The World Breastfeeding Week, an annual celebration to promote breastfeeding is observed during the first week of August every year. On this occasion, we review the impact of the pandemic on recommended breastfeeding practices and the key policy changes to improve adherence. The review is collated from resources published on Poshan-Covid 19 Resources Page. The Poshan-Covid 19 initiative aims to aid policy and planning by maintaining a repository of information on child nutrition and maternal health and related topics in the context of COVID-19.1
India has a high rate of infant mortality. In 2020, the infant mortality rate in India was estimated to be 28 deaths per 1,000 live births.2 Ensuring adequate availability of human milk during the pandemic was critical towards the reduction of infant mortality and morbidity. Hence, it was recommended that health care systems undertake unabated promotion, protection and support to breastfeeding during COVID-19 with due precautions.3 In India, the rates of recommended breastfeeding practices are poor to moderate. As per the latest NFHS survey (5th round), early initiation of breastfeeding within one hour of birth was 41.8% and exclusive breastfeeding under 6 months was 63.7% in 2019-21.4-5
At the start of the pandemic, incomplete understanding of COVID-19 pathogenesis and transmission led to mothers being frequently separated from their new-born and prevented from breastfeeding. In several lower-middle-income countries, the International Code of Marketing of Breast-Milk Substitutes was violated during the pandemic. This would have likely affected breastfeeding rates. However, recent research has found that the role of breast milk as a vehicle of COVID-19 transmission is very limited. Studies have found that breast milk produced by infected mothers contains anti–SARS-CoV-2 IgA and IgG, which can protect infants from infection. Moreover, the secretion of antibodies to COVID-19 in mother’s milk post vaccination also protects the infant against the infection.6
Given the need to continue with recommended breastfeeding practices during COVID-19, WHO has developed guidance for health workers and mothers on breastfeeding during the pandemic.7 WHO also advised mothers to continue breastfeeding after vaccination.8 In India, the Central and state governments developed guidance material including videos for health systems and the public to safely continue breastfeeding even with Covid-19. The benefits of following recommended breastfeeding practices such as exclusive breastfeeding for the first 6 months during the pandemic were also communicated9-12. There was also advocacy on factors that result in violation of the IMS Act, a law that bans the promotion of foods marketed to children up to 2 years of age.13 This includes prohibition of the promotion of feeds during the exclusive breastfeeding period. The PoshanCOVID19 monitoring page features many such developments including measures adopted by the respective state and central governments to address the situation.
- UNICEF. (2022). Poshan Covid-19 Resources.
- UNICEF. (n.d.) Early Childhood- Manifestation. Infant Mortality Rate, India. Nutrition India Info.
- Bharadva, K., Bellad, R. M., Tiwari, S., Somasekar, R., Phadke, M., Bodhankar, U., … & Gupta, P. (2022). Breastfeeding in Coronavirus Disease 2019 (COVID-19): Position Statement of Indian Academy of Pediatrics and Infant and Young Child Feeding Chapter. Indian Pediatrics, 59(1), 58-62.
- UNICEF. (n.d.) Delivery PNC- Interventions. Early initiation of breastfeeding within one hour of birth in children , India. Nutrition India Info.
- UNICEF. (n.d.) Early Childhood- Determinants. Exclusive breastfeeding in 0-5 month olds, India. Nutrition India Info.
- North, K., Gao, M., Allen, G., & Lee, A. C. (2022). Breastfeeding in a global context: epidemiology, impact, and future directions. Clinical Therapeutics, 44(2), 228-244.
- WHO : Breastfeeding advice during the COVID-19 outbreak
- IFE, UNICEF, USAID : FAQs: COVID-19 vaccines and breastfeeding based on WHO SAGE interim recommendations
- NHM, MoHFW, MAA (n.d.) FAQs on Breastfeeding during the COVID-19 Pandemic (English)
- NHM, Poshan Abhiyaan, Govt of Uttar Pradesh. (n.d). Video on providing support to mothers recovered from COVID for breastfeeding (Hindi)
- NHM, MoHFW. (n.d.) Breastfeeding guidelines, through illustrations (Hindi)
- Regarding guidelines related to breastfeeding and baby food (IYCF) during COVID-19
- Government of UP. (N.D). What leads to violation of IMS Act