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1.
Front Immunol ; 12: 801797, 2021.
Article in English | MEDLINE | ID: covidwho-1793017

ABSTRACT

Background: Limited data are available regarding the balance of risks and benefits from human milk and/or breastfeeding during and following maternal infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objective: To investigate whether SARS-CoV-2 can be detected in milk and on the breast after maternal coronavirus disease 2019 (COVID-19) diagnosis; and characterize concentrations of milk immunoglobulin (Ig) A specific to the SARS-CoV-2 spike glycoprotein receptor binding domain (RBD) during the 2 months after onset of symptoms or positive diagnostic test. Methods: Using a longitudinal study design, we collected milk and breast skin swabs one to seven times from 64 lactating women with COVID-19 over a 2-month period, beginning as early as the week of diagnosis. Milk and breast swabs were analyzed for SARS-CoV-2 RNA, and milk was tested for anti-RBD IgA. Results: SARS-CoV-2 was not detected in any milk sample or on 71% of breast swabs. Twenty-seven out of 29 (93%) breast swabs collected after breast washing tested negative for SARS-CoV-2. Detection of SARS-CoV-2 on the breast was associated with maternal coughing and other household COVID-19. Most (75%; 95% CI, 70-79%; n=316) milk samples contained anti-RBD IgA, and concentrations increased (P=.02) during the first two weeks following onset of COVID-19 symptoms or positive test. Milk-borne anti-RBD IgA persisted for at least two months in 77% of women. Conclusion: Milk produced by women with COVID-19 does not contain SARS-CoV-2 and is likely a lasting source of passive immunity via anti-RBD IgA. These results support recommendations encouraging lactating women to continue breastfeeding during and after COVID-19 illness.


Subject(s)
Antibodies, Viral/analysis , Immunoglobulin A/analysis , Milk, Human/immunology , SARS-CoV-2/immunology , Adult , Antibodies, Viral/immunology , Breast Feeding , COVID-19/immunology , Female , Humans , Immunization, Passive , Immunoglobulin A/immunology , Lactation , Longitudinal Studies , Milk, Human/virology , RNA, Viral/genetics
3.
Nutrients ; 13(9)2021 Aug 26.
Article in English | MEDLINE | ID: covidwho-1374474

ABSTRACT

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus that was declared a Public Health Emergency of International Concern by the World Health Organization (WHO). One major problem faced is whether breastfeeding by mothers infected with the virus is safe. The objective of this work is to study the impact that the SARS-CoV-2 virus can have on breastfeeding, and whether the virus or antibodies can be transmitted from mother to child through milk. We carried out a systematic review of studies focusing on the impact of SARS-CoV-2 on breastfeeding by mothers infected with the virus. The bibliographic search was done through Medline (Pubmed), MedlinePlus and Google Scholar. From 292 records, the title and summary of each were examined according to the criteria, and whether they meet the selection criteria was also analysed. A total of 30 articles are included, of which 26 deal with the study of RNA virus in breastmilk and its involvement in breastfeeding and four on the study of SARS-CoV-2 antibodies in milk. Most studies have been conducted in China. Breastfeeding by mothers infected with SARS-CoV-2 is highly recommended for infants, if the health of the mother and the infant allow for it. Direct breastfeeding and maintaining appropriate protective measures should be encouraged. Should the mother's health condition not permit direct breastfeeding, infants should be fed with pumped breastmilk or donor milk.


Subject(s)
Breast Feeding/adverse effects , COVID-19/transmission , Infectious Disease Transmission, Vertical/prevention & control , Milk, Human/immunology , Pregnancy Complications, Infectious/virology , COVID-19/immunology , COVID-19/virology , Female , Humans , Infant , Milk, Human/virology , Pregnancy , SARS-CoV-2/immunology
5.
Virol J ; 18(1): 130, 2021 06 28.
Article in English | MEDLINE | ID: covidwho-1286827

ABSTRACT

BACKGROUND: Since last year, COVID-19, the disease caused by the novel Sars-Cov-2 virus, has been globally spread to all the world. COVID-19 infection among pregnant women has been described. However, transplacental transmission of Sars-Cov-2 virus from infected mother to the newborn is not yet established. The appropriate management of infants born to mothers with confirmed or suspected COVID-19 and the start of early breastfeeding are being debated. CASE PRESENTATION: We report a case of the joint management of a healthy neonate with his mother tested positive for Covid-19 before the delivery and throughout neonatal follow-up. The infection transmission from the mother to her baby is not described, even after a long period of contact between them and breastfeeding. CONCLUSION: It may consider an appropriate practice to keep mother and her newborn infant together in order to facilitate their contact and to encourage breastfeeding, although integration with infection prevention measures is needed.


