CNA Health Matters: World Breastfeeding Week – Dr Natalie Epton

In honour of World Breastfeeding Week, Dr Natalie Epton, Specialist Pediatrician and Neonatologist at SBCC Baby & Child Clinic (a member of Healthway Medical), addresses some common concerns regarding breastfeeding while the mother or infant is being tested for COVID-19. Watch the video in the link below.



Transcript of full segment:

1. COVID-19 related:

  • Can breastmilk spread the virus to babies?

According to the CDC, current evidence suggests that risk of transmitting COVID via breastfeeding is very low. Mothers who are diagnosed with COVID should be encouraged to breastfeed if they feel well enough so that the infant can benefit from antibodies in the breast milk that will protect the infant- not only from COVID, but many other infectious diseases.

  • How shall mothers manage breastfeeding in the face of COVID-19?

As mentioned, breast milk contains special ingredients not found in formula milk which help the baby to fight infections and other diseases. Mothers should be given every support and encouragement to breastfeed during this period.

  • Should mothers still continue to breastfeed if they test positive for COVID-19 and if so, what
    are the precautions to take?

If you are breastfeeding, and have been diagnosed with COVID, please continue to breastfeed. But please take sensible precautions to minimise the risk of transmission of COVID to your baby. These precautions include washing your hands with soap and water for 20 seconds before handling your baby, wearing a mask when within 1.8m of your baby, and keeping more than 1.8m away from your baby when not feeding or caring for your baby.

  • What if infants test positive for COVID-19? Shall mothers still continue with breastfeeding

Of course, if an infant tests positive, they should receive every possible help available. As the mother of a COVID positive baby would probably have been exposed to COVID at the same time as the baby, the breastmilk is highly likely to contain antibodies that can help the baby fight the infection, as well as other potential secondary infections.

2. Beyond COVID-19 – common questions raised by new mothers:

  •  Is breastfeeding for everyone?

Although around 4% of new mothers will be unable to breastfeed for one reason or another, most mothers can succeed and have a highly rewarding breastfeeding journey of given the right help and support. Unfortunately, sometimes people do not have access to the right support, or are given conflicting or wrong advice from well-meaning friends, relatives, or even confinement nannies.

  • Is breast milk really ‘liquid gold’?

Whilst many people are amazed at the scientific research that goes into milk formula production, what most people do not realise is that all these scientific advances are an attempt to artificially manufacture something approaching the rich nutritional food which is breast milk.
Made up of many proteins, fats and lactose, and enriched with vitamins, minerals, bioactive factors including white blood cells, oligosaccharides and antibodies, as well as probiotics, breast milk is so much more than just a complete nutrition for the developing infant.
Breastmilk is designed to change and adapt with the growing baby, providing the nutrition and immunity required for each stage of an infants early life. This is why every major Paediatric authority in the world continues to recommend exclusive breastfeeding for the first 6 months as the gold standard of infant nutrition, and continued breastfeeding whilst introducing solid food, up to two years and beyond.

  • How should mothers prepare for breastfeeding?

A healthy diet and plenty of rest and fluids are important. Surrounding yourself with people who are genuinely supportive of your desire to breastfeed is equally important- as hearing older relatives or confinement nannies telling you that your baby is crying because you don’t have enough milk or your milk is not nutritious enough is not likely to encourage you to persevere in the early days and weeks.

  • Does breastfeeding have to be exclusive?

Although exclusive breastfeeding is ideal, some mothers find that they really cannot produce enough milk- particular if their baby had to stay in the neonatal intensive care unit after birth, or if they had twins or triplets. In cases where it is medically necessary to introduce formula, it is still very valuable to continue with breastfeeding. Your baby continues to get many of the immunity benefits. And sometimes, mothers may find that their milk supply increases over time until they are able to provide most, if not all, of their baby’s needs.

3. Mental well-being of breastfeeding mothers:

  • Is it true that many mothers in Singapore feel shamed when they experience hypogalactia, or inability to produce enough breast milk?

Unfortunately, Singapore had very low exclusive breastfeeding rates. Whilst around 50% of mothers are exclusively breastfeeding at discharge from the hospital, only 28% are still exclusively breastfeeding at 2 months, and that number drops to only 1% exclusively breastfeeding at 6 months. This is compared to 15% in USA and Australia.

However, around 48% of mothers are still providing some breastmilk to their infants at 6months, which shows that many women do recognise the importance of breastfeeding and breastmilk.

Rather than shame women, we need to support them- reminding them that, even if they cannot exclusively breastfeed, there is huge value in continuing to supply breastmilk to their infants. We also need to improve support of new mothers in the first few weeks of life so that many more can achieve exclusive breastfeeding and a happy and rewarding breastfeeding journey. Finally, doctors and medical professionals need to receive appropriate skills and training in this field so that they can provide the correct information and advice to support breastfeeding mothers.

  • What should mothers do when feeling a sense of guilt for under-producing breast milk?

First- don’t! The very fact that you recognise how important breastmilk is- and want to give it to your baby- makes you a super mummy! As mentioned previously, surround yourself with your “dream team”- a group of relatives, friends and professionals who feel passionately about supporting you on your journey. You may need to get yourself out there and find your support group- go and look for lactation consultants, mothers support groups, whatever village you need to feel supported.

Talk to your doctor about ways to increase your breastmilk supply. There are many safe and effective ways of doing this. Informal milk sharing is not encouraged, as it may inadvertently expose your baby to infections and toxins from the donor milk. If you are unable to exclusively breastfeed, give as much as you can, and then top up with formula. Remember, a healthy and thriving baby is the goal- as well as a healthy and happy mummy!