L.I.F.E.™ Support for COVID-19

The Carolina Global Breastfeeding Institute, Lactation and Infant Feeding in Emergencies (L.I.F.E.™) Initiative is a hub for research, technical assistance, health communications, policy, advocacy, and training for infant and young child feeding in emergencies at the Gillings School.

Information on Breastfeeding, Community, Mental Health, and Child Care may be found by clicking through the tabs below.

Click here for CGBI infographics and webinars.

“Ready Set Baby Live” Virtual Prenatal Education (offered during the pandemic)

Formula Shortage
Mental Health
Child Care

National Healthcare Provider Sourced Information

Academy of Breastfeeding Medicine

American Academy of Nursing

American Academy of Pediatrics

Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)

Centers for Disease Control and Prevention

Federal Drug Administration

North American Society For Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN)

US Health and Human Services


US Department of Agriculture

US Lactation Consultant Association

White House (US Government)

World Health Organization

State and Community Breastfeeding Organization Sourced Information

Alimentacion Segura Infantil ASI (Puerto Rico)

“Signs that feeding is going well” Infographic (UK)

Infant Ready (NOLA Breastfeeding Center and Birthmark Doula Collective)

La Leche League International

Michigan Breastfeeding Network: Breastfeeding in emergencies resources and graphics

North Carolina

Safely Fed USA

Community Milk Sharing Resources

Eats on Feets

Free to Feed

Get Pumped (Florida)

Human Milk 4 Human Babies (see state and local sites on Facebook)

LLLI Milk donation and sharing

Mother’s Milk Alliance  (Wisconsin)

Perinatal Services BC

Workplace Supports

A Better Balance blogpost discusses the role of workplace support on new families trying to feed their babies. Some highlights:

  1. Federal laws may protect against discrimination and accommodations for pregnant and lactating workers
  2. State protections for postpartum and lactating workers have ramped up – see a map here.
  3. State paid family & medical leave and paid sick time laws can provide time off from work: state list
  4. Individual employers may have specific policies regarding paid time off
  5. For more info: a family can consult their Workplace Rights Hub, or the free confidential legal helpline at 1-833-NEED-ABB

(Info in this tab last updated July 01, 2022)

Key Links to Interim Guidance on Breastfeeding and COVID-19

Information about perinatal COVID-19 transmission is changing rapidly. These resources linked below contain key messages for the protection, promotion, and support of breastfeeding, use of donor human milk, and safer use of breastmilk substitutes for COVID-19. We recommend that organizations draw upon these key messages to design tailored health communications materials appropriate for their patient populations, communities, and other audiences.

COVID-19 – Key Messages

COVID-19 – Vaccines and Lactation

Bookmark the sites below to stay up to date on the emerging guidance for infant feeding and COVID-19.

World Health Organization and UNICEF Global Guidance

Compilation of Global Health and Health Professions’ Organizational Guidance

U.S. Centers for Disease Control and Prevention

While there is limited guidance for COVID-19 and formula feeding, the CDC website provides recommendations for washing and sanitizing bottles, nipples, and/or cups used to feed infants as well as washing and sanitizing pumps used for milk expression. The World Health Organization also has guidance on the Safe preparation, storage, and handling of infant formula: Guidelines. Appropriate respiratory hygiene, hand washing, and cleaning and disinfecting of surfaces and feeding supplies is recommended for infant care and feeding for all infant caregivers who have symptoms of, are under investigation for, or have confirmed COVID-19 regardless of infant feeding method.

Human Milk Banking Position Statements

Evidence Reviews and Round-Ups

COVID-19, Maternal Child Health Nutrition – What does the science tell us?

An Evidence Summary of Paediatric COVID-19 Literature (English language only; posted 5 April 2020)

Operational Guidance for Infant and Young Child Feeding in Emergencies

(Info in this tab last updated September 17th, 2021)

Mobilizing Community Response for COVID-19 and L.I.F.E. Support

The disruption of employment, education, job security, food security, social support networks, and access to basic health care services puts people who are pregnant, infants, and young children at high risk of illness in any outbreak or emergency. Communities in which there is pre-existing poor health, poverty, and constrained access to resources bear a disproportionate burden of disease and suffering. It is critical that communities, emergency responders, and health care facilities join together to create a social safety-net for maternal, child, and family health.

The CDC has released guidance for community-based preparedness and response that may assist community-based organizations to adapt their perinatal and postpartum services during the COVID-19 outbreak. Some recommended actions include:

  • Assist families to complete their home checklist by providing them with contact information to local community organizations offering perinatal, postpartum, and infant/young child health care services, social services, and mental health support;
  • Assess families’ access to public health communications, phone and internet service, transportation, and basic perinatal and postpartum medical care and social support services in your area;
  • Assist in linking pregnant individuals, infant caregivers, and families in need with programs that provide emergency food, supplies, and other essential needs during the COVID-19 outbreak in your area;
  • Set up phone trees, check-ins, and other systems of social support (e.g., grocery delivery services; medication refills) to ensure families have what need they if they are sick or are caring for sick people in their home;

More Resources for Community-Based Perinatal and Postpartum Support Organizations

Birthing People’s Bill of Rights

Healthy Mothers, Healthy Babies Coalition of Georgia Navigating COVID-19 Resources for Pregnant and Postpartum Families

Health Connect One Statement on COVID-19 and resources for community-based doulas, breastfeeding peer counselors, community health workers, and partner organizations.