Subject(s)
COVID-19/transmission , Infectious Disease Transmission, Vertical/prevention & control , Adult , Breast Feeding , COVID-19/diagnosis , COVID-19/prevention & control , Female , Humans , Infant, Newborn , Milk, Human/virology , Mothers , Nasopharynx/virology , SARS-CoV-2/isolation & purification
6.
Gac Med Mex ; 157(2): 194-200, 2021.
Article in English | MEDLINE | ID: covidwho-1285651

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has affected all dimensions of health care, including exclusive breastfeeding assurance and its promotion. The risk of contagion and the consequences of the pandemic have raised concerns among future mothers or in those who are already breastfeeding due to the risk of possible transmission of the virus through breast milk, although active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not yet been detected in breast milk. The fear of contagion has favored mother-child isolation policies. So far, there is no evidence of vertical transmission, and the risk of horizontal transmission in the infant is similar to that of the general population. In infants with COVID-19, breastfeeding can even favorably change the clinical course of the disease.


La pandemia de enfermedad por coronavirus 2019 (COVID-19) ha afectado a todas las dimensiones de la atención en salud, entre ellas el aseguramiento de la lactancia materna exclusiva y su promoción. El riesgo de contagio y las consecuencias de la pandemia han provocado preocupación entre las futuras madres o las que se ya encuentran lactando debido al riesgo de una posible transmisión del virus a través de la leche materna. Aunque aún no se ha detectado el coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2) activo en la leche materna. El miedo al contagio ha favorecido las políticas de aislamiento madre-hijo. Hasta el momento no existe evidencia de transmisión vertical y el riesgo de transmisión horizontal en el lactante es similar al de la población general. En lactantes con COVID-19 la lactancia materna incluso puede cambiar favorablemente el curso clínico de la enfermedad.


Subject(s)
Breast Feeding , COVID-19 , Milk, Human , Pandemics , Breast Feeding/psychology , COVID-19/epidemiology , COVID-19/transmission , Colostrum/chemistry , Colostrum/metabolism , Disease Transmission, Infectious , Female , Gastrointestinal Microbiome/physiology , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Milk, Human/chemistry , Milk, Human/cytology , Milk, Human/metabolism , Milk, Human/virology , SARS-CoV-2/isolation & purification , Time Factors
7.
Am J Perinatol ; 38(11): 1209-1216, 2021 09.
Article in English | MEDLINE | ID: covidwho-1284751

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..


Subject(s)
Breast Feeding , COVID-19 , Infection Control/methods , Infectious Disease Transmission, Vertical/prevention & control , Milk, Human/virology , Pregnancy Complications, Infectious , SARS-CoV-2/isolation & purification , Adult , Asymptomatic Infections , Breast Feeding/adverse effects , Breast Feeding/methods , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Testing/methods , Female , Humans , Infant, Newborn , Male , New York City/epidemiology , Outcome Assessment, Health Care , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Prospective Studies
8.
Breastfeed Med ; 16(1): 29-38, 2021 01.
Article in English | MEDLINE | ID: covidwho-1228415

ABSTRACT

In addition to providing life-giving nutrients and other substances to the breastfed infant, human milk can also represent a vehicle of pathogen transfer. As such, when an infectious disease outbreak, epidemic, or pandemic occurs-particularly when it is associated with a novel pathogen-the question will naturally arise as to whether the pathogen can be transmitted through breastfeeding. Until high-quality data are generated to answer this question, abandonment of breastfeeding due to uncertainty can result. The COVID-19 pandemic, which was in full swing at the time this document was written, is an excellent example of this scenario. During these times of uncertainty, it is critical for investigators conducting research to assess the possible transmission of pathogens through milk, whether by transfer through the mammary gland or contamination from respiratory droplets, skin, breast pumps, and milk containers, and/or close contact between mother and infant. To promote the most rigorous science, it is critical to outline optimal methods for milk collection, handling, storage, and analysis in these situations, and investigators should openly share their methods in published materials. Otherwise, the risks of inconsistent test results from preanalytical and analytical variation, false positives, and false negatives are unacceptably high and the ability to provide public health guidance poor. In this study, we provide "best practices" for collecting human milk samples for COVID-19 research with the intention that this will also be a useful guide for future pandemics.


