Am J Perinatol 2021; 38(11): 1209-1216
DOI: 10.1055/s-0041-1731451
Original Article

Breast Milk and Breastfeeding of Infants Born to SARS-CoV-2 Positive Mothers: A Prospective Observational Cohort Study

Bgee Kunjumon
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Elena V. Wachtel
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Rishi Lumba
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Michelle Quan
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Juan Remon
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Moi Louie
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Sourabh Verma
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Michael A. Moffat
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Insaf Kouba
4   Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York City, New York
,
Terri-Ann Bennett
3   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York City, New York
4   Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York City, New York
,
Claudia Manzano De Mejia
2   Department of Pediatrics, New York University Long Island School of Medicine, New York City, New York
,
Pradeep V. Mally
1   Department of Pediatrics, New York University Grossman School of Medicine, New York City, New York
,
Xinhua Lin
2   Department of Pediatrics, New York University Long Island School of Medicine, New York City, New York
,
Nazeeh Hanna
2   Department of Pediatrics, New York University Long Island School of Medicine, New York City, New York
› Author Affiliations
Funding None.

Abstract

Objective There are limited published data on the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus from mothers to newborns through breastfeeding or from breast milk. The World Health Organization released guidelines encouraging mothers with suspected or confirmed COVID-19 to breastfeed as the benefits of breastfeeding outweighs the possible risk of transmission. The objective of this study was to determine if SARS-CoV-2 was present in the breast milk of lactating mothers who had a positive SARS-CoV-2 nasopharyngeal swab test prior to delivery, and the clinical outcomes for their newborns.

Study Design This was a single-center, observational, prospective cohort study. Maternal–newborn dyads that delivered at New York University Langone Hospital Brooklyn with confirmed maternal SARS-CoV-2 positive screen test at the time of admission were recruited for the study. Breast milk samples were collected during postpartum hospitalization and tested for the presence of SARS-CoV-2 genes N1 and N2 by two-step reverse transcription polymerase chain reaction. Additionally, the clinical characteristics of the maternal newborn dyad, results of nasopharyngeal SARS-CoV-2 testing, and neonatal follow-up data were collected.

Results A total of 19 mothers were included in the study and their infants who were all fed breast milk. Breast milk samples from 18 mothers tested negative for SARS-CoV-2, and 1 was positive for SARS-CoV-2 RNA. The infant who ingested the breast milk that tested positive had a negative nasopharyngeal test for SARS-CoV-2, and had a benign clinical course. There was no evidence of significant clinical infection during the hospital stay or from outpatient neonatal follow-up data for all the infants included in this study.

Conclusion In a small cohort of SARS-CoV-2 positive lactating mothers giving birth at our institution, most of their breast milk samples (95%) contained no detectable virus, and there was no evidence of COVID-19 infection in their breast milk-fed neonates.

Key Points

  • Breast milk may rarely contain detectable SARS-CoV-2 RNA and was not detected in asymptomatic mothers.

  • Breast milk with detectable SARS-CoV-2 RNA from a symptomatic mother had no clinical significance for her infant.

  • Breast feeding with appropriate infection control instructions appears to be safe in mother with COVID infection.

Supplementary Material



Publication History

Received: 08 January 2021

Accepted: 12 May 2021

Article published online:
28 June 2021

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