Throughout history, breastfeeding has survived pandemics, famines, and catastrophes. However, the current health crisis may become an impediment for new mothers who decide to breastfeed. According to Alba Padró, president of the Alba Lactancia association and co-founder of the Spanish application LactApp, "the fear of professionals and mothers has made many lactations start with difficulties, or even be prohibited."
At the start of the pandemic, the protocols of the Spanish hospitals were reluctant to allow women to breastfeed with Covid-19, despite the fact that the WHO and Unicef encourage it since the available evidence suggests that it is not transmitted through of milk. "Over time we will be able to have data of what this pandemic has meant in the initiation and maintenance of breastfeeding in the world," Padró points out. The Spanish Society of Neonatology (SeNeo), which at first did not support the recommendation to allow breastfeeding, has done so in its latest protocols, among other benefits due to "the potential passage of mother-child antibodies against SARS-CoV- two".
Along the same lines, José María Paricio, pediatrician and founder of e-lactancia.org, a reference website on the compatibility of breastfeeding with diseases and medications, speaks out. "The virus has not been found to be transmitted through lactation, and yet it is expected that it will leave an immune signal in milk that will provide antibodies and defenses, as is the case with other respiratory viruses," he says.
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APILAM, the scientific association behind e-lactation, has analyzed the medications used to treat Covid-19 and states that practically all of them are compatible with breastfeeding. "We receive consultations from several hospitals to verify this compatibility, and coronavirus is already the second most searched term on our website. It is a welcome concern, since it means that there are many mothers and professionals concerned about maintaining these lactations," celebrates Paricio.
Still, women with coronaviruses who start breastfeeding these days may encounter several stones along the way. The latest indication from Seneo advises hospitals to enter "isolated and separated from their mother" babies of symptomatic women with positive infection or under investigation, and leave those of asymptomatic positive mothers in a crib two meters away, at the risk of spit drops. However, this physical separation can be a great difficulty in establishing lactation.
Carmela Baeza, a family doctor at Madrid's Centro Raíces and IBCLC (certified international lactation consultant), warns that isolating a baby is not so easy in practice. "On the one hand, if another person has to take care of the baby from a positive mother, how do we make sure that it is not going to infect the baby? If it is left to the other parent, it is a person who has been living with the mother ", in a home exposed to contagion. "And also, a baby separated from his mother has high levels of stress, and therefore lower defenses," he says. For this reason, it calls for a relaxation of the protocols. "The problem has been thinking that separating a baby from its mother offered zero risk, something that does not exist with this pandemic."
Paricio, for his part, considers the isolation of a family member inside the house to be "ineffective", since according to him, in all probability, all the cohabitants of the house will have been infected. "The recommendation is unrealistic. In most houses, especially in cities, there is not enough space to keep one of the people away. We do not live in palaces."
The also family doctor, pediatrician of Primary Care and IBCLC Sarai de la Fuente Gelabert agrees that the separation "puts at risk the establishment and maintenance of breastfeeding itself", since the first moments after childbirth are key to her good health. development. "The consequences of a separation are important, so if it cannot be changed, for the safety not only individual but collective, it will be necessary to re-bond the mother with her baby when they can be reunited. Meanwhile, it must be possible to express milk so as not to have engorgement problems or breast obstructions and maintain milk production. "
These problems, which any first-time mother can encounter today, add to the difficulty of finding face-to-face support because of confinement. LactApp, which has tripled the number of consultations since the alarm started, has detected an increase in mastitis, a condition that infants can suffer due to inflammation of the mammary gland. According to Padró, the barriers that women face to go to breastfeeding groups and the health system, as well as the lack of information, may be causing symptoms that could have been detected early, evolve and require more intervention. Baeza verifies it. These days has seen "all the usual difficulties" increase: mastitis, pain, abandonment ... De la Fuente also stresses that today "nursing mothers are waiting more to consult things that before they would immediately ask their midwife, their pediatrician or their lactation consultant. They are enduring situations that never evolved. "
Given this, and to prevent breastfeeding rates from plummeting, Baeza claims to facilitate telephone and online consultations. If there is no consistent support network, there may be consequences in terms of "physical, emotional, personal and population health". From Lactapp, Padró confirms that mothers have "a great need to be able to ask questions" and, although nothing replaces face-to-face care, technology offers "new collaborative spaces in which to find information and tranquility, as well as close contact and personalized follow-up".
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