Subject(s)
Benchmarking , Breast Feeding/methods , COVID-19/prevention & control , Infection Control/methods , Infectious Disease Transmission, Vertical/prevention & control , COVID-19/transmission , Female , Humans , Infant, Newborn , Intention , Milk, Human/virology , Mothers/psychology , SARS-CoV-2
9.
Mol Med Rep ; 23(5)2021 05.
Article in English | MEDLINE | ID: covidwho-1167801

ABSTRACT

Although the COVID­19 epidemic has lasted for months, it has not yet been successfully controlled, and little is known about neonatal COVID­19. Therefore, literature search was conducted for references in PubMed, Science Direct, ProQuest, Web of Science and China National Knowledge Infrastructure for detailed case reports on neonatal COVID­19 published as of July 15, 2020, to facilitate the clinical treatment, epidemic prevention and control of neonatal COVID­19. Forty nonoverlapping case reports focusing mainly on the demographic characteristics, transmission modes, clinical features, treatments and prognosis of neonatal COVID­19, including 3 in Chinese and 37 in English, were available.


Subject(s)
COVID-19/pathology , SARS-CoV-2/physiology , Antibodies, Viral/analysis , Antiviral Agents/therapeutic use , Asymptomatic Diseases , COVID-19/drug therapy , COVID-19/transmission , COVID-19/virology , Humans , Infant, Newborn , Milk, Human/virology , RNA, Viral/metabolism , SARS-CoV-2/genetics , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Thorax/diagnostic imaging
10.
Breastfeed Med ; 16(5): 439-442, 2021 05.
Article in English | MEDLINE | ID: covidwho-1157992

ABSTRACT

Introduction: In addition to hand washing and wearing masks, social distancing and reducing exposure time to <15 minutes are the most effective measures against the spread of COVID-19. Unfortunately, three of these guidelines are very difficult, if not impossible, for nursing babies: they cannot wear masks, stay six feet away from the lactating breasts, nor consistently finish within 15 minutes while nursing. We report a case of a nursing mother with SARS-CoV-2 infection, documenting changes of immune cells and cytokines in breast milk with and without the infection. Case Description: With Institutional Review Board (IRB) approval, we obtained expressed breast milk samples from a lactating mother before and during SARS-CoV-2 infection as documented by reverse transcription-PCR. Using flow cytometry analysis, we measured the immune cell profiles and expression of cytokines such as interferon alpha (IFNα) in milk leukocytes before and during infection. Results: There was an eightfold increase in IFNα+ milk leukocytes, from 1% before SARS-CoV-2 infection to 8% when actively infected. The milk macrophages showed the highest increase in IFNα expression. Both T and B lymphocytes showed mild increase. Innate lymphoid cells, neutrophils, and natural killer cells showed no increase in IFNα expression and the dendritic cells actually showed a reduction. Conclusion: We document the presence and high expression of IFNα in the breast milk macrophages of a lactating mother with confirmed COVID-19, compared with her milk before the infection.


Subject(s)
COVID-19/diagnosis , Interferon-alpha/blood , Milk, Human/metabolism , Antibodies, Viral/metabolism , Breast Feeding , COVID-19/immunology , COVID-19/virology , Female , Humans , Immunity, Innate , Lactation , Lymphocytes , Macrophages , Milk, Human/immunology , Milk, Human/virology , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification
11.
Front Public Health ; 8: 589736, 2020.
Article in English | MEDLINE | ID: covidwho-1143436

ABSTRACT

COVID-19 pandemic since the end of 2019 spreads worldwide, counting millions of victims. The viral invasion, systemic inflammation, and consequent organ failure are the gravest features of coronavirus disease 2019 (COVID-19), and they are associated with a high mortality rate. The aim of this study is to evaluate the role of breast milk in the COVID-19 pandemic, analyzing its antiviral, anti-inflammatory, and immunoregulatory effects due to its bioactive components, so numerous and important for the protection of infants. The study tried to demonstrate that all the components of human milk are capable of performing functions on all the pathogenic events recognized and described in COVID-19 disease. Those human milk factors are well-tolerated and practically free of side effects, so breast milk should become a research topic to discover therapies even in this epidemic. In the first part, the mechanisms of protection and defense of the breast milk elements will be delineated; in the second section, it will describe the human milk effects in viral infections and it will be hypothesized how the known mechanisms could act in COVID infection.


