A study of breastfeeding practices, SARS-CoV-2 and its antibodies in the breast milk of mothers confirmed with COVID-19

Peng, Sicong; Zhu, Huaping; Yang, Lixia; Cao, Li; Huang, Xiaona; Dynes, Michelle; Narayan, Anuradha; Xia, Jianbo; Chen, Yang; Zhang, Pei; Liu, Hongyan; Li, Hua; Xia, Shiwen

Background The possibility of 2019 novel coronavirus disease (COVID-19) transmission to neonates through breast milk remains unverified. Methods This paper presents the interim results of a longitudinal study being carried out in Hubei province. As of 1 April 2020, 24 mothers confirmed with COVID-19, 19 mothers suspected with COVID-19 but Polymerase chain reaction negative, and 21 mothers without COVID-19 and their neonates have been recruited. Telephone follow-up was conducted to collect information on breastfeeding practices. Forty-four breast milk samples were collected from 16 of the 24 mothers with confirmed COVID-19 for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) ribonucleic acid (RNA) and antibodies (IgM and IgG) testing. Findings The average mother-child separation time was 36•7 ± 21•1 days among mothers confirmed with COVID-19, significantly longer than that of the suspected group (16•6 ± 13•1 days) and control group (10•5 ± 8•2 days). Both the COVID-19 confirmed (58•3%) and suspected (52•6%) groups presented significantly lower rates of breastfeeding as compared with the control group (95•2%). All 44 breast milk samples tested negative for the SARS-CoV-2 nucleic acid. Thirty-eight breast milk samples underwent antibody testing and all tested negative for IgG. Twenty-one breast milk samples from 8 women tested positive for IgM, while the remaining samples from 11 women tested negative. Interpretation Considering the lack of evidence for SARS-CoV-2 transmission through breast milk, breastfeeding counselling along with appropriate hand hygiene precautions and facemasks should be provided to all pregnant women. Funding The study was funded by the Hong Kong Committee for UNICEF.