The Covid-19 pandemic raises many questions with regard to human milk और feeding with (donor) मानव दूध. Current recommendations change regularly depending on local situations and occurrences.^{1 2}

In short
As always, follow the Four Pillars of Safe स्तन का दूध शेयरिंग. Frequently wash hands, face, objects, and surfaces that come into contact with milk before and after handling.

During Times of Social Distancing, consider:

• Donors to follow official guidelines and refrain from transporting human milk.
• Recipient to follow official guidelines and cite baby food as a vital need.

During Times of Quarantine
If a member of a donor household has been quarantined due to infection, suspected infection, or exposure, milk should not be donated.

If a member of a recipient household has been quarantined, these recipient suggestions still apply.

Recipients
It is incumbent upon the recipient family to communicate and ensure that safety guidelines are followed to the extent needed to meet their baby’s needs. As always, use donor milk at your discretion. If your baby is immuno-compromised or has underlying health conditions, it is extremely important that you give serious consideration to the most appropriate food for your baby.

• Wash high-traffic areas in your home at least once per day.
• Wash your hands before leaving your home.
• Wash doorknobs of home and car.
• Communicate with the donor to leave donations at a safe distance from the front door.
• Place a clean towel on the seat of the car where you plan to place the milk. Do not set the milk on the floor of the car.
• Once home, use light soapy water to wipe off the bags of milk, and rinse with water.
• Store as you normally would.
• Consider pasteurizing the breastmilk using the Holder method before feeding it to the baby.³
• Studies have documented complete heat inactivation of genetically similar viruses. We closely follow milk bank releases for the latest information.

Donors: 

• Wash high-traffic areas in your home at least once per day.
• Wash the baby’s hands and face prior to breastfeeding if pumping at the same time.
• Wash your breast prior to pumping.
• Wash hands and equipment prior to pumpings.
• Wash hands and equipment after pumping.
• Wash down milk bags and transport carriers (paper bags or cardboard boxes preferred).
• Wipe handles of doors and doorbells (better: text your donor upon arrival).
• Place the transport container 6ft from the door, on a clean cloth.

Until we have a greater understanding, consider: 

• Not breast/chestfeeding someone else’s child, ie wetnursing, unless this regards a live-in situation and healthy wetnurse.
• Not offering to transport/meet for milk exchange but have the recipient family pick it up outside of your house.
• Wiping down the container or bag before putting it in their car.
• Refraining from milksharing if you have any of the following symptoms: cough, difficulty breathing, chest pain, fever, flu-like symptoms such as chills, headache, and muscle aches.

If there have been no reports of Covid-19 or no social distancing has been required, consider:

• Asking if the donor has traveled to an area affected by Covid-19 within the past 4 months.
• Asking if the donor has, directly or indirectly, been in contact with a suspected or confirmed case of Covid-19.
• Asking if the donor or recipient has any of the following symptoms: cough, difficulty breathing, chest pain, fever, flu-like symptoms such as chills, headache, and muscle aches.

Without having any evidence to the contrary and no virus having been detected in human milk, it is our current position that breastmilk-sharing during this COVID-19 pandemic can be done safely when proper procedures are used.

We trust in the informed-choice process of milk-sharing families who are dedicated to the safety of their children and we trust that community-based milksharing allows for swift action in order to flatten the curve of the COVID-19 spread. Milksharing involves fewer individual human touchpoints than formula or milk and milk-type products, even when using a delivery service.

क्लीनिकल Management
HMBANA – अस्पताल की स्थापना में COVID-19 सकारात्मक या संदिग्ध माताओं के लिए दूध की देखभाल

_______________

1. World Health Organization – कोरोनावाइरस रोग (COVID-19): गर्भावस्था, प्रसव और प्रसवोत्तर अवधि ↩︎
2. United States Breastfeeding Committee – आपात स्थिति में शिशु और युवा बाल आहार, COVID-19 सहित ↩︎
3. Research shows that Holder pasteurization deactivated SARS-CoV-2. कैरिना कोंजेलमैन, और अन्य. 2020. धारक पाश्चुरीकरण मानव स्तन के दूध में SARS-CoV-2 को निष्क्रिय कर देता है ↩︎