DONA International COVID-19 and Doulas – DONA International Recommendations and Doulas & COVID-19 Toolkit

Mamatoto Village’s A Black Mama’s Guide to Living and Thriving

National Association of Community Health Workers COVID-19 Resources, Resources to Help Community Health Workers

National Association of the Deaf: Communicating with Medical Personnel During Coronavirus

YWCA USA COVID-19 Emergency Response resources page

YWCA USA Gender-Based Violence fact sheets for helpers and program planning [scroll to the bottom of the page for links]

U.S. CDC Interim guidance for homeless service providers to plan and respond to coronavirus disease 2019 (COVID-19)

U.S. CDC Caring for Children: Tips to keep children healthy while school’s out

U.S. CDC Recommendation regarding the use of cloth face coverings, especially in areas of significant community-based transmission

U.S. DHHS National Culturally and Linguistically Appropriate Services Standards

North Carolina Department of Health and Human Services, Interim Coronavirus 2019 (COVID-19) Guidance on Personal Protective Equipment for Non-Medical Setting, including In-Home Service and Non-Emergency Medical Transportation Providers

Community Engagement, Health Equity and COVID-19

African American Policy Forum

Asian and Pacific Islander American Health Forum What Asian American, Native Hawaiian, and Pacific Islander Community Organizations Need in the Face of the COIVD-19 Pandemic

Health Connect One and Alimentación Segura Infantil (ASI) Maternal Health in Puerto Rico During COVID-19

Medium Healing Resources for BIPOC Organizers

NAACP Coronavirus and Our Communities of Color

National Academy of Medicine Resources on Health Equity in the Context of COVID-19 & Disproportionate Outcomes for Marginalized Groups

United Nations Interagency Standing Committee COVID-19: How to include marginalized and vulnerable people in risk communication and community engagement

(Info in this tab last updated July 24, 2020)

Resources to Support Caregivers and Families

It is critical that the unique mental health and psychosocial needs of parents and other caregivers of infants and young children in emergency situations are included in the prenatal and postpartum care that people receive.

Community organizations and the lactation professionals and peer supporters providing perinatal and postpartum care to families in community settings may find the resources below useful during your COVID-19 response.

Consider ways that these resources may be integrated into your practices and services in emergency settings, such as the COVID-19 pandemic.

American Psychological Association Pandemics Resource – a comprehensive directory of websites with resources to support mental health and psychosocial support in the U.S.

Coronavirus Disease 2019 (COVID-19) CDC Resources:

Duke Center for Child and Family Policy Strategies to Support the Well-Being of Essential Child Care Staff and Young Children During COVID-19

FUTURES Without Violence Information on COVID-19 for Survivors, Communities, and DV/SA Programs

Marcé of North America – COVID-19 Resources for Mental Health and Medical Professionals

Mamatoto Village’s A Black Mama’s Guide to Living and Thriving

National Child Traumatic Stress Network Public Health Resources: Parent/Caregiver Guide to Helping Families Cope with the Coronavirus Disease 2019

National Harm Reduction Coalition Pregnancy and Substance Use: A Harm Reduction Toolkit

On Our Sleeves Behavioral Health Resources for Coronavirus from Nationwide Children’s Hospital

SAHMSA Taking Care of your Behavioral Health During an Infectious Disease Outbreak: Tips for Social Distancing, and Isolation

Zero to Three Tips for Families: Talking about the Coronavirus


Accessing Mental Health Services

Disaster Distress Helpline – Immediate crisis counseling related to disasters, 24/71-800-985-5990

HRSA National Maternal Mental Health Hotline: Call or text 1-833-9-HELP4MOMS (1-833-943-5746)

Marcé of North America – Perinatal mental health resources

National Suicide Prevention Lifeline – 1-800-273-TALK (8255) Free and confidential support for people in distress

Postpartum Support International Get Help PSI Helpline and links to find local resources

SAMSHA Behavioral Treatment Services Locator

SAMSHA National Helpline – Treatment referral and information, 24/7 1-800-662-HELP (4357)


Additional Resources for Helpers and First Responders

Creating Trauma-Informed Systems

National Child Traumatic Stress Network

Psychological First Aid Mobile Response App for Helpers and First Responders: PFA Mobile (iOS and Android)

Psychological First Aid Training

Resources to Provide Trauma-Informed Care to Families


Gender-Based Violence Prevention & Survivors’ Support

GBV Pocket Guide (International Rescue Committee, Inc.) The GBV Pocket Guide resource provides step-by-step guidance and tools to all humanitarian practitioners across all sectors on how to support survivors of gender-based violence (GBV) when there are no GBV services, referral pathways or focal points in your area. It uses global standards on providing basic support and information to survivors of GBV without doing further harm. The user-guide for this tool is found here.

