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Breastfeeding during the pandemic: FAQs

Laura Kair

Laura Kair

(SACRAMENTO) — August is national breastfeeding month and we asked Laura Kair, medical director of Well Newborn Care at UC Davis Children’s Hospital, some frequently asked questions about breastfeeding.

Can babies get COVID-19 from breastmilk?

Spread of the virus from mother to infant through breast milk does not appear to be a major concern. Women with COVID-19 who are feeling well enough to do so are recommended to breastfeed. In fact, breast milk helps protect babies from viral infections, so it is likely that immune components in the breast milk of a mother with COVID-19 may help her baby fight infection.

Should a mom continue breastfeeding if she has COVID-19?

Yes! We recommend mothers wash their hands and any skin that will be touching baby, wear a mask to prevent the baby from contacting the mother’s respiratory droplets and breastfeed! If a mother is too ill to be around her baby, she should wash her hands, clean her breast and pump supplies, and pump breast milk to be given to the baby.

Does breastmilk help fight against diseases?

Yes! For infants, breast milk helps protect against gut, lung and ear infections, allergic diseases and leukemia. It also is beneficial for optimal neurodevelopment. For women, breastfeeding helps protect against breast, ovarian and endometrial cancer, along with heart disease and diabetes.

How much breastmilk does a baby typically get in a feeding?

For the first week of life, this changes day by day. On the first day, this is as little as 2-10 ml. (about a teaspoon) per feeding and this increases by about 15 ml. or ½ ounce at each feeding per day. By two weeks, babies take about 2.5 oz. per feeding, and by about a month, about 4 oz. per feeding. However, this varies by time of day and for different babies. If pumping and giving breast milk by bottle or freezing milk, it’s good to store in smaller, 2-ounce portions so it is easier to thaw and you can use it all once thawed. The best thing to watch is that baby is growing appropriately, making wet diapers and can be consoled between feeds. Your baby’s primary care provider or lactation consultant can help you come up with a plan if you are separated from baby and determining how much breast milk to put in each bottle and how often to pump.

Is UC Davis a baby-friendly hospital?

Yes! We were just designated in 2020.

Why should a mom seek a lactation consultant?

With your first baby, a lactation consultant can help teach some of the basics, see how baby is feeding and give you tips about a good latch and positioning. For women struggling with low milk production or oversupply, they can help you come up with a feeding plan that works in your life and support you along the way. Not every parent and baby needs to follow with a lactation consultant long-term, but some may find it helpful or find support groups led by a lactation consultant to be helpful.

Can a tongue tie or lip tie create breastfeeding difficulties?

Yes, a tongue tie especially can lead to some difficulties in the baby creating a vacuum in their mouth, staying at the breast, and successfully getting milk out without popping off or causing pain for the mother. Not every baby with a visible frenulum under their tongue has a problem though. It depends how well the baby can feed. A lip tie is a newer consideration and a bit more controversial, as there haven’t been randomized clinical trials looking at whether releasing them helps fix breastfeeding problems. If you have a concern about your baby’s latch or their tongue or lip tie, I recommend discussing it with your baby’s doctor and/or lactation consultant.

What are your thoughts on using lecithin to prevent clogged ducts?

There is not a great deal of scientific evidence to guide an answer to this. Anecdotally, several of my breastfeeding-medicine colleagues at times prescribe sunflower lecithin, given as a powder for women with nipple blebs (also known as milk blisters) or plugged ducts. There are a few reports of this practice in the scientific literature and how to dose it, but currently there isn’t enough evidence from trials for me to specifically recommend it. I do recommend that women with plugged ducts feed directly at the breast, rather than by pump if possible, and talk with their doctors for the latest evidence.  

How do you start weaning?

There’s the how and then there’s the why and when. The American Academy of Pediatrics (AAP) and World Health Organization (WHO) recommend exclusive breastfeeding for the first six months. The AAP then recommends the addition of complementary foods with continued breastfeeding for at least the next six months, when baby turns a year old. WHO recommends a minimum of two years of ongoing breastfeeding plus complementary foods.

 As toddlers get bigger and eat more table food, they naturally take less and less breast milk. For women who have a reason to want to speed up weaning, I recommend working together with their doctors or lactation specialists. Milk production is all about demand, so the less milk you empty from the breasts, the less your body will make. For women who are pumping, this can mean gradually decreasing the number of pumping sessions per day.