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.
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
- WHO – New FAQ addresses healthcare workers questions about breastfeeding and COVID-19, including a decision tree. Story | FAQ Document
- WHO – Pregnancy and Breastfeeding Infographics (available in all UN languages, click top of the page to access translated pages).
- WHO – Q&A on Pregnancy and Childbirth
- Global Breastfeeding Collective – Key Messages on Breastfeeding and COVID-19
- SafelyFed Canada & Save the Children – Infant Feeding in the Context of COVID-19: FAQ for frontline health & nutrition workers
- UNICEF – COVID-19 IYCF Counselling Cards
- U.S. Centers for Disease Control and Prevention – Pregnancy & Breastfeeding Key Messages
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
- Advice on the Use of Masks in the Context of COVID-19
- Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected (see 12. Caring for infants and mothers with COVID-19: IPC and breastfeeding, p.11-12)
- Coronavirus disease (COVID-19): What parents should know
- Home care for patients with suspected novel coronavirus (nCoV) infection presenting with mild symptoms and management of contacts
- Q&A on COVID-19, pregnancy, childbirth, and breastfeeding
- UNICEF Infant and Young Child Feeding in the Context of COVID-19 brief No. 2 (v1) (March 30th, 2020) [this tool for program implementers will be updated every 10 days]
- United Nations System Standing Committee on Nutrition (UNSCN) COVID-19 Nutrition Resources
Compilation of Global Health and Health Professions’ Organizational Guidance
- Academy of Breastfeeding Medicine (ABM) Statement on Coronavirus 2019 (COVID-19)
- GTAM (Global Nutrition Cluster Technical Assistance Mechanism) COVID19 and Nutrition Technical Brief
- International Lactation Consultant Association (ILCA) COVID-19 Resources
- National Perinatal Association COVID-19 Resources; Shared Decision Making Joint Position Statement and Infographic (with National Association of Neonatal Nurses)
- SafelyFed Canada COVID19 Resources and Statements Related to Breastfeeding
- United States Breastfeeding Committee: Infant and Young Child Feeding in Emergencies, including COVID-19
- World Alliance for Breastfeeding Action (WABA) Coronavirus disease (COVID-19) and breastfeeding
U.S. Centers for Disease Control and Prevention
- COVID-19 Landing Page
- Interim guidance on breastfeeding for a mother confirmed or under investigation for COVID-19
- Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings
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
- Human Milk Banking Association of North America (HMBANA) Milk Banking and COVID-19
- European Milk Banking Association (EMBA) COVID-19 Position Statement
Evidence Reviews and Round Ups
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 May 18, 2020)
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;
- Consider transitioning to remote/virtual services, where possible and feasible, such as video, SMS, phone consultations, and telehealth. Some ideas specifically for lactation consultants have been created by Paperless Lactation, with updated information for COVID-19: Virtual Consult Best Practices for Lactation Consultants.
More Resources for Community-Based Perinatal and Postpartum Support Organizations
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
YWCA USA Gender-Based Violence fact sheets for helpers and program planning [scroll to the bottom of the page for links]
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
- COVID-19 Compiled Resources
- Webinar: Under the Black Light: The intersectional failures that COVID lays bare (recorded 25 March 2020)
(Info in this tab last updated May 18, 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
On Our Sleeves Behavioral Health Resources for Coronavirus from Nationwide Children’s Hospital
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
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
SAMSHA National Helpline – Treatment referral and information, 24/7 1-800-662-HELP (4357)
Additional Resources for Helpers and First Responders
Psychological First Aid Mobile Response App for Helpers and First Responders: PFA Mobile (iOS and Android)
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.
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 May 18, 2020)
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.
- North Carolina: 15A NCAC 18A .2803 & .2804
Strengthening COVID-19 Response
Considerations for Infants and Toddlers in Emergency Child Care for Essential Workers have been developed by Zero to Three and include guidance for policymakers and advocates as they design systems to deliver care.
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: May 16, 2020
CDC page last reviewed: March 19, 2020
CDC page last reviewed: March 12, 2020
CDC page last updated: April 21, 2020
Guidance for Child Care Settings- North Carolina
- 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.
- 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 Note: Approved posted Signage has been updated since original release. Spanish translation now available.
DCDEE- FREQUENTLY ASKED QUESTIONS FOR PROVIDERS (updated May 8th, 2020)
Guidance for Child Care Settings- South Carolina
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.
Child Care Aware of America (CCAoA)
Coordination with Local Health Officials
Determine a course of action for closures or appropriate operation:
- Specific child care questions, please call the CCR&R line 1-888-600-1685.
- NC DHHS Division of Child Development and Early Education COVID-19 information.
- General questions related to COVID-19, please dial 2-1-1 or 888-892-1162. Sign up for updates by texting COVIDNC to 898211.
- 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, email@example.com
- 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:
- How to keep your breast pump kit clean
- How to clean, sanitize, and store infant feeding items
- Safe storage and handling of powdered infant formula guidelines
(Info in this tab last updated May 22, 2020)