April 9, 2020

Among the myriad health concerns that the coronavirus has created for caregivers and patients, questions have arisen about how to prevent the transmission of the virus to newborns from mothers who are suspected or confirmed to be infected.

Both the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC) recommend that the mother’s breastmilk should be provided to the infant. While the WHO’s guidance encourages new mothers to breastfeed while wearing a mask and practicing good hygiene, the CDC’s guidance directs new mothers to express breastmilk for a healthy caregiver to feed to the newborn via bottle.

The WHO has issued a recommendation that mothers and newborns remain together and practice skin-to-skin contact during the days and nights following delivery. However, the CDC advises facilities to consider separating mothers and babies temporarily until the mother is no longer contagious and recommends that the risks and benefits of temporary separation should be discussed with the mother by the health care team.

Dr. Alison Stuebe

Dr. Alison Stuebe

Today in Breastfeeding Medicine, Alison Stuebe, MD, MSc, professor of maternal and child health and distinguished professor in infant and young child feeding at the Carolina Global Breastfeeding Institute at the UNC Gillings School of Global Public Health, has written a commentary addressing the risks and benefits of temporary separation.

Stuebe writes that while temporary separation does reduce the risk of transmission while immediately in the hospital, it creates a greater set of concerns that put the health and well-being of both mother and baby at risk in the long-term. Such concerns include how to effectively isolate a newborn at home from other potential infected family members, the physiological burden that lack of skin-to-skin contact has on newborn health and the extreme stress that separation places on the mother. In addition, Stuebe notes that separation of mother and newborn in the hospital puts twice the burden on the healthcare system to provide two separate sets of caregivers, protective equipment and hospital rooms.

“At the time of writing, we have no evidence to show that early separation improves outcomes,” Stuebe states in the commentary.

While the coronavirus pandemic evolves globally and experts continue to collect new data, Stuebe stresses the need for policymakers and caregivers to consider the overall benefit to maternal and child health when creating guidelines and recommendations for effective postnatal care in infected patients.

“As we navigate the COVID-19 pandemic, I am hopeful that we can center mothers and babies and remember to first do no harm,” says Stuebe.

Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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