Birth Detroit and Black Mothers Breastfeeding Association (BMBFA) believe that parents and newborns should not be separated and the risk of COVID-19 infection should be minimized in ways that support bonding and attachment. Despite recent guidance from national and international public health organizations, some Metro Detroit hospitals are separating people who test positive for COVID-19 from their babies immediately after birth. This means people are not being allowed to have skin-to-skin contact with and breastfeed their newborn babies in the critical first hours after birth. It also costs health systems more money to provide nursing care for the infants who are separated.
Why does this matter?
According to the Centers for Disease Control (CDC), parent/infant skin-to-skin contact has many benefits, including mother-infant bonding, stabilization of glucose levels, maintaining infant body temperature and increased likelihood of breastfeeding. Breastfeeding protects babies from illness and infection by building and supporting the immune system. It is the best food for babies in their first year of life, and it is the safest and most reliable form of infant feeding during an emergency. There is no evidence to suggest that COVID-19 is present in breast milk.
What do national and international public health organizations recommend?
World Health Organization (WHO) COVID-19 Clinical Management Guidelines state parents and newborns should be supported to remain together and practice skin-to-skin contact, especially immediately after birth during establishment of breastfeeding, whether they or their infants have suspected, probable, or confirmed COVID-19.
Centers for Disease Control (CDC) Considerations for Inpatient Obstetric Healthcare Settings, updated on April 4, 2020, recommend shared decision-making between the birthing person and clinical team to determine whether to keep a birthing person with known or suspected COVID-19 and their infant together or separated after birth on a case-by-case basis. If a birthing person with known or suspected COVID-19 wishes to breastfeed, they should put on a face mask and practice hand hygiene before each feeding. If temporary separation is undertaken, parents who intend to breastfeed should be encouraged and supported to express their breast milk to establish and maintain milk supply; and expressed breast milk should be fed to the newborn by a healthy caregiver.
What can we do?
Birth Detroit and Black Mothers Breastfeeding Association support keeping parents and newborns together in the critical hours after birth. No parent should be separated from their newborn without informed consent. Every parent has the right to be with their newborn baby – even in a pandemic.
To ensure optimal health for birthing persons and infants:
- Hospital protocols must follow evidence-based public health guidelines issued by the CDC and WHO and include shared decision making.
- Birthing parents should be supported to exercise their right to informed consent.
- Birthing parents impacted by COVID-19 should receive skilled lactation support before leaving the hospital.
What resources are available?
To support shared decision making and informed consent, a link to Evidence Based Birth’s Informed Consent Form for Refusal of Separation from Newborn Infant is provided here.
The White Ribbon Alliance has developed Safer Together: Respectful Maternity Care in COVID-19, a comprehensive education and social media toolkit.
Additional resources on breastfeeding and COVID-19 include: the International Confederation of Midwives (ICM) Official Statement: Women’s Rights in Childbirth Must be Upheld During the Coronavirus Pandemic, United Nations Population Fund (UNFP) UNFPA statement on novel coronavirus (COVID-19) and pregnancy, and La Leche League International resources on Breastfeeding and COVID-19.
For more on birth rights, see the Birth Rights Bar Association: Know Your Rights, The Rights of Childbearing Women and the Black Birthing Bill of Rights by the National Association to Advance Black Birth.
The mission of Birth Detroit is to midwife safe, quality, loving care through pregnancy, birth, and beyond. The mission of Black Mothers Breastfeeding Association is to reduce racial inequities in breastfeeding support for black families. We see the fear and concern in our communities around COVID-19, pregnancy and birth. In the spirit of both loving care and concern for our communities, and support for provider partners doing their best in this crisis, we offer this position statement. For more information email firstname.lastname@example.org.