SARS-CoV-2 Transmission Risk through Expressed Breast Milk Feeding in Neonates Born to COVID 19 Positive Mothers: A Prospective Observational Study

Background: Mother-to-child transmission of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) has become a matter of great concern in post-partum wards and neonatal units. With little prior experience of this novel infection, there are contradictory findings in the literature regarding breastfeeding and rooming-in for newborns of mothers with COVID-19 disease. To assess the transmission risk of SARS-CoV- 2 in neonates who were fed expressed breast milk of COVID-19 positive mothers. Methods: This prospective study included 16 neonates born to COVID-19 positive mothers. The neonates were nursed in a neonatal unit separate from their mother. Expressed breast milk was fed by health care givers ensuring proper safety measures. Nasal and throat swabs of neonates were tested twice for SARS CoV-2, firstly, at 48 h of life and secondly, before discharge. Results: Pneumonia was present in 3 (20%) mothers, and C- reactive protein was raised in 9 (60 %) mothers. Birth weight was low in 8 (50%) neonates. Respiratory distress syndrome and meconium aspiration syndrome were present in two and one newborns, respectively. Nasal and throat swabs of all 16 newborns tested negative for SARS-CoV- 2 infection twice, at 48 h of life and before discharge. Conclusion: Expressed breast milk feeding can be considered safe in neonates born to COVID-19 positive mothers. Even sick mothers with COVID-19 can continue to express breast milk after ensuring proper safety measures.