Why experts think breastmilk might help protect babies from COVID-19

Kristine Sabillo, ABS-CBN News

Posted at Oct 01 2020 09:42 PM | Updated as of Oct 01 2020 10:35 PM

MANILA — Rozen Nava wiped tears away, remembering how she wasn’t able to touch and breastfeed her baby right after she gave birth on September 9.

“Yung sinasabi nyo na unang yakap nung lumabas si baby. Ang expected ko ilalapit sa akin. Tapos pipicture-an kayo. Kaso walang ganun,” she sadly recalled in an interview with ABS-CBN News.

(What they call the first touch after giving birth…I expected that my baby will be brought to me and then we’ll get a picture. But that did not happen.)

She tested positive for COVID 8 months into her pregnancy, despite staying indoors for weeks. While her mild symptoms were gone by the time she went into labor and she was already considered clinically recovered, she had yet to get a negative swab test.

On the first day, she was only able to watch a video of her baby drink someone else breastmilk. It was only on the second day that hospital staff asked her to hand express milk.

Rozen said it hurt to be apart but she just focused on the health of her baby girl.

She said one of her doctors wanted to keep them apart longer as a precaution but her neonatologist, a doctor specializing in newborn babies, said they can finally be together. 

After 2 days, she was reunited with her child. They were inside the car, on their way home.

Rozen Nava is reunited with her daughter, two days after she gave birth. Contributed photo

Neonatologist Dr. Mianne Silvestre of the Healthcare Professionals Alliance Against COVID-19 (HPAAC) said there was a lot of confusion about how to deal with breastfeeding during the early months of the pandemic. 

But the World Health Organization’s guidelines to keep mothers and infants together have prevailed, prompting the Department to Health to eventually release similar guidelines.

“Mothers should be counseled that the benefits of breastfeeding substantially outweigh the potential risks for transmission,” the WHO said in its recommendation.

However, Silvestre said there are still people who are not aware of this and of the current protocol allowing mothers who have COVID-19 to be with their infants. She said it should be generally safe for mothers to breastfeed, as long as they wear a face mask, frequently wash their hands and avoid coughing into their arms since that is where their baby is placed.

Even before the COVID-19 pandemic, studies have shown how antibodies and other anti-viral factors in breast milk can protect an infant from illnesses

A recent study from Beijing, based on a laboratory experiment, showed that human breast milk actually suppresses the SARS-CoV-2 virus.

The breast milk, collected in 2017, was “blocking viral attachment, entry and even post-entry viral replication,” wrote a team of scientists from the Beijing University of Chemical Technology in two non-peer-reviewed papers posted on biorxiv.org last week.

The study concluded that breast milk can inhibit the COVID-19 infection. The team said finding the cause of this might help in antiviral drug development.

The Department of Health said this week that it will review the study first but added that it is known that breast milk protects infants from certain diseases.

The latest study supports the WHO’s official stance that mothers should be allowed to continue breastfeeding even if they have COVID-19.

Experts from the Philippines agree, citing a number of reasons why mothers should not be separated from their babies even amid mandatory isolation during the pandemic.

1. BREAST MILK MIGHT PROTECT BABIES FROM COVID-19, OTHER DISEASES

Silvestre said there’s a lot of potential for the study.

“My bias is it’s the antibodies in milk,” Silvestre told ABS-CBN News. “Yung tinatawag na first breast milk o colostrum ng ina (What they call the first breast milk or a mother’s colostrum). The highest levels of antibodies is contained in colostrum.”

She explained that so-called “secretory antibodies” from breast milk coat the gut, “lining the nostrils down to your trachea down to your lungs.”

Silvestre, who is also founding president of Kalusugan ng Mag-Ina (KMI), pointed out that these are the parts of the body most hit by the SARS-CoV-2. 

“Nagmi-migrate yun (antibodies) through the bloodstream and into the lungs where they are most important fighting respiratory infections like COVID and pneumonia,” she said, adding that it also addresses diarrhea. Pneumonia and diarrhea are among the top causes of infant mortality.

(The antibodies migrate through the bloodstream and into the lungs where they are most important in fighting respiratory infections like COVID and pneumonia.)

Dr. Amado Parawan, who is a pediatrician and the health and nutrition advisory of Save the Children Philippines, said he thinks the paper from Beijing is “a very important study.”

After reading the actual paper, he said it seems to be “scientifically done” although more studies are needed to confirm it.

Parawan said breastfeeding advocates have long been promoting breast milk for its antibodies and antiviral properties.

“Breastmilk helps develop the microbiome of the gut. It helps develop the good bacteria. It also prevents diarrhea,” he said. “Of course, we know it prevents other infections because of the antibodies present in the breastmilk. So it will fight infections. It could be viral, it could be bacterial. It increases also the immune system.”

