COVID-19 and infant feeding

The Royal College of Paediatrics and Child Health and Royal College of Obstetricians and Gynaecologists have issued wide ranging advice relating to COVID-19 / Coronavirus and breastfeeding and pregnancy. They make the following recommendations:

"At the moment there is no evidence that the virus can be carried in breastmilk, so it’s felt that the well-recognised benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk.

"The main risk of breastfeeding is close contact between you and your baby, as you may share infective airborne droplets, leading to infection of the baby after birth.

"A discussion about the risks and benefits of breastfeeding should take place between you, your family and your maternity team.

"If you choose to breastfeed your baby, the following precautions are recommended:

• Wash your hands before touching your baby, breast pump or bottles
• Try and avoid coughing or sneezing on your baby while feeding at the breast
• Consider wearing a face mask while breastfeeding, if available
• Follow recommendations for pump cleaning after each use

"If you choose to feed your baby with formula or expressed milk, it is recommended that you follow strict adherence to sterilisation guidelines. If you are expressing breast milk in hospital, a dedicated breast pump should be used."

This guidance may change as knowledge evolves, so please refer to the RCOG or RCPCH website for up to date advice.

Images of empty shelves and stories of shoppers fighting for food provisions has triggered panic buying across supermarkets in the UK. The UK government has advised that people should plan ahead on what is needed for self-isolation in the specified time frame only. Do not be misinformed by articles suggesting stockpiling beyond government advice. Follow the advice of UK supermarkets to avoid risking food shortages to others.

The British Specialist Nutrition Association (BSNA), which represents manufacturers, have stated all infant formula companies are continually monitoring supply and demand in the UK. If you are concerned, or require specific information, all infant formula companies can be contacted via their careline services. In the extreme case of shortages, please look for guidance directly from the manufacturers on using appropriate alternatives.

There have been claims that some infant formula companies are making free provisions to those unable to gain access to infant formula. This is not the approach of any infant formula company in the UK currently.

It is very important that you follow the manufacturers normal instructions on how to prepare your infant formula, unless otherwise advised by your healthcare professional. 'Watering down', manipulating or diluting the formula as a way to ‘ration’ your stock of powdered infant formula is not a good idea as the formula will no longer provide sufficient nutrition to your child.

For healthy infants over six months, cow’s milk (or alternatives where applicable) may be used in complementary foods, and as a main drink in those over one year. Offer other sources of calcium rich foods and continue to provide a varied diet, or where necessary, an age appropriate vitamin and mineral supplement daily.

If breastfeeding and using infant formula, consider replacing formula feeds with breastfeeds. If breastfeeding has been stopped, it is possible to re-start breastfeeding (contact the National Breastfeeding Helpline for assistance).

Some manufacturers have provided further information about accessing their products:

• SMA
• Cow and Gate
• Aptamil

There have also been claims that parents of infants should consider early introduction of complementary foods in light of the COVID-19 outbreak and potential infant formula shortages. This is not official advice.

Most infants should be offered complementary foods from around six months of age, only when they are developmentally ready. Some infants may begin complementary feeding after four months of age (but not before seventeen weeks). This should only start when developmental readiness has been achieved. Parents and caregivers should consult a healthcare professional when deciding to do this.

This Complementary Feeding Food Fact Sheet has lots more information about how and when to start this with your child.

Content: BDA