MyPlan is a tool to help with safety decisions if you, someone you care about, is experiencing abuse in their intimate relationship. Additional information about MyPlan can be found here.

New Mom Health Being Safe at Home page also links to resources at the National Domestic Violence Hotline and love is respect (loveisrespect.org)

YWCA USA Locator – YWCA is the largest provider of domestic violence services in the U.S. Across the country, we serve over 500,000 women and children every year with programs ranging from emergency shelters and resources to support groups and crisis hotlines.

*Please note that the resources linked above are resources that have been developed primarily for implementation in the United States. Some of the resources listed may only be accessible in the U.S.

(Info in this tab last updated June 07, 2022)

Resources to Support ECE Professionals

Early Care and Education (ECE) professionals provide an important link between families, communities, and public health. Several national standards like The Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs (CFOC) and national organizations like The U.S. Centers for Disease Control and Prevention provide guidance on healthy child care, including safety and hygiene for infant feeding.

  • CGBI supports child care settings to implement recommended infant and young child feeding practices. Parents, including child care staff, who wish to nurse their child or provide expressed human milk for feedings in child care settings are encouraged to continue to do so during the COVID-19 outbreak.
  • 10 Steps to Breastfeeding Friendly Child Care: COVID-19 Considerations  Step by Step | Summary PDF

Standard hygienic feeding practices should be implemented per state child care health regulations. 

Strengthening COVID-19 Response

Infection prevention and control in child care settings are critical to community COVID-19 response. Below are links to resources that are recommended to assist ECE professionals in strengthening their response to COVID-19:

U.S. Centers for Disease Control and Prevention (CDC)

The following information serves as provisional guidance. Coordinate with local health officials to determine appropriate action steps for child care programs remaining open or re-opening. This guidance does not supersede state and local laws and policies for child care programs:

CDC page last reviewed: April 10, 2020

CDC page last reviewed: July 23, 2020

CDC page last updated: July 23, 2020


Guidance for Child Care Settings- North Carolina

Click to view flow chart (on last page of PDF document)

Communicable Diseases and Exclusion from Child Care

Daily Health Checks

Thermometers and Temperature Taking

Child Care Strong NC Public Health Toolkit: Interim Guidance

Important Updates and Action Needed for Child Care Facilities: COVID-19 Response

Click to view example door sign developed by NC DHHS

  • Facilities should encourage parents and caregivers to keep children at home with them if they are able. This will reduce the chance of spread.
  • Signs with screening criteria should be posted at the entrance to the facility.  English | Spanish
  • Only staff needed to maintain ratio compliance should be inside classrooms. Facilities should restrict teachers to one classroom with one group of children and should not use “floater” teachers. This is in order to reduce the number of people coming in and out of classrooms.

Please NoteBreastfeeding mothers access to the building/ classroom is an allowable exception to recommendations attempting to reduce the number of people coming in and out. This includes the program’s breastfeeding employees. (June 4, 2020) 



Guidance for Child Care Settings- South Carolina

School and Childcare Exclusion List

Interim COVID-19 Guidance for Child Care Providers: Management of Suspect and Confirmed COVID-19 Cases

COVID-19 Announcements-SC Division of Early Care and Education has created a page to help providers and parents stay up-to-date on the latest recommendations regarding the Coronavirus.

COVID-19 Resource Updates– SC Child Care Resource & Referral (CCR&R) has created a page with more information about resources for families and child care providers as it comes available.


Click to view Consideration for Child Care Closure Flowchart

Child Care Aware of America (CCAoA)

Pandemics (COVID-19) preparedness and response

News and Resources for Child Care Professionals, Families, and Policymakers



Coordination with Local Health Officials

Determine a course of action for closures or appropriate operation:

North Carolina:

  • Specific child care questions, please call the CCR&R line 1-888-600-1685.
  • General questions related to COVID-19, please dial 2-1-1 or 888-892-1162. Sign up for updates by texting COVIDNC to 898211.

South Carolina:

  • Child Care Administrators planning to close, expand your capacity, or with the ability to set up a temporary child care site contact Child Care Licensing by phone, 1-888-825-7174, or by email, centralofficechildcare@dss.sc.gov
  • General questions related to COVID-19, please call the DHEC Care Line 1-855-472-3432. Staff are answering calls 8:00 a.m.-6:00 p.m. every day.

Guidance When COVID-19 Infection is Neither Suspected nor Confirmed

When there are no persons with suspected or confirmed COVID-19 infection among children, staff, or their family members, child care providers are encouraged to follow recommendations on best practices to reduce the spread of infectious diseases in child care settings.

Caring for Our Children (CFOC)

Parents who are nursing or pumping milk for their infant or toddler at home are encouraged to continue nursing and to practice hygienic feeding practices when preparing to send expressed human milk or formula to a child care setting:

(Info in this tab last updated August 11, 2020)

Please contact Dr. Aunchalee Palmquist with inquiries about CGBIs COVID-19 resources and response activities: 919-966-0928 or apalmquist@unc.edu. This page was updated on February 15th, 2021.