Following the idea that breastmilk has the antibodies of the mother from previous infections, Silvestre said it was possible that it could provide protection from COVID-19.

“Imagine natin yung isang ina bagong panganak let’s say nagka-COVID sya right before she delivered. She started to produce antibodies already for herself,” she pointed out. “Yung colostrum may taglay na antibodies not just for COVID but all other infections na pinagdaanan ng nanay.”

(Imagine a mother who had COVID right before she delivered. She started to produce antibodies already for herself. The colostrum would have antibodies not just for COVID but all other infections the mother went through.)

As early as May, the Icahn School of Medicine at Mount Sinai was already looking at how antibodies in milk produced by women who recovered from COVID-19 can treat other people. 

Silvestre also cited previous studies showing how contact and breastfeeding immediately after childbirth significantly lessened the risk of infection and death among babies.

“If you delay the breastfeeding dumodoble yung panganib na mamatay yung baby from infection,” she said, citing studies done in Nepal and Ghana where majority of babies are exclusively breastfed.

(If you delay the breastfeeding…the risk of the baby dying from infection doubles.)

She said this is why the WHO advised countries to keep mother and child together even if the mother tests positive for COVID-19.

Silvestre said as long as the mother has mild symptoms or is asymptomatic, she should be allowed to be with and breastfeed her child while wearing a face mask. She also advised mothers not to cough or sneeze into their arm or elbow and instead use a tissue, as well as wash hands frequently.

This is also in accordance with current Department of Health protocols.

2. OTHER HEALTH BENEFITS FOR THE BABY

Parawan said breastfeeding also improves the brain development of infants. Studies have shown that breastmilk increases brain growth.

3. HEALTH BENEFITS FOR THE MOTHER

“Nakikita din natin may benefits sa nanay. Protection sya sa breast cancer, ovarian cancer,” he added.

(You also see the benefits for the mother. It’s protection against breast cancer, ovarian cancer.)

According to the World Cancer Research Fund, “there is strong evidence that breastfeeding decreases the risk of breast cancer. There is also limited or suggestive evidence that it also results in decreased risk of ovarian cancer.

Parawan said breastfeeding also helps develop the bond between mother and child, resulting in better mood and stress levels for the mother.

He said it’s not true that breastfeeding will take a toll on the body of a mother, a concern for some of his patients. He pointed out that many models and celebrities advocate breastfeeding.

4. SAFE FOR THE BABY

He said exclusive breastfeeding also ensures that the baby’s won’t ingest contaminated food.

“Kasi hindi naman natin alam kung ang tubig ititimpla sa gatas malinis ba yun. Or yung feeding bottle malinis ba yun,” he said.

(You don’t know if you the water used for formula milk is clean or if the feeding bottle is clean.)

He said some parents opt to buy mineral water but it is an unnecessary expense when breastfeeding is a free option.

A joint statement of United Nations agencies in the Philippines released in April stated, “During emergency situations, the rates of disease and death among babies and children are higher than for any other age group… Babies who drink formula from an unsterile bottle or teat, or made with unclean water, can become very sick with diarrhea and die within a few hours.”

5. ECONOMICAL

Parawan said breastfeeding also benefits the whole family.

“May benefits din sa family kasi economical sya. Kung bibili ka ng milk formula bawas yan sa budget ng family, lalo na sa COVID pandemic ang daming nawalan ng trabaho,” he said.

(It benefits the family because it is economical. If you buy milk formula, that eats into the family budget, especially now during the COVID pandemic, a lot of people lost their jobs.
“It’s the first form of food security.”

6. ENVIRONMENT-FRIENDLY

Finally, Parawan said breastfeeding is ultimately environment friendly.

“Yung feeding bottle harmful sa environment. Artificial nipple hindi yan biodegradable,” he said.

(The feeding bottle is harmful to the environment. The artificial nipple is not biodegradable.

Parawan said breastfeeding is not easy. “It requires a lot of dedication. It requires a lot of commitment
But you’re giving liquid gold to your baby.”

Silvestre reminded the public that keeping babies away from their mothers for 14 days, the standard isolation period for COVID-19, is a death sentence for breastfeeding.

She argued, “no active virus capable of multiplying or reproducing has been documented in human breastmilk” and that the WHO itself has been firm in emphasizing the importance of breastfeeding.

And for mothers unable to produce enough milk, there are other options such as receiving donations from family members or from a milk bank.

The Human Milk Bank website lists down the locations and contact details of the milk banks nationwide: https://hmb.ph/milkBankLocation.php.