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Covid-19 HSE Clinical Guidance and Evidence

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Recommendations for breastfeeding during the Coronavirus (Covid-19) Pandemic

Recommendations for breastfeeding during the Coronavirus (Covid-19) Pandemic (CD 19-043 002/11.05.20)


As practising clinicians in this unprecedented time, we all need to act on local and national guidelines for the management of Covid-19. We need to engage with management and clinical teams to plan our local response in our own hospitals and in line with the Health Protection Surveillance Centre (HPSC). This interim guidance has been issued to provide additional guidance to clinicians (doctors, midwives and nurses) during the COVID-19 pandemic on the importance of continuing to support and encourage breastfeeding during this time.

During the Covid-19 pandemic, the HSE and Faculty of Paediatrics encourage breastfeeding to protect children.
 

For All Mothers
  • Skin to skin contact with babies is encouraged
  • Breastfeeding protects infants and children from infections and is freely available
  • If combined feeding, maximising exposure to breast milk should be supported. Some parents may need extra information about increasing supply or relactation
For Mothers with Confirmed or Suspected Covid-19
  • If a person is affected with Covid-19, there is no evidence that the virus is transmitted via breast milk and breastfeeding is encouraged as normal
  • The benefits of breastfeeding outweigh the potential for exposure to the virus https://www.hse.ie/file-library/infant-feeding-policy-for-maternity-neonatal-services-2019.pdf
  • Hand hygiene should be performed before feeds and a facemask should be worn for close contact with baby
  • If their baby/babies is/are preterm or ill and admitted to NICU/HDU/SCBU they should supported to express breast milk for them
     
For Mothers with Confirmed or Suspected Covid-19: Expressing Milk in Hospital
  • Hand hygiene should be performed before expressing and a face mask should be worn
  • Where available disposable expressing kits should be used, once opened they can be used for 24 hours if they are cleaned (washed and dried)
  • A new kit should be used every 24 hours
  • The kits should be disposed of as healthcare risk waste
  • Once the mother is well enough to be discharged, normal reusable kits can be used at home
  • If the expressed breast milk (EBM) is being transported to the NICU/HDU/SCBU, the container should be thoroughly cleaned prior to being labelled.
  • The EBM should be brought to the NICU/HDU/SCBU and stored as per local guidelines (if a separate fridge/freezer is unavailable, a separate shelf will suffice)
     
For Mothers with Confirmed or Suspected Covid-19: Admitted to Acute Hospital
  • In the event that a breastfeeding mother is admitted to hospital with Covid-19 infection, if well enough she should be encouraged and supported to express during her hospital stay so that the baby can continue to receive breast milk at home.
  • It is recommended that the baby is cared for at home if the mother is admitted to an Acute Adult Hospital so as to reduce the risk of infection to the baby.
  • Breastfeeding support is available from maternity units, community midwives, public health nurses in CHO areas, mychild.ie, La Leche League, Cuidiu and from the Association of Lactation Consultants of Ireland.
     
General Principles
Acknowledgements

Membership of Neonatology-Paediatric Covid-19 Guidance Group March 2020

  • Dr Anne Doolan (author), Consultant Neonatologist, Coombe Hospital
  • Dr. John Murphy, Clinical Lead, Neonatology, Consultant Neonatologist National Maternity Hospital, Holles Street
  • Prof Ellen Crushell, Dean, Faculty of Paediatrics, RCPI, Consultant Paediatrician SI in Inherited Metabolic Disorders
  • Dr. Claudine Vavasseur, Director of Neonatology, National Maternity Hospital, Holles Street
  • Dr. Michael Boyle, Consultant Neonatologist, Rotunda Hospital
  • Dr. Paula Cahill, Consultant Paediatrician, Portiuncula University Hospital, Galway.
  • Dr. Rhona Mahony, Master of National Maternity Hospital, Holles Street, Consultant Obstetrician and Gynaecologist
  • Dr. Brendan Murphy, Consultant Neonatologist, Cork University Hospital
  • Dr Ethel Ryan, National Lead CD Programme QI Division, Consultant Neonatologist / Paediatrician, GUH

Stakeholder Review Group March 2020

  • Neonatology Clinical Advisory Group, RCPI
  • Laura McHugh, National Breastfeeding Co-Ordinator
  • Meena Purushothaman , Assistant National Breastfeeding Co-Ordinator

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