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

Authors

  • 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

Funding None.
Preview

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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