Subject(s)
Anti-Infective Agents/analysis , Anti-Inflammatory Agents/analysis , Antiviral Agents/analysis , COVID-19/prevention & control , Immunologic Factors/analysis , Milk, Human/chemistry , Milk, Human/virology , Adult , Female , Humans , Infant , Infant, Newborn , Male , Pandemics/prevention & control , SARS-CoV-2
12.
Ann N Y Acad Sci ; 1484(1): 32-54, 2021 01.
Article in English | MEDLINE | ID: covidwho-1105352

ABSTRACT

The pandemic of coronavirus disease 2019 (COVID-19) is caused by infection with a novel coronavirus strain, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At present, there is limited information on potential transmission of the infection from mother to child, particularly through breast milk and breastfeeding. Here, we provide a living systematic review to capture information that might necessitate changes in the guidance on breast milk and breastfeeding given the uncertainty in this area. Our search retrieved 19,414 total records; 605 were considered for full-text eligibility and no ongoing trials were identified. Our review includes 340 records, 37 with breast milk samples and 303 without. The 37 articles with analyzed breast milk samples reported on 77 mothers who were breastfeeding their children; among them, 19 of 77 children were confirmed COVID-19 cases based on RT-PCR assays, including 14 neonates and five older infants. Nine of the 68 analyzed breast milk samples from mothers with COVID-19 were positive for SARS-CoV-2 RNA; of the exposed infants, four were positive and two were negative for COVID-19. Currently, there is no evidence of SARS-CoV-2 transmission through breast milk. Studies are needed with longer follow-up periods that collect data on infant feeding practices and on viral presence in breast milk.


Subject(s)
Breast Feeding , COVID-19 , Infectious Disease Transmission, Vertical , Milk, Human/virology , SARS-CoV-2/metabolism , COVID-19/epidemiology , COVID-19/metabolism , COVID-19/transmission , Child , Female , Humans , Infant , Infant, Newborn
13.
J Hum Lact ; 37(2): 269-272, 2021 05.
Article in English | MEDLINE | ID: covidwho-1082617

ABSTRACT

INTRODUCTION: During the Coronavirus Disease 2019 global pandemic, maternal and newborn wellbeing has received much attention. Detailed reports of infected women breastfeeding their infants are uncommon. Due to incomplete information available, full data about those infants' outcomes are lacking, and evidence of infectivity through breastfeeding has not been documented. MAIN ISSUE: Here, we report about a mother who breastfed her infant until she was confirmed with the SARS-Cov-2 infection. After follow-up, we have confirmed that the infant, who was breastfed by the infected mother, was not infected. METHODS: A 33-year-old woman gave birth to a full-term male infant on November 8, 2019. Since birth, she had been exclusively breastfeeding the baby until she was confirmed with the SARS-Cov-2 infection on February 8, 2020. She was hospitalized, isolated from her baby, and stopped breastfeeding. Even though she remained asymptomatic, her milk was expressed using a breast pump and discarded. The mother's milk sample was collected on February 9, 2020, and the result of the nucleic acid test for COVID-19 was negative. Her infant was asymptomatic and remained virus negative. Her laboratory findings and chest Computed Tomography imaging was normal. She was treated according to the national protocol with aerosolized interferon α2ß, lopinavir/ritonavir and ribavirin. Her serum SARS-CoV-2 specific antibodies(IgG and IgM) tested positive when discharged. She returned to breastfeeding after discharge. CONCLUSION: Our findings suggest that breastfeeding may be less of a risk than anticipated. Additional research is needed to explore this possibility.


