The information about coronavirus and breastfeeding on this page is being checked regularly and will develop in response to guidelines and evidence. This page was last updated on 19th October 2020.
Coronavirus 2019-nCoV or COVID-19 is a new respiratory illness that has not previously been seen in humans. The first coronavirus cases have been confirmed in the UK and the rising death toll worldwide is causing alarm and concern. This can be especially worrying for all parents with new babies and young children, including those who are worried about coronavirus and breastfeeding.
Can I breastfeed if I have COVID-19?
Current evidence suggests that it is safe to breastfeed and continue to offer breastmilk if you have COVID-19. “The long-term well established benefits of breastfeeding are highly likely to outweigh any potential risks of transmission of the virus through breastmilk” (RCOG, RCM July 2020, Walker, June 2020 & WHO June 2020)
In fact, breastmilk is the best source of nutrition for infants and provides protection against many illnesses. If you have confirmed COVID-19 or have symptoms you should take all possible precautions to avoid spreading the virus to your baby, including washing your hands before touching your baby, sterilising any breast pump or bottles and washing your hands after changing their nappy.
Consider wearing a face covering or fluid-resistant face mask while feeding or caring for the baby.
If you are too unwell to breastfeed you may still be able to express milk for your baby. Pump equipment and bottles need to be sterilised according to manufacturer’s instructions.
Babies should not wear a face covering or mask as they may risk suffocation.
It can be difficult to differentiate between a cold, flu and coronavirus. The information in this diagram may help:
Image taken from https://www.bbc.co.uk/news/health-54145299
For information on cough and cold remedies when you are breastfeeding see: https://www.breastfeedingnetwork.org.uk/cold-remedies/
For information on products which help to relieve sore throats: https://www.breastfeedingnetwork.org.uk/sore-throats/
For information on painkillers which may also help to relieve temperature and aches & pains: https://www.breastfeedingnetwork.org.uk/analgesics/
Should you be diagnosed with COVID-19 and be admitted to hospital you may be prescribed stronger medication including anti-virals:
Dumitriu D, Emeruwa UN, Hanft E, et al. Outcomes of Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection at a Large Medical Center in New York City. JAMA Pediatr. Published online October 12, 2020. doi:10.1001/jamapediatrics.2020.4298
Sections 6:1-3, Version 11: updated 24 July 2020. Guidance for healthcare professionals on coronavirus (COVID-19) infection in pregnancy, published by the RCOG, Royal College of Midwives, Royal College of Paediatrics and Child Health, Public Health England and Public Health Scotland. https://www.rcog.org.uk/coronavirus-pregnancy
Walker, KF, O’Donoghue, K, Grace, N, Dorling, J, Comeau, JL, Li, W, Thornton, JG. Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis. BJOG 2020; https://doi.org/10.1111/1471-0528.16362. 127: 1324– 1336.
WHO, June 2020, WHO/2019-nCoV/Sci_Brief/Breastfeeding/2020.1
What are the symptoms?
How to avoid catching or spreading coronavirus
- wash your hands with soap and water often – do this for at least 20 seconds
- always wash your hands when you get home or into work
- use hand sanitiser gel if soap and water are not available
- cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- put used tissues in the bin straight away and wash your hands afterwards
- try to avoid close contact with people who are unwell
- touch your eyes, nose or mouth if your hands are not clean
I am feeling unwell and may have coronavirus
If you are feeling unwell, and have symptoms of coronavirus, the general information provided by Public Health England [in the link] should be helpful.
Other things that may be of help include keeping yourself hydrated and taking painkillers such as paracetamol or ibuprofen*, as described on the packet, to help you feel more comfortable.
*There was some uncertainty about taking ibuprofen when you have symptoms of coronavirus. The Commission on Human Medicines has now confirmed there is no clear evidence that using ibuprofen to treat symptoms such as a high temperature makes coronavirus worse.
If you have been prescribed anti-inflammatory medication by your doctor for other reasons please do not stop treatment without discussion.
Guidance on how long to stay at home and how to contact NHS 111 is also on the PHE site above.
If you suspect you have COVID-19 or it has been confirmed and you want information on breastfeeding follow the link:
The main points include:
- Wash your hands before touching your baby, breast pump or bottles
- Try to avoid coughing or sneezing on your baby while feeding, whether breastfeeding or giving a bottle.*
- Consider wearing a face mask while breastfeeding or bottle feeding, if available*. Discuss options with your midwife.
- Follow manufacturers recommendations for pump cleaning after each use.
- If you are feeling too unwell to breastfeed directly consider asking someone who is well to feed your expressed breast milk to your baby.
- If you choose to feed your baby with formula or expressed milk, it is important that you follow the sterilisation guidelines [link to NHS site https://www.nhs.uk/conditions/pregnancy-and-baby/sterilising-bottles/ . ]
- If you are expressing breast milk in hospital, a dedicated breast pump should be used. The hospital may have guidance about bringing the bottles into the neonatal unit.
