Breastfeeding during the COVID-19 pandemic: what do we know so far?

Natarelli, Taison Regis Penariol; Brassarola, Heloisa Gasparini Marigheti; Fonseca, Luciana Mara Monti

doi:10.31744/einstein_journal/2022RW6609

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Review • Einstein (São Paulo) 20 • 2022 • https://doi.org/10.31744/einstein_journal/2022RW6609 linkcopy

Breastfeeding during the COVID-19 pandemic: what do we know so far?

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective This study aimed to conduct a literature review on safety in breastfeeding in mothers with COVID-19. An integrative review of national and international literature was carried out.

Methods The search took place in the SciELO, LILACS and MEDLINE^® databases.

Results A total of 25 scientific articles that specifically addressed the theme of breastfeeding and its risk and protective factors for infection by SARS-CoV-2 were selected. According to the studies analyzed, although the presence of viral RNA had already been detected by reverse transcriptase polymerase chain reaction in breast milk samples, there are still no proven cases of vertical transmission via human milk.

Conclusion Breastfeeding appears to be safe if practiced according to precaution measures recommended by the World Health Organization. In addition, there is evidence of a potential for immunological protection by transfer of antibodies against SARS-CoV-2 in breast milk. Breastfeeding should continue to be promoted even in cases of mothers with clinical suspicion or confirmation of COVID-19, as well as the provision of expressed breast milk in cases where there is no possibility of direct breastfeeding.

Breast feeding; Lactation; Milk, human; COVID-19; Coronavirus infections; Betacoronavirus; SARS-CoV-2; Infant, newborn; Child health; Protective factors

References	Country of origin	Type of study
Lang et al.⁽⁸⁾	China	Case report
Wu et al.⁽⁹⁾	China	Single center cohort study
Salvatori et al.⁽¹⁰⁾	Italy	Experience report
Ferrazzi et al.⁽¹¹⁾	Italy	Retrospective multicenter study
Zhu et al.⁽¹²⁾	China	Retrospective study
Lowe et al.⁽¹³⁾	Australia	Case report
Pereira et al.⁽¹⁴⁾	Spain	Retrospective study – experience report
Marín Gabriel et al.⁽¹⁵⁾	Spain	Multicenter study
Yu et al.⁽¹⁶⁾	China	Case report
Pereira et al.⁽¹⁷⁾	Spain	Case series
Chambers et al.⁽¹⁸⁾	USA	Quantitative research (analysis of breast milk samples from mothers with COVID-19)
Marín Gabriel et al.⁽¹⁹⁾	Spain	Prospective observational study
Patil et al.⁽²⁰⁾	USA	Retrospective cross-sectional study
Bastug et al.⁽²¹⁾	Turkey	Case report
Lebrão et al.⁽²²⁾	Brazil	Case report
Kalamdani et al.⁽²³⁾	India	Retrospective study – case review
Salvatore et al.⁽²⁴⁾	USA	Observational cohort study
Zhao et al.⁽²⁵⁾	China	Quantitative research (analysis of breast milk samples from mothers with COVID-19)
Oba et al.⁽²⁶⁾	Brazil	Case report
Okeahalam et al.⁽²⁷⁾	South Africa	Cross-sectional study
Perrone et al.⁽²⁸⁾	Italy	Case report
Olivini et al.⁽²⁹⁾	Italy	Retrospective observational study – case series
Dong et al.⁽³⁰⁾	China	Case report
Lugli et al.⁽³¹⁾	Italy	Case report
Marín Gabriel et al.⁽³²⁾	Spain	Multicenter descriptive study

References	Human milk samples from mothers with COVID-19				Outcomes of breastfed children
References	Positive RT-PCR	Negative RT-PCR	Total n	Presence of antibodies	Positive RT-PCR	Negative RT-PCR or asymptomatic	Total n
Lang et al.⁽⁸⁾	0	1	1	-	0	1	1
Wu et al.⁽⁹⁾	1	2	3	-	0	5	5
Salvatori et al.⁽¹⁰⁾	0	2	2	-	2	-	2
Ferrazzi et al.⁽¹¹⁾	-	-	-	-	2	8	10
Zhu et al.⁽¹²⁾	1	4	5	-	-	-	-
Lowe et al.⁽¹³⁾	-	-	-	-	0	1	1
Pereira et al.⁽¹⁴⁾	-	-	-	-	0	21	21
Marín Gabriel et al.⁽¹⁵⁾	-	-	-	-	-	19	19
Yu et al.⁽¹⁶⁾	0	4	4	Yes (2/2)	1	0	1
Pereira et al.⁽¹⁷⁾	-	-	-	-	0	20	20
Chambers et al.⁽¹⁸⁾	1	63	64	-	-	-	-
Marín Gabriel et al.⁽¹⁹⁾	0	7	7	-	-	-	-
Patil et al.⁽²⁰⁾	-	-	-	-	0	31	31
Bastug et al.⁽²¹⁾	1	0	1	-	1	0	1
Lebrão et al.⁽²²⁾	-	-	-	Yes (2/2)	0	1	1
Kalamdani et al.⁽²³⁾	-	-	-	-	12	173	185
Salvatore et al.⁽²⁴⁾	-	-	-	-	0	64	64
Zhao et al.⁽²⁵⁾	0	4	4	-	-	-	-
Oba et al.⁽²⁶⁾	0	2	2	-	1	0	1
Okeahalam et al.⁽²⁷⁾	-	-	-	-	-	-	-
Perrone et al.⁽²⁸⁾	0	1	1	-	0	1	1
Olivini et al.⁽²⁹⁾	0	2	2	-	4	1	5
Dong et al.⁽³⁰⁾	0	7	7	Yes (6/6)	0	1	1
Lugli et al.⁽³¹⁾	2	0	2	-	0	1	1
Marín Gabriel et al.⁽³²⁾	-	-	-	-	0	198	198

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[TFN1] RT-PCR: reverse transcriptase polymerase chain reaction.