Subject(s)
Breast Feeding , COVID-19/diagnosis , COVID-19/transmission , Infectious Disease Transmission, Vertical/prevention & control , Milk, Human/virology , SARS-CoV-2 , Adult , COVID-19/therapy , China/epidemiology , Female , Guideline Adherence , Humans , Infant , Male , Treatment Outcome
14.
Arch Dis Child Fetal Neonatal Ed ; 106(5): 514-521, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1079041

ABSTRACT

OBJECTIVE: To systematically review and meta-analyse the rate of SARS-CoV-2 genome identification and the presence of SARS-CoV-2 antibodies in breastmilk of mothers with COVID-19. DESIGN: A systematic review of studies published between January 2019 and October 2020 without study design or language restrictions. SETTING: Data sourced from Ovid Embase Classic+Embase, PubMed, Web of Science, Scopus, relevant bibliographies and the John Hopkins University COVID-19 database. PATIENTS: Mothers with confirmed COVID-19 and breastmilk tested for SARS-CoV-2 by RT-PCR or for anti-SARS-CoV-2 antibodies. MAIN OUTCOME MEASURES: Presence of SARS-CoV-2 genome and antibodies in breastmilk. RESULTS: We included 50 articles. Twelve out of 183 women from 48 studies were positive for SARS-CoV-2 genome in their breastmilk (pooled proportion 5% (95% CI 2% to 15%; I2=48%)). Six infants (50%) of these 12 mothers tested positive for SARS-CoV-2, with one requiring respiratory support. Sixty-one out of 89 women from 10 studies had anti-SARS-CoV-2 antibody in their breastmilk (pooled proportion 83% (95% CI 32% to 98%; I2=88%)). The predominant antibody detected was IgA. CONCLUSIONS: SARS-CoV-2 genome presence in breastmilk is uncommon and is associated with mild symptoms in infants. Anti-SARS-CoV-2 antibodies may be a more common finding. Considering the low proportion of SARS-CoV-2 genome detected in breastmilk and its lower virulence, mothers with COVID-19 should be supported to breastfeed.


Subject(s)
Breast Feeding , COVID-19 Testing , COVID-19/diagnosis , Milk, Human/virology , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , Female , Humans , Infectious Disease Transmission, Vertical/prevention & control
15.
mBio ; 12(1)2021 02 09.
Article in English | MEDLINE | ID: covidwho-1075939

ABSTRACT

Whether mother-to-infant SARS-CoV-2 transmission can occur during breastfeeding and, if so, whether the benefits of breastfeeding outweigh this risk during maternal COVID-19 illness remain important questions. Using RT-qPCR, we did not detect SARS-CoV-2 RNA in any milk sample (n = 37) collected from 18 women following COVID-19 diagnosis. Although we detected evidence of viral RNA on 8 out of 70 breast skin swabs, only one was considered a conclusive positive result. In contrast, 76% of the milk samples collected from women with COVID-19 contained SARS-CoV-2-specific IgA, and 80% had SARS-CoV-2-specific IgG. In addition, 62% of the milk samples were able to neutralize SARS-CoV-2 infectivity in vitro, whereas milk samples collected prior to the COVID-19 pandemic were unable to do so. Taken together, our data do not support mother-to-infant transmission of SARS-CoV-2 via milk. Importantly, milk produced by infected mothers is a beneficial source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness.IMPORTANCE Results from prior studies assaying human milk for the presence of SARS-CoV-2, the causative virus of COVID-19, have suggested milk may act as a potential vehicle for mother-to-child transmission. Most previous studies are limited because they followed only a few participants, were cross-sectional, and/or failed to report how milk was collected and/or analyzed. As such, considerable uncertainty remains regarding whether human milk is capable of transmitting SARS-CoV-2 from mother to child. Here, we report that repeated milk samples collected from 18 women following COVID-19 diagnosis did not contain SARS-CoV-2 RNA; however, risk of transmission via breast skin should be further evaluated. Importantly, we found that milk produced by infected mothers is a source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness as milk likely provides specific immunologic benefits to infants.


