Many of you are nurses, nursing assistants, doctors, cleaners and hospital food workers in this current health crisis, who are in daily contact with people who have COVID-19 or are suspected of having it and are also breastfeeding.

First of all, we would like to say a big Thank You, thank you for everything you are doing, thank you for taking care of us and for taking care of our loved ones. Thank you for staying by our side in these very difficult times and for often acting as a communication bridge with our family and friends.

We get a lot of your consultations in our App with concerns such as: what to do to protect my baby from infection, what to do when I get home, how do I manage breastfeeding if I have been exposed to infection at work?

When you get home from work

There are some recommendations for women who are exposed to COVID-19 at work on what to do when you arrive home, which we recommend you should know. But unfortunately there is little information specifically for those of you who are also breastfeeding.

Recommendations for professionals exposed to COVID-19 (information taken from the University Clinic of Navarra):

When you get home after your work shift:

• Do not touch anything
• Take off your shoes
• Leave personal objects in a box at the entrance (handbag, sunglasses, keys…) and close the box
• Clean your mobile phone and glasses, if you have them, with a sponge of soapy water or disinfectant wipes
• If you bring an object from outside, clean it with 25 ml of bleach in 1L of water
• Take a shower

On a daily basis:

• Prevent people you live with from having direct contact with your body fluids (especially nasal droplets and saliva)
• Avoid sharing personal items (toothbrush, cutlery, plates, glasses, towels,…)
• Wash your clothes, sheets and towels at a minimum of 40ºC
• Wash your dishes, cutlery and glasses with washing up liquid and water or, if possible, in the dishwasher
• Regularly clean the bathroom and kitchen with bleach or disinfectant and use single-use products
• Clean the following with disinfectant wipes: telephone, TV remote control, switches, computer keyboard, taps, door handles…
• Keep common areas in the house well ventilated

Recommendations on breastfeeding and coronavirus exposure

As far as we currently know from research, coronavirus is not present in breastmilk, so international health organisations continue to recommend breastfeeding without making exceptions for risk groups. They even encourage breastfeeding in women with COVID-19, unless the woman is unwilling or unable to breastfeed. Although evidence is limited, it also appears that newborn and children are unlikely to get the disease, and if they do, it is usually with very few complications.

The measures to take also depend on each family and their circumstances, whether you have help or not, whether your baby co-sleeps with you regularly and whether or not there is a possibility that you sleep on your own. Consider also the necessary energy involved in making changes at home when you are probably already facing a lot of pressure at work.

The World Health Organization and other official health organizations have not defined what to do in these cases. But something we should remember is that the baby can also transmit the infection, even if she has no symptoms or they are mild. Therefore, it is important to avoid leaving your baby in care of people at risk when you are working, whenever possible.

And, if this is not possible, try to follow protective measures as strictly as possible.

Hygiene recommendations if you live with a person at higher risk

If you live with a person who is in a high risk group for coronavirus (over 65 years old or with chronic diseases such as hypertension, diabetes or problems with the immune system):

• Try to have as little physical contact with them as possible
• Sleep in separate beds
• Use a different sink or disinfect it after your use
• Take general measures of personal protection
  • Frequent hand washing and hygiene
  • Cover your mouth with the inside of your elbow if you cough or sneeze
  • Use single use paper tissues
  • Avoid close contact
  • Avoid touching your mouth, nose and eyes

Other considerations

We do receive many enquiries about concerns of mothers relating to the disease itself, but we also get consultations about feelings of guilt that you might have.

Returning to work is always a difficult time for new mums, as many decisions need to be made about who will take care of the baby when you are at work, how the baby will be fed and how to make important readjustments at home and in the family management.

Now women who get back to work from maternity leave to a job with coronavirus exposure find themselves in a very difficult situation and many doubts can arise.

Some of the questions we receive at LactApp these days are: What if I just stay at home with my baby and don’t go back to work? And if I go back to work, who should I leave my baby with? Should I leave my baby with my parents, even though they are in the high risk group? Should I go back to work, as I know they really need me and services are overwhelmed as my colleagues are getting sick? Who needs me more: my job or my baby?

How do I manage these feelings? What is the right thing to do?

We are afraid we can’t answer this for you. Every one of you must find out what is best for her and her specific situation. There is no easy solution and it is likely that whatever you do, those useless and painful feelings of guilt will appear either way. These are difficult feelings to deal with, and you might feel bad regardless of the decision you take. Try not to worry so much about making the right decision right now, because it doesn’t exist, but listen carefully to yourself and choose what you think is best in your own personal circumstances at this particular time.