Greetings All,
New case report from The People's Republic of China:
Title: Antibodies in the breast milk of a maternal woman with COVID-19.
In: Emerging Microbes & Infections 2020 Dec;9(1):1467-1469. doi: 10.1080/22221751.2020.1780952.
Authors: Yunzhu Dong, Xiangyang Chi, Huang Hai, Liangliang Sun, Mengyao Zhang, Wei-Fen Xie, Wei Chen.
Abstract: "A maternal woman was positive for SARS-CoV-2 tested in throat swabs but negative tested in other body fluids, and she had IgG and IgA detected in breast milk. Her infant negative for SARS-CoV-2 at birth had elevated IgG in serum but quickly decayed. These findings suggest that breastfeeding might have the potential benefit to the neonates. Keywords: COVID-19; IgA; IgG; breastmilk; maternal woman."
From this open access paper: "Due to the pregnancy, there was neither antiviral nor antibiotic treatment for the patient" in regard to the 33 y/o mother's admission at 38.2 weeks of gestation for labor and birth, with mild COVID-19 symptoms, testing positive for SARS-CoV-2 at admission. Management differs here in the U.S. re: safety of antiviral use in pregnancy, at least according to the U.S. Centers for Disease Control (CDC) in regard to the treatment of influenza:
https://www.cdc.gov/flu/professionals/antivirals/avrec_ob.htm#:~:text=Treatment%20with%20antiviral%20medications%20is,during%20any%20trimester%20of%20pregnancy.
In this patient information page, the Mayo Clinic briefly discusses antibiotics that are considered safe for use in pregnancy, cautioning against the use of tetracycline in pregnancy re: risk of staining baby's teeth:
https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/antibiotics-and-pregnancy/faq-20058542
In discussing antibiotic use in pregnancy for the treatment of urinary tract infections, the CDC also cites a 2011 statement from ACOG: "Because of the potential risk for birth defects, a 2011 committee opinion from the American College of Obstetricians and Gynecologists recommended that sulfonamide antibiotics and nitrofurantoin may be prescribed in the first trimester of pregnancy only when other antimicrobial therapies are deemed clinically inappropriate."
https://www.cdc.gov/mmwr/volumes/67/wr/mm6701a4.htm
Back to the last paragraph from this COVID-19 case report: "Although the SARS-CoV-2 has been detected in breast milk in recent publication, in our study there is no detection of SARS-CoV-2 in the mother’s body fluids serially collected after delivery when her throat swabs showing positive results for SARS-CoV-2, especially in breast milk. The neonate had negative result for SARS-CoV-2 RNA at the birth and her IgG antibody to SARS-CoV-2 was observed only within one and half month after birth, indicating the placenta transmission of COVID antibody. The mother’s IgG antibody usually remains in neonate for more than 6 months after birth. Infants incapable of producing immunoglobulins are protected by maternal antibodies for up to 12 months after birth, however, our follow-up identified that IgG to SARS-CoV-2 in the neonate maintained less than one and half month, suggesting the potential risk for subsequent COVID-19 in neonates. More importantly, the IgG and IgA antibodies were detected in breast milk indicate the potential immune protection for the neonates. Nonetheless, data from large-scale cohort are warranted."
Full text: https://www.tandfonline.com/doi/full/10.1080/22221751.2020.1780952
With best regards,
Debbie
Debra Swank, RN BSN IBCLC
Program Director
More Than Reflexes Education
Elkins, West Virginia USA
http://www.MoreThanReflexes.org
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