Subject(s)
Antibodies, Neutralizing/metabolism , Antibodies, Viral/metabolism , COVID-19/immunology , Milk, Human/immunology , Pregnancy Complications, Infectious/immunology , SARS-CoV-2/immunology , Adult , Breast/virology , Breast Feeding , COVID-19/transmission , COVID-19/virology , Female , Humans , Infant , Infectious Disease Transmission, Vertical , Male , Milk, Human/virology , Mothers , Pregnancy , Pregnancy Complications, Infectious/virology , RNA, Viral/isolation & purification , SARS-CoV-2/isolation & purification
18.
BMC Pregnancy Childbirth ; 21(1): 78, 2021 Jan 22.
Article in English | MEDLINE | ID: covidwho-1044307

ABSTRACT

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) is a novel disease which has been having a worldwide affect since December 2019. Evidence regarding the effects of SARS-CoV-2 during pregnancy is conflicting. The presence of SARS-CoV-2 has been demonstrated in biological samples during pregnancy (placenta, umbilical cord or amniotic fluid); however, maternal and fetal effects of the virus are not well known. METHODS: Descriptive, multicentre, longitudinal, observational study in eight tertiary care hospitals throughout Spain, that are referral centres for pregnant women with COVID-19. All pregnant women with positive SARS-CoV-2 real-time reverse transcriptase polymerase chain reaction during their pregnancy or 14 days preconception and newborns born to mothers infected with SARS-CoV-2 will be included. They will continue to be followed up until 4 weeks after delivery. The aim of the study is to investigate both the effect of COVID-19 on the pregnancy, and the effect of the pregnancy status with the evolution of the SARS-CoV-2 disease. Other samples (faeces, urine, serum, amniotic fluid, cord and peripheral blood, placenta and breastmilk) will be collected in order to analyse whether or not there is a risk of vertical transmission and to describe the behaviour of the virus in other fluids. Neonates will be followed until 6 months after delivery to establish the rate of neonatal transmission. We aim to include 150 pregnant women and their babies. Ethics approval will be obtained from all the participating centres. DISCUSSION: There is little information known about COVID-19 and its unknown effects on pregnancy. This study will collect a large number of samples in pregnant women which will allow us to demonstrate the behaviour of the virus in pregnancy and postpartum in a representative cohort of the Spanish population.


Subject(s)
COVID-19/physiopathology , Pregnancy Complications, Infectious/physiopathology , Abortion, Spontaneous/epidemiology , Adult , Amniotic Fluid/virology , COVID-19/mortality , COVID-19/transmission , Feces/virology , Female , Fetal Blood/virology , Hospitalization/statistics & numerical data , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/statistics & numerical data , Intensive Care Units/statistics & numerical data , Longitudinal Studies , Milk, Human/virology , Observational Studies as Topic , Perinatal Mortality , Placenta/virology , Pre-Eclampsia/epidemiology , Pregnancy , Pregnancy Complications, Infectious/mortality , Premature Birth/epidemiology , SARS-CoV-2 , Spain/epidemiology , Urine/virology
20.
Curr Nutr Rep ; 10(1): 71-75, 2021 03.
Article in English | MEDLINE | ID: covidwho-1006328

ABSTRACT

PURPOSE OF REVIEW: Breastfeeding is beneficial to both the newborn and the mother. During the COVID-19 pandemic, concerns have been raised on whether the SARS-CoV-2 virus could be transmitted from COVID-19 positive mother to the newborn through breastmilk. The purpose of this review is to examine the available evidence on the risks of transmission of infection from COVID-19 mothers to their newborns through breastfeeding. RECENT FINDINGS: Data is very limited in this regard, with only a few smaller case series, and case reports have been published so far. In most of the studies, breastmilk samples from COVID-19 mothers tested negative for the virus. In the case reports where the virus was detected in breastmilk and the infants were diagnosed with COVID-19, it remained unclear whether the disease was transmitted through breastmilk or direct contact or through delivery. Another hypothesis is that the viral antibodies could pass to the newborn passively through breastmilk of COVID-19 positive mothers and give immunity to the child, but data is minimal. Based on the currently available limited evidence and recognizing the benefits of breastfeeding, it may be concluded that if the health of the mother and her newborn allows, direct breastfeeding or extracted breastmilk should be encouraged by the healthcare providers after a careful discussion of the risks of vertical transmission to the mother and her family. Preventive measures should be taken by COVID-19 mothers to prevent droplet transmission of infection to the infants while breastfeeding.


Subject(s)
Breast Feeding , COVID-19/transmission , Milk, Human/virology , Pregnant Women , Antibodies, Viral , COVID-19/prevention & control , Case-Control Studies , Cohort Studies , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Milk, Human/immunology , Mothers , Pandemics/prevention & control , Pregnancy , SARS-CoV-2
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