Advice for breastfeeding and pregnant women on COVID-19
The Royal Women’s Hospital is closely monitoring developments regarding the novel coronavirus (COVID-19) and is taking all advised precautions.
The health of our patients, visitors and staff is our biggest priority. We have put in place a number of measures to keep our community safe while providing the highest level of care.
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Published scientific data regarding the effects of COVID-19 on pregnant women and their babies is currently limited, but the Women's continues to look to authorities for the latest developments on this.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has issued the following information (29 March):
Pregnant women should be considered a vulnerable or at-risk group, however, information and advice to the general public applies equally to pregnant women.
At this time, pregnant women do not appear to be more severely unwell if they develop COVID-19 infection than the general population.
There have been a handful of very recent case reports suggesting that the virus may pass from the mother to the baby (vertical transmission). However, this is very early, preliminary data and has not been confirmed. There was no evidence of harm to the babies.
There is no evidence that caesarean section or induction of labour is necessary to reduce the risk of vertical transmission.
Pregnant women are encouraged to discuss their concerns and, in particular, to report any early symptoms to their obstetrician, GP or midwife in a timely manner.
Pregnant women are advised to avoid all non-essential overseas travel.
While it will not influence response to COVID-19 infection, everyone will reduce their risk of influenza through vaccination.
Source: RANZCOG website
The Royal College of Obstetrics and Gynaecologists from the UK issued this information (26 March):
Pregnant women do not appear to be more susceptible to the consequences of COVID-19 than the general population and there is no evidence that the virus can pass to a baby during pregnancy.
There are currently no data suggesting an increased risk of miscarriage or early pregnancy loss in relation to COVID-19.
At the moment there is no evidence that the virus can be carried in breastmilk, so it is felt the benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk.
There is limited evidence about managing women with coronavirus infection in women who have just given birth; however, there are no reports of women diagnosed with coronavirus during the third trimester of pregnancy having passed the virus to their babies while in the womb.
Source: RCOG website
Professor Mark Umstad, Director of Maternity Services at the Women’s, reassures women who are pregnant.
“As the impact of COVID-19 extends through our society, we want to reassure pregnant women that there is still no evidence that they are more susceptible to infection than non-pregnant women, and that there is no sign that their unborn babies can be infected,” said Professor Mark Umstad.
"The Women's is safe place to be for women giving birth. And while there are extra precautions in place, such as screening upon entry, you will recieve the care you need when you come to our hospital.
“Doctors, nurses, midwives and hospitals across Victoria are working together to ensure the safest possible outcomes for pregnant women and their babies during this understandably stressful period for them.”
Taking advice from the World Health Organization and other breastfeeding authorities, the Women’s continues to advise women to establish and maintain breastfeeding and to promote skin-to-skin contact at birth for all women and their babies
Anita Moorhead, senior lactation consultant and clinical midwife at the Women’s, says that as with other peak times for illnesses (like the seasonal flu), mothers are encouraged to continue to breastfeed - but with careful attention to hand hygiene and how they direct their coughs and sneezes.
“It’s important that breastfeeding mothers are paying close attention to advice on reducing your risk of coronavirus,” said Anita Moorhead.
“With current advice, if you are a suspected or confirmed that a mother has COVID 19, we would encourage you to wear a mask when feeding or expressing breast milk for your baby, have your baby in a cot about 1.5 metres away from mother when not feeding and, where possible, have someone else help with the care of the baby.
“We know that breastfeeding and providing breast milk is one of the best things to help prevent many infections for babies, so our advice at the moment remains the same: keep breastfeeding and keep up with the careful handwashing. Know that you are caring for your baby well and we will help you to do that.”
“Where a mother needs to use infant formula, strict hand washing and careful attention to sterilising of bottles and making of infant formula is so important,” added Anita Moorhead.
“Due to recent issues with food availability, if the infant formula that you usually use for your baby is not available, then it’s okay to use another formula.
“Make sure it is infant formula suitable for babies from birth to 12 months and to ensure careful attention to the directions on the can. Be aware alternative brands may have different size scoops in the tin and use different amounts of water.”
Sources: World Health Organization, Australian Breastfeeding Association, Academy of Breastfeeding Medicine, Royal College of Obstetrics and Gynaecology (UK) and the Centers for Disease Control and Prevention (US).
- Practice good hand hygiene – wash your hands regularly with soap and water for at least 20 seconds and dry with paper towel or a hand dryer. Alcohol based hand rub is an acceptable alternative.
- Cover your nose and mouth with a tissue when coughing or sneezing or cough or sneeze into the crook of your elbow, and encourage others to do the same. Make sure you put the tissue into a bin and then wash your hands afterwards.
- Avoid touching your eyes, nose and mouth with unclean hands.
- Where possible, keep at least one metre away from people who have a respiratory illness and/or is coughing and sneezing.
- Avoid shaking hands with others.
This is a rapidly changing situation, so please visit the Department of Health and Human Services website for regular updates.