Breastfeeding of Infants Born to Mothers with COVID-19: A Rapid Review

Nan Yang; Siyi Che; Jingyi Zhang; Xia Wang; Yuyi Tang; Jianjian Wang; Liping Huang; Chenglin Wang; Hairong Zhang; Muna Baskota; Yanfang Ma; Qi Zhou; Xufei Luo; Shu Yang; Xixi Feng; Weiguo Li; Toshio Fukuoka; Hyeong Sik Ahn; Myeong Soo Lee; Zhengxiu Luo; Enmei Liu; Yaolong Chen

COVID-19 is relatively contagious with an estimated basic reproduction number R0 of 3.49 (95% CI: 3.42 to 3.58) based on 27,100 confirmed cases from January 17 to February 8, 2020 in Hubei province without intervention (33) , which is similar to SARS (R0 2.2-3.6) (34), but clearly higher than Influenza A H1N1 (R0 1.4-1.6) (35) . But according to the five case reports (2, (18) (19) (20) (21) found by our review the nucleic acid test results for SARS-CoV-2 of breast milk samples from thirteen mothers with COVID-19 were all negative. No studies have reported the existence of virus nucleic acid in breast milk from mothers infected with SARS, MERS or influenza. Based on the considerations above, we believe that SARS-CoV-2 is unlikely to be transmissible via breast milk, but the quality of evidence remains low. As SARS-CoV-2 is transmitted via close contact and droplets, transmission from mother to infant may be possible while breastfeeding. A case series indicated that influenza infected breastfeeding women who washed hands thoroughly did not transmit to their children during a one-month follow-up, regardless of if the mothers wore a mask or not (22) . A systematic review conducted in 2016 also revealed that wearing masks and hand hygiene can notably decrease the possibility of respiratory virus transmission (wearing masks: OR 0.32, 95% CI, 0.26 to 0.39; hand hygiene: OR 0.54, 95% CI, 0.44 to 0.67) (36) . Therefore, we believe that by taking All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.