Italy was one of the first to face the COVID-19 pandemic, so Italian breastfeeding guidelines were adopted even before WHO consolidated its position on this matter. In particular, on February 28, 2020, the Italian Ministry of Health, together with the Italian Society of Neonatology (SIN) and the Italian Association of Breast Milk Banks, developed the document Breastfeeding and SARS-CoV-2 infection (coronavirus disease 2019 — COVID-19), which includes a table describing different feeding options depending on the condition of the mother and baby.
In accordance with this document, medical institutions must make every effort to ensure that mothers who can breastfeed do so. Accordingly, if a mother is suspected or diagnosed with COVID-19, but she does not have symptoms or they are mild, she can be placed in the same room with the baby and breastfeed, regardless of the test result for COVID-19 in the newborn. However, strict infection control measures must be followed:
- washing hands before each feeding or other contact with the newborn;
- wearing a surgical face mask while breastfeeding or any close contact with a newborn;
- placing the baby’s cradle at a distance of 2 meters from the mother’s head;
- lack of visits from relatives and friends.
Separation of mother and child is recommended only in cases of poor health of the mother (fever, cough, profuse respiratory discharge) or the need for treatment of the newborn. In these cases, it is recommended that the newborn be fed expressed breast milk (which is expressed in sterile containers) without prior pasteurization, since breast milk is not believed to be a carrier of COVID-19, and pasteurization reduces its biological and immunological value (Augusto Pereira et al., 2020 ).
The Italian Society of Neonatology (SIN) also proposes to assess the compatibility of breastfeeding with medicines that can be prescribed to women with COVID-19 on an individual basis. (Riccardo Davanzo et al., 2020).
The Italian National Institute of Health (ISS) also advised that in light of the available scientific evidence and the protective potential of breast milk, a woman with suspected or confirmed COVID-19 should begin and continue to breastfeed under favorable clinical conditions and if she wishes. To reduce the risk of passing the infection on to your baby, it is recommended that you take preventive measures such as washing / disinfecting your hands before feeding and using a face mask during feeding. (Riccardo Davanzo et al., 2020).
The guidelines of the Union of European Neonatal and Perinatal Societies (UENPS) build on WHO recommendations and also support mother-child cohabitation, direct breastfeeding while adhering to strict infection control measures. In addition to the preventive measures already listed, UENPS draws attention to the need for regular cleaning and disinfection of all surfaces in the room where the mother and newborn are located.
Authors of a multicenter retrospective study, conducted in Italy, involving 42 women, recommended that doctors and midwives working in regions with high COVID-19 infection should encourage all women to wear face masks during labor, during labor, when caring for an infant and when feeding. breastfeeding in order to reduce the likelihood of transmission of infection to newborns, given that the mother’s disease may be asymptomatic, therefore, she may simply not know about it (E Ferrazzi et al., 2020).
Thus, even before the consolidation of the WHO recommendations on breastfeeding during the COVID-19 pandemic, a document was developed in Italy that largely corresponded to them, allowing a newborn to stay with his mother, who is suspected / confirmed of COVID-19, and feeding breastfeeding in compliance with precautions.