*This is to ensure good respiratory hygiene when close to your baby such as when feeding, or changing their nappy.
If you would like to know more about donor milk as an option while you are ill follow this link to find your nearest milk bank. Supplies are limited, they will do what they can. http://www.ukamb.org/
If your baby needs to be cared for in a Neonatal Unit (NICU) these links have general information and specific details about COVID-19 in neonatal units.
Please message the Drugs in Breastmilk information service via the Facebook page, or email firstname.lastname@example.org
Link checked 14 May 2020
Drugs in Breastmilk information here:
Facebook link here:
Starting breastfeeding - the first few days.
How is feeding going?
Helping your baby attach well will allow them to make the most of your milk and avoid hurting your breasts. You are looking for short sucks to begin, which can feel strong, followed by long rhythmic sucks and swallows. When your baby finishes the feed, they should appear content and satisfied – though they may want more from the second breast before they finally settle. Your nipples should look like they did before the feed, if sore, misshapen or have pressure lines, the attachment may have shifted during the feed – this is something to work on. Keep in mind the phrase ‘CHINS’, trained peer supporters use this acronym when supporting mothers to help remember the ways of holding and attaching your baby: Close, your baby needs to be close to you so that they can scoop enough breast into their mouth Head free, so your baby can tilt their head back when attaching to your breast. This allows their chin to lead as he comes on to the breast In Line, your baby’s head and body need to be in a straight line so they are comfortable and can swallow easily. Nose to nipple, this should be at the top of the list – start the feed with your nipple level with your babies nose so that as they root and tilt their head you can bring them closer to you so they will be well attached. Sustainable, comfortable for both of you through the feed. Your baby’s wet and dirty nappies are a good indication of the amount of milk taken.
The first 48 hours
- At the beginning, your baby will pass a black tar-like poo (called meconium)
- In the first 48 hours, your baby is likely to have only 2 or 3 wet nappies.
Wet nappies should then start to become more frequent, with at least 6 every 24 hours from day 5 onwards. You may notice an orange or red, brick-dust coloured stain in your baby’s nappy in the first couple of days after birth. This can look alarmingly like blood, but is urate crystals, which is normal at this time. As feeds increase the urine will become less concentrated and the staining will disappear. Let your midwife know if it is still there by day 3 or 4. It is also common for baby girls to have a vaginal discharge in the first few days after birth. At times this may be slightly blood stained and is due to the presence of your hormones in your daughter’s body; this is entirely normal but if in doubt please check with your midwife. https://www.cuh.nhs.uk/rosie-hospital/pregnancy-labour-and-birth/going-home/caring-for-your-baby/what%E2%80%99s-nappy
- By day 3, your baby’s poo becomes easier to clean as the meconium mixes with your milk and should be changing to a lighter, loose, greenish poo.
- From day 4 and for the first 4 – 6 weeks your baby should pass at least 2 yellow poos every day, with poos at least the size of a £2 coin.
If on any day during the first week your baby has not had a poo, or you have any concerns, call the National Breastfeeding Helpline. You can also speak to your midwife. They will help you check how well your baby is feeding and any difficulties you may be having. There will be many times when your baby is doing well with a gap in poo, yet it is better to be careful and to seek support to help guide you. To discuss this, or any question, ask your midwife or call the National Breastfeeding Helpline, 0300 100 0212, open 9.30am-9.30pm, every day of the year. It’s important to stay connected so call as often as you like.
Link to all the breastfeeding support available during COVID-19 https://www.breastfeedingnetwork.org.uk/breastfeeding-support-in-the-uk-during-the-coronavirus-covid-19-situation/
These links below can make it all seem easy when the reality may be harder. Talk it through with someone on the helpline as they are skilled at knowing how to help.
See colour changes of baby poo on p17 https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2010/11/otbs_leaflet.pdf
Beginning breastfeeding https://www.nhs.uk/conditions/pregnancy-and-baby/breastfeeding-positioning-attachment/
Longer, ten minute, video showing more detail on attachment and how babies signal they are ready to feed through feeding cues https://globalhealthmedia.org/portfolio-items/attaching-your-baby-at-the-breast/
Feeding on day 2 – to show babies need to calm to feed. Too upset on first try https://www.breastfeedinginc.ca/baby-28-hours-old-assisted-latching
How can I increase the amount of breastfeeds? I’m breastfeeding and also giving bottles of formula.
I have stopped breastfeeding, can I restart?
Is sharing breastmilk safe during coronavirus?
Is donor breastmilk from a milk bank an option?
Health workers expressing milk at work
Breastfeeding support in the UK during the COVID-19 situation
- National Breastfeeding Helpline (run by the Association of Breastfeeding Mothers and the Breastfeeding Network) – 0300 100 0212 Open 9.30am-9.30pm, every day of the year. This line also includes an option for Welsh and Polish language support.
