NGOs defend breastfeeding as COVID-19 misinformation rages

WASHINGTON — Misinformation about the safety of breastfeeding during the coronavirus pandemic has led to decreases in the practice by women who fear it could harm babies, NGOs say.

Combating misinformation about breastfeeding — already rampant in some countries before the pandemic — is even more complicated when access to mothers through hospitals, clinics, and home visits has been restricted by lockdown measures. The World Health Organization recommends exclusive breastfeeding for an infant’s first six months — guidance that did not change with the onset of COVID-19.

“In certain hospitals the breastfeeding rates … dropped by 40 to 50%,” said Alex Iellamo, global adviser on infant and young child feeding in emergencies at Save the Children UK. “There has been a lot of confusion, not just at the community level but among agencies.”

NGOs say anecdotes from different countries indicate that various types of misinformation are causing women to avoid breastfeeding during the pandemic. These include concerns that a mother could be infected with the virus and spread it to her baby through breast milk, as well as fears that the virus is floating in the air and could make its way into breast milk.

“When babies are born, their immune systems aren’t really functioning yet. Nature has intended that they get their initial immunity from the mother’s breast milk,” said David Clark, a legal specialist with the nutrition section at UNICEF. “We know that up until now … there’s been no evidence of transmission of active COVID virus through breast milk, so breastfeeding is still very important and to be protected.”

As hospitals around the world saw influxes of COVID-19 patients, they began limiting visitors and unnecessary contact inside their buildings to prevent the spread of the highly contagious virus. Iellamo said that initial confusion about what best practice should be — including guidance from the U.S. Centers for Disease Control and Prevention — created uncertainty around whether mothers and babies should remain together in hospitals.

WHO recommends that mothers initiate breastfeeding within one hour of birth to establish the practice. Separating mother and baby can prevent skin-to-skin contact and this initial breastfeeding progress. Hospital restrictions to limit both family members and additional health personnel in the building can also leave new mothers alone and afraid during the pandemic, without the support of a partner, lactation consultant, or other provider to assist with initial breastfeeding, Iellamo said.

UNICEF is working with countries to promote breastfeeding right after birth and to discourage national policies that recommend hospitals separate infants from their mothers, Clark said. He said there must be consistent messaging from both NGOs and country health ministries if it is to be effective at ensuring mothers know breastfeeding is safe during the pandemic.

“Each country will determine what is the best way to reach the policymakers, but then of course it has to get down to the mothers, the caregivers,” Clark said. “We’re trying to ensure that we’re all getting the same message. We’re making sure that we have the same information that is consistent and that it’s using whatever media is appropriate in the context.”

While babies are not completely immune from contracting COVID-19, the virus has shown to be more fatal for older people and those with comorbidities. WHO eventually adjusted its guidance to clarify that social distancing did not apply to mothers and babies and that an infected mother can have contact with her infant after taking precautions such as washing hands and wearing a mask.

NGOs have also seen evidence that formula companies have tried to capitalize on confusion over breastfeeding during the pandemic to promote their products as a safer alternative.

“With COVID, the companies are using this to just reinforce the fears and the worries of mothers, saying: ‘We’re here for you. We know how stressful this is for you during the pandemic, et cetera, but we’re here. We’re making sure our formula’s safe and available.’ And they are also resorting to the old tactics — which we had managed to really stop over the years — and that’s providing free formula,” Clark said. “We have various examples being shown to us from different parts of the world where the companies are doing this.”

In countries where breastfeeding counseling programs in clinics or via house visits have been restricted due to social-distancing or lockdown requirements, organizations have tried to adapt their messaging to reach new mothers and continue breastfeeding promotion. They have used WhatsApp groups, television, and radio messaging, and social media like Facebook to distribute information about breastfeeding during the pandemic.

In other countries where lockdowns were not imposed nationwide, some women have incorrectly been led to believe that anyone working in a health setting has the virus. This means fewer women are visiting clinics where they would normally receive information and counseling on breastfeeding because they think mother and baby are at high risk of contracting it from nurses or doctors.

Such misinformation happened in Benin, where many health programs continued throughout the pandemic because parts of the countries never saw mobility restrictions. Still, women were hesitant to attend, said CARE Nutrition Director Tom Schaetzel. The organization supported a radio campaign to teach precautionary hygiene practices and encourage mothers to keep breastfeeding even if they were not comfortable visiting clinics.

In Bangladesh, CARE conducted a rapid assessment to determine what messages mothers were receiving about breastfeeding. The team discovered that mothers were confident in their knowledge around the practice during the pandemic — but the information they had was incorrect, Schaetzel said, demonstrating the need for education campaigns.

Ultimately, the clear health benefits of breastfeeding, which WHO says strengthens babies’ immune systems and provides all essential nutrients for the first six months of life, outweighs the potential negative effects of being near a mother that has the virus, Schaetzel said.

“Certainly it’s not that there’s zero risk for babies, but everything we know about this virus is that it is, in general — not everywhere and not exclusively — but in general it is less of a danger to the young than it is to the old,” Schaetzel said.

“There are so many other threats to child health that breastfeeding protects against, that it’s maybe even a little bit tragic that people would stop breastfeeding over a small risk of COVID-19 when there are really large risks of pneumonia and diarrhea and other illnesses.”

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