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

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.