- Breastfeeding Network Bengali/Sylheti Helpline 0300 456 2421
- The National Breastfeeding Helpline also provides support via web chat at www.nationalbreastfeedinghelpline.org.uk and via Facebook messenger www.facebook.com/nationalbreastfeedinghelpline
- The Breastfeeding Network’s Drugs in Breastmilk Information service offers evidence based info on the safety of medications and treatments during breastfeeding. A series of fact sheets covering a wide range of issues and medications can be found at: www.breastfeedingnetwork.org.uk/drugs-factsheets Or you can message the BfN Drugs in Breastmilk Information page on Facebook at www.facebook.com/BfNDrugsinBreastmilkinformation Or email email@example.com
- Many Breastfeeding Network local services are running virtual groups for mothers to meet up for support with other families, staff and trained volunteers. or offering 1-1 support over the phone or via video calls.
- There are lots of local BfN Facebook pages and groups that you can join to chat to other mums and to get support from trained volunteers. Many local areas also have an email address so you can contact them directly
- In a few areas with commissioned services, The Breastfeeding Network is offering some face to face support (clinic appointments, home visits and walking groups), where this can be provided in a secure way and with full permission of the health board/NHS Trust or local authority. These services may change in accordance with local guidelines so check this page regularly for updates, More details on what is available in your area can be viewed here https://www.breastfeedingnetwork.org.uk/peersupportprojects/
- La Leche League – 0345 120 2918 (8am-11pm) and visit https://www.laleche.org.uk/get-support/ for a range of online and telephone breastfeeding support options.
- NCT – 0300 330 0700 Feeding line (8am-midnight) https://www.nct.org.uk/baby-toddler/feeding/early-days/breastfeeding-support-nct
- You can also contact your local health visiting team or local infant feeding support team to see what other resources are available. An internet search using ‘breastfeeding’ and the name of your town or county will usually get you to the right teams. In many areas, there are increased levels of phone support and support available online and through video.
- You can also visit lcgb.org to find a local lactation consultant: https://www.lcgb.org/find-an-ibclc/. Many are offering additional remote support options.
- There are several reliable sources of online information about breastfeeding, talking about what’s normal and how to deal with problems, including: https://www.laleche.org.uk/ www.breastfeedingnetwork.org.uk www.abm.me.uk https://www.nct.org.uk/baby-toddler/feeding https://breastfeeding.support/ https://globalhealthmedia.org/videos/breastfeeding/
- The national charity Best Beginnings has created Baby Buddy, the free NHS approved app for pregnant women and new parents includes supportive daily information about breastfeeding, maternal mental health and more. Also, within the app you can watch over 30 films about breastfeeding including practical films on positioning and attachment. For anyone wanting to see the breastfeeding films via a website, you can click here: https://web.bestbeginnings.org.uk/web/videos/breastfeeding
- For joint expert information from midwives and doctors on breastfeeding and caring for a baby during a COVID-19 infection or suspected infection, please visit this site and scroll down to find the later questions: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/
- UNICEF Baby Friendly also has some useful resources here: https://www.unicef.org.uk/babyfriendly/COVID-19/
This information was prepared jointly by the breastfeeding support organisations.
If you are finding it hard to find your baby’s usual brand of infant formula
Protecting your mental health during anxious times
- One You https://www.nhs.uk/oneyou/every-mind-matters/
- Lots of good information here plus links to online CBT modules here: https://www.breastfeedingnetwork.org.uk/anxiety/
- Mental Health Foundation have published a very good guide here https://mentalhealth.org.uk/coronavirus/staying-at-home
- BfN’s Big Tea Break – Moment of Calm https://www.youtube.com/watch?v=9T3KRiO2kaE – everyday should include at least 5 minutes of calm!
- Anxiety UK have resources specific to coronavirus https://www.anxietyuk.org.uk/coronanxiety-support-resources/
- Headspace has a section on stress and anxiety which may help you ground yourself by listening to your breathing, e.g. https://www.headspace.com/meditation/anxiety
Useful information for supporting children
Mindheart has published a short book to support and reassure children under the age of 7 about coronavirus. Covibook is available to download in 21 languages including English. Read the news story: #COVIBOOK Supporting and reassuring children around the world
Read the book: Covibook (PDF)
Mental Health and Wellbeing
The Anna Freud National Centre for Children and Families has published advice and guidance for Parents and Carers and Schools
There is much that each one of us can do to support the wellbeing of those in our lives. We don’t know whether the coronavirus situation will impact on children and young people’s mental health, but we think that it may.
The Association for Child Mental Health has released a podcast discussing the coronavirus and children and young people’s mental health.
Read the news story and listen to the podcast: https://player.fm/series/association-for-child-and-adolescent-mental-health-acamh/dr-jon-goldin-on-the-coronavirus-and-child-mental-health
Information about online safety
You can find a summary and original NSPCC sources of information we have described above here
Here are some of the latest guidelines:-
Other Information and further support
Useful information for staying at home