Infants vulnerable to infection through infected mother’s milk

Mariecar Jara-Puyod, Senior Reporter

Nursing mothers infected with the viral diseases Novel Coronavirus (COVID-19) and Monkey Pox must be cautious when breastfeeding.

The reminder that is basically a reiteration of regulations by world health institutions, was from Paediatric Infectious Diseases specialist Dr Nipunie Rajapakse who was email interviewed for the August 1 to 7 “World Breastfeeding Week.”

The 2022 theme of the global campaign, not only for the promotion of, but more importantly for the realisation of concrete action for breastfeeding - as decided on by the World Health Organisation (WHO), the United Nations Children’s Fund (UNICEF) and the World Alliance for Breastfeeding Action – was “Step Up for Breastfeeding: Educate and Support.”

Rajapakse, the Mayo Clinic (Rochester, Minnesota, USA) Anti-Microbial Stewardship Programme vice chairman/Paediatric Anti-Microbial Stewardship Programme medical director was asked regarding updates on the importance of breastfeeding in light of the existing Novel Coronavirus (COVID-19) pandemic as well as the Monkeypox outbreak.

Additionally, she was asked if pregnant and nursing mothers could transmit the COVID-19 causing SARS-CoV2 and the “virulent strain of a virus in the Orthpoxvirus Genus,” said to be the trigger for Monkeypox to their infants.

Rajapakse’s reply: “It is unknown if Monkeypox virus is present in breast milk. The primary way that Monkeypox spreads is by close skin-to-skin contact as occurs during breastfeeding. Therefore, currently, the recommendation is that women do not breastfeed or provide their breast milk to their baby while they have active Monkeypox infection and are in isolation.”

“Donor breast milk or formula can be used instead,” she added.

Rajapakse also said: “The mother should talk to her healthcare provider to determine when breastfeeding can be safely resumed.”

Regarding COVID-19, Rajapakse whose interests include “optimising anti-biotic use in children and decreasing anti-biotic resistance,” said: “COVID-19 has not been found to spread to babies through breast milk so breast milk can be fed to babies even if their mothers have active COVID-19 infection.”

Meanwhile, Gulf Today came across the University of Rochester Medical Centre and New York University study titled “Comparison of Human Milk Antibody Induction, Persistence, and Neutralising Capacity in Response to SARS-CoV 2 Infection Versus mRNA Vaccination” involving 77 mothers. The conclusions are published over the University of Rochester Medical Centre website since November 10, 2021.

The study wherein 47 of the mothers were COVID-19-infected and 30 protected with COVID-19 immunisation revealed that “mothers with two types of immunity from COVID-disease-acquired (those who have contracted COVID-19 and recovered) and mRNA vaccination-acquired) produced breast milk with active SARS-CoV2 anti-bodies.”

Rajapakse said: “Breast milk has been found to contain anti-bodies against the COVID-19 virus, both from mothers who have had COVID-19 infection before and/or who have been vaccinated. This can provide babies with some protection against the virus as well, especially before they are able to be vaccinated themselves.”

She repeated the UNICEF advisory on breastfeeding which is for mothers “to wear a mask and wash their hands to reduce the chances of spreading the infection to their baby when they are in close contact with them.”

Another option is to “pump the breast milk and have an uninfected person bottle feed it to the baby to reduce the transmission from close contact with the baby.”

Saying that breast milk is the most nutritious and therefore is a protection against many illnesses in infants and children, Rajapakse also wrote: “We strongly recommend all pregnant and breastfeeding mothers receive COVID-19 vaccination to provide protection bot for themselves as well as their babies.

In the July 31 (Sunday) Joint Statement by UNICEF executive director Catherine Russell and WHO director general Dr. Tedros Adhanom Ghebreyesus, both underscored that “breastfeeding also acts as a baby’s first vaccine, protecting them from common childhood illnesses.”