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Table 4 Recommendations on breastfeeding and human milk handling for the mother-infant dyad exposed to SARS-CoV-2

From: The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study

Recommendation Brazilian hospital guidelines existence (n = 24) Available recommendations in Brazilian and international literature [15,16,17,18,19,20,21,22,23,24,25,26,27]
Yes (%) No (RA/NR-%)
Hospital pumping 21 (87.5) 3 (12.5)/RA RCOG, WHO, UNICEF, UENPS, SBP, rBLH, ABM and CDC allow.
Bedside pumping 19 (79.1) 5 (20.8)/RA RCOG, WHO, UNICEF, UENPS, SBP, rBLH, ABM and CDC do not specify.
Fresh mother’s breast milk 21 (87.5) 3 (12.5) WHO, UNICEF, RCOG, SBP, ABM and CDC suggest as a breastfeeding alternative;
UENPS does not recommend if mother is symptomatic;
rBLH allows expressing, but for patients in neonatal units the milk must be pasteurized and the milk from mothers in intensive care units must be thrown away.
Feeding line at the breast 2 (8.3) 23 (95.8)/NR UNICEF, ABM, SBP, CDC UENPS and RCOG do not specify. WHO recommends.
Cup feeding 18 (75) 6 (25)/NR WHO, UNICEF, ABM, SBP, CDC and UENPS recommend cup or spoon feeding;
RCOG does not specify.
Pasteurization 4 (16.6) 20 (83.3)/RA UENPS discourages, even for preterm babies;
SBP and rBLH recommend that for patients in neonatal units the milk must be pasteurized;
RCOG, ABM, CDC, WHO and UNICEF do not specify.
Donation permission 2 (8.3) 23 (95.8)/RA SBP and rBLH don’t allow that these women are donors up to 15 days after the onset of symptoms;
ABM, RCOG, WHO, and UNICEF do not specify; CDC forbids.
Home pumping 11 (45.8) 13 (54.1)/RA WHO, CDC, UNICEF, RCOG, ABM, rBLH and UENPS allow.
  1. RA Recommended against, NR There was no description of the recommendation in guidelines, ABM Academy of Breastfeeding Medicine, rBLH Brazilian Network of Human Milk Banks, SBP Brazilian Society of Pediatrics CDC Centers for Disease Control and Prevention, PPE Personal Protective Equipment, RCOG Royal College of Obstetricians and Gynaecologists, UENPS Union of European Neonatal and Perinatal Societies, UNICEF United Nations Children’s Fund, WHO World Health Organization
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