contains antibodies that help your baby fight off viruses and bacteria. Breastfeeding lowers your baby's risk of having asthma or allergies. Plus, babies who are breastfed exclusively for the first six months, without any formula, have fewer ear infections, respiratory illnesses, and bouts of diarrhea. They also have fewer hospitalizations and trips to the doctor.

The physical closeness, skin-to-skin touching, and eye contact all help your baby bond with you and feel secure. Breastfed infants are more likely to gain the right amount of weight as they grow rather than become overweight or underweight children. 

What is the link between breastfeeding and a healthy planet? 

Breastfeeding contributes positively towards the health of our planet. Breastmilk is natural, renewable and environmentally safe – requires no packaging and creates no waste or pollution and it doesn’t cause diarrhoea or other childhood infections.  

What are some of your most pressing concerns regarding infants and their nutrition?

Governments across the world, including the government of Sudan, 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 to continue breastfeeding their infants and young children up to at least two years. Breastmilk offers the best protection and nourishment for a 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?

Considering the benefits of breastfeeding, the mother with suspected/confirmed COVID-19 infection should be encouraged to continuing breastfeeding. The mother should wear a mask (she could make one at home) when she is near her baby and perform hand hygiene before and after having close contact with the baby. She will also need to follow the other precautions to prevent virus transmission.

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 is possible, the best course of action is to seek advice and support from a health worker. 

Mothers can express breast milk with her hands, manual or electric breast pump. She should wash her hands before expressing breast milk or touching any pump or bottle parts and ensure proper pump cleaning after each use.

Giving infant formula is the last resort while a mother is recovering from COVID-19, and until exclusive breastfeeding can be established or reestablished.

How can families that are struggling economically 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 with the economic situation many 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 options 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, so other good sources of nutrients are pulses, such as legumes, 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.

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 favorite food. 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 from 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 from 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 and half metre away from others, if that is possible, and wearing a mask if you are infected as well as wearing mask to avoid getting infected by touching your face. These are the most important actions to prevent infection. 

Good nutrition is crucial for health, particularly in times when the immune system might need to fight back. Limited access to fresh foods may compromise opportunities to continue eating a healthy and varied diet. It can also potentially lead to an increased consumption of highly processed foods, which tend to be high in fats, sugars and salt. Nonetheless, even with few and limited ingredients, one can continue eating a diet that supports good health.

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.