By Dr Rosemary Marsh, GP Specialist Trainee, MRCPCH
On 11th March 2020, the WHO classified the outbreak of Coronavirus disease (COVID-19) as a pandemic. Information on COVID-19 is rapidly changing as research and understanding progresses. At the time of publication (08/04/2020, correct at review on 06/06/2020), there is broad support for commencing or continuing breastfeeding in cases of COVID-19 in the mother or infant/child. Clinicians should check relevant Public Health England (PHE), Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Paediatrics and Child Health (RCPCH) guidance as there is potential for advice to change over time. Current PHE guidance regarding “staying at home” when you have COVID-19 symptoms includes a paragraph on breastfeeding.
During this period of social distancing, it is likely to be more difficult than usual for mothers to access face to face breastfeeding support. Some breastfeeding charities have increased their provision of online, telephone and virtual support to cover this gap. GPs can signpost families to these resources and explain that remote support may be available.
GPIFN Letter to GPs: In June 2020, GPIFN wrote to GPs with a links to organisations and resources available during the COVID-19 pandemic.
Postnatal and Newborn and Infant Physical Examination
The Royal College of General Practitioners (RCGP) has advised ongoing provision of post-natal checks and childhood immunisations at 8 weeks (see RCGP Guidance on workload prioritisation during COVID-19 linked from this page) which means GPs will still have an opportunity to meet new mothers and infants and discuss any feeding concerns. NHS England have recommended that provision of Newborn and Infant Physical Examination (NIPE) in line with national guidance should continue (from Newborn and infant physical examination screening programmes technical guidance during the coronavirus COVID-19) pandemic). RCPCH have issued guidance on performing visualisation of the soft palate.
Postnatal Maternal and Infant Care during the COVID-19 Pandemic – A guide for General Practice (published in June 2020) is available from the RCGP COVID-19 Resource Hub, in the ‘Specialist Issues with COVID-19’ section (under both the ‘Pregnancy and sexual health’ and ‘Paediatrics and child health’ tabs).
RCOG guidance regarding the impact of COVID-19 on maternity care, including a Q&A section about breastfeeding
UNICEF information, resources and statements regarding breastfeeding, maximising breastmilk and supporting relactation, expressing breastmilk and formula feeding aimed at the UK population.
Prescribing in breastfeeding information and contact details for specific case advice.
Breastfeeding women and breastfed babies require Vitamin D supplementation.