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Mothers and healthcare workers who support them have many questions and concerns about whether it is safe for mothers with confirmed or suspected COVID-19 to be close to and breastfeed their babies during the pandemic.

To address their questions, WHO has released a list of Frequently asked questions: Breastfeeding and COVID-19. The FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection when COVID-19 is suspected and draws upon other WHO recommendations on infant and young child feeding.

The FAQs aim to provide information to healthcare workers supporting mothers and families in maternity services and community settings, and communicate how the interim guidance should be implemented. Additionally, the FAQs provide information about the protective effects of breastfeeding and skin-to-skin contact, and the harmful effects of inappropriate use of infant formula milk.

Accompanying the FAQs is a decision tree which provides step-by-step guidance to health workers on how to support mothers with confirmed or suspected COVID-19 to breastfeed. It provides advice on what to do if mothers are not well enough to breastfeed, as well as appropriate hygiene measures for mothers, including wearing a medical mask if available, to reduce the possibility of the COVID-19 virus being spread to her infant.

Benefits of breastfeeding outweigh potential risks

The COVID-19 virus has not been detected in the breastmilk of any mother with confirmed and suspected COVID-19 and there is no evidence so far that the virus is transmitted through breastfeeding. Researchers continue to test breastmilk from mothers with the infection.

WHO recommends that all mothers with confirmed or suspected COVID-19 continue to have skin-to-skin contact and to breastfeed. In all socio-economic settings, breastfeeding improves survival and provides lifelong health and development advantages to newborns and infants. Breastfeeding also reduces the risk of breast and ovarian cancer for the mother. Skin-to-skin contact, including kangaroo mother care, reduces neonatal mortality, especially for low birth weight newborns.

While infants and children can contract COVID-19, they are at low risk of infection. The few confirmed cases of COVID-19 in young children to date have experienced only mild or asymptomatic illness.

WHO’s recommendations on the care and feeding of infants whose mothers have confirmed or suspected COVID-19 aim to improve the immediate and lifelong survival, health and development of their newborns and infants. These recommendations consider the likelihood and potential risks of COVID-19 in infants and also the risks of serious illness and death when infants are not breastfed or when infant formula milk are used inappropriately.

WHO’s Q&A on breastfeeding and COVID-19 also provides additional infection prevention advice to mothers with confirmed or suspected COVID-19.

On World Day for Safety and Health at Work, the World Health Organization calls upon all governments, employers and workers organizations and the global community to take urgent measures for strengthen countries’ capacities to protect occupational health and safety of health workers and emergency responders respect their rights to decent working conditions, and develop national programmes for occupational health of health workers and to provide them with occupational health services. Amidst the COVID-19 pandemic, ILO has dedicated World Day for Safety and Health at Work 2020 in addressing the outbreak of infectious diseases at work, in particular, on the COVID-19 pandemic.

Health workers are at the front line of the COVID-19 outbreak response and as such are exposed to hazards that put them at risk of infection. Hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigma, and physical and psychological violence.

Infections with COVID-19, insufficient measures for infection prevention and control, occupational safety and health, mental health and psychosocial support for health workers result in high rates of absenteeism and deplete the health workforce – the most precision resources for stopping the COVID outbreak. 

COVID-19 infections among health workers:

• As of 21 April 2020 countries reported to WHO that over 35, 000 health workers were infected with COVID19. This number is significantly higher because of underreporting.
• The major occupational risks for COVID19 infection among health workers are:late recognition or suspicion of COVID-19 in patients, working in a higher-risk department, longer duty hours, sub-optimal adherence to infection prevention and control measures, such as hand hygiene practices, and lack of or improper use of personal protective equipment (PPE). Other factors have also been documented, such as inadequate or insufficient IPC training for respiratory pathogens, including the COVID-19 virus, as well as long exposure in areas in healthcare facilities where large numbers of COVID-19 patients were being cared for.
• The prevention of infections requires the use of appropriate infection prevention and control measures by all health workers, with a special focus on the adherence to hand hygiene and personal protective equipment when caring for COVID-19 patients, as well as a combination of environmental and administrative controls
• Health workers infected with COVID-19 following exposure in the workplace should have the right to employment injury benefits for occupational disease, including compensation, rehabilitation, and curative services.

The annual World Day for Safety and Health at Work on 28 April promotes the prevention of occupational accidents and diseases globally. It is an awareness-raising campaign intended to focus international attention on the magnitude of the problem and on how promoting and creating a safety and health culture can help reduce the number of work-related deaths and injuries.

Thirty-five-year old Salihu Umar was diagnosed with COVID-19 after returning from a six-day trip to London in March 2020. Although asymptomatic, he tested positive and underwent treatment. Having recovered and back with his family in the Nigerian capital Abuja, the father of three stresses the importance of getting tested especially after having travelled to an area affected by the virus. 

“I initially did not show any symptoms. Knowing fully well about the guidelines for people who travelled to high risk areas like the UK, I self-isolated for a day and decided to get in touch with the Nigeria Centre for Disease Control (NCDC) to take the COVID-19 test to be on the safe side. 

Health officials showed up … they promised to get back to me the next day or later that same day.  It however took three days to get a response from them. (Days later) I got a call from a doctor who introduced herself as an NCDC official. She broke the unfortunate news that my result turned out positive. She added that they need to take another sample to rerun the test for confirmation. I could not believe her as I was not showing any symptoms. At some point I felt it was a mistake, but I couldn’t do anything to prove them wrong as that’s the only place that runs the tests. 

In a few minutes, NCDC officials picked me from my house to Gwagwalada isolation centre. Upon arrival, I was examined by a doctor and placed on some medications. The doctors gave me some counselling and assured me of their commitment to making sure we make it out of the isolation centre healthy. The doctor added that even though I was asymptomatic, I still needed to commence treatment as soon as possible. 

I had mixed feelings, especially knowing that the disease has no cure and the number of people the virus kills every day.

It was quite depressing, being confined in a facility away from family and friends. It was the first time I was in that kind of situation. I was always (up and about) and suddenly I couldn’t move. From face timing (online chatting) with my family to tweeting and linking up with friends to sending emails. There was no time my kids missed me for one day. We were always connected.

A week into my isolation, another sample was taken to see how I was progressing. Unfortunately, it still came back positive. At that point I was losing hope for survival. The doctors assured me of my progress, saying I was doing well…

Lo and behold, another sample was taken on the twelfth day of isolation and it came out negative. Another one was taken after a few days and was still negative. I was free to go but was advised to self-isolate for one more week to ensure full recuperation and completion of the drugs which I did and finally finish without showing any more symptoms. That was the last time I heard from NCDC.

I’m so grateful to the NCDC, World Health Organization and all the doctors and the nurses in Nigeria who risked their lives to save my life.

For those battling COVID-19, I want you to know that this disease is not a death sentence. Never succumb to fear. 
As for other people hiding their travel history and symptoms for fear of social stigma, you can do better. Let us fight this together. Do the necessary. Go get tested.”