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Breastfeeding must continue amidst COVID-19

In observance of Breastfeeding Awareness Month, the Department of Health (DOH), World Health Organization (WHO), and United Nations Children’s Fund (UNICEF) jointly appeal to the public to protect, promote, and support the practice of exclusive breastfeeding of infants from birth up to six months, and continued with complementary feeding onwards with breastfeeding being the most healthy, efficient, and environmentally-sustainable action of mothers for their children.

This year’s theme, “I-BIDA ang Pagpapasuso Tungo sa Wais at Malusog na Pamayanan!”, reinforces the importance of breastfeeding now, more than ever, because of the COVID-19 pandemic which poses a challenge to infant feeding. We enjoin everyone to ensure that Filipino infants will have proper and adequate nutrition to improve their resilience against the disease and minimize the long-term effects of malnutrition, ultimately meeting the country’s commitment to sustainable development.

The COVID-19 pandemic has taken a toll in many Filipino families’ health. Because of this, we cannot stress enough the importance of ensuring that the correct information on health and nutrition—which includes breastfeeding—reach our people. The child and the environment greatly benefit from the efficient, climate-smart practice of breastfeeding that contributes to food security and reduces our carbon and ecological footprints.

“Breastfeeding is the most complete and sustainable nutrition for the first 6 months of life, with continued benefits when done with complementary feeding for older infants and children. In this pandemic, mothers should not be worried about breastfeeding, as long as proper infection prevention and control (IPC) measures are observed,” Health Secretary Francisco T. Duque, III said.

Duque added that mothers with suspected and/or confirmed COVID-19 should continue breastfeeding, following proper wearing of masks, and frequent, proper handwashing before and after contact with the child. Among the few cases of confirmed COVID-19 infection in children, most have experienced only mild or asymptomatic illness—and this must be supported with the immunological benefits of breastfeeding in infants and young children.

To date, COVID-19 has not been detected in the breastmilk of any mother with confirmed or suspected COVID-19. While researchers continue to conduct tests, it appears unlikely that COVID-19 would be transmitted through breastfeeding or by giving breastmilk that has been expressed by a mother who is confirmed or suspected to have COVID-19. Babies who receive their mothers’ breastmilk receive antibodies that protect them from potentially deadly infections like pneumonia, diarrhea, and sepsis. This is a call for mothers to breastfeed without any additional food or fluids, not even water, for the first six months—and continue breastfeeding with safe, nourishing, and diverse complementary food. Appropriate complementary feeding should be introduced at six months with continuous breastfeeding up to 2 years and beyond.

Following delivery, medical practitioners and midwives are also advised to facilitate immediate and continued skin-to-skin care, including Kangaroo Mother Care, to improve thermal regulation

of newborns and several other physiological outcomes. Aside from the association with reduced neonatal mortality, placing the newborn close to the mother also enables early initiation of breastfeeding which also reduces neonatal mortality.

“Exclusive breastfeeding protects against childhood diseases and death in infancy and childhood, while improving the nutritional status of babies. The protective effect of breastmilk is particularly strong against infectious diseases that are prevented through both direct transfer of antibodies and other anti-infective factors.” said Dr. Rabi Abeyasinghe, WHO Representative in the Philippines “Therefore, it is important to ensure all babies enjoy exclusive breastfeeding during the first six months of their life even during the COVID-19 pandemic,  following standard infant feeding guidelines but with appropriate precautions for  infection prevention and control, such as wearing a mask, practicing hand hygiene and cough etiquette.

In all socio-economic settings, breastfeeding improves survival and provides lifelong health and development advantages to newborns and infants. Breastfeeding also improves the health of mothers. According to the 2018 Expanded National Nutrition Survey, however, the percentage of 0-5 months old children who are exclusively breastfed remains to be low at 29.0 percent.

“Exclusive breastfeeding is the first step towards achieving optimum nutrition for children. Aside from improving lifelong health and development, it paves the way for addressing nutrition gaps that prevent children from achieving their full potential,” said Oyunsaikhan Dendevnorov, UNICEF Philippines Representative. “We call on mothers to take this necessary first step as we remain committed in working towards sustainable health and nutrition services for every child and mother in the country.”

Several legislations have been enacted by the Philippine Congress to support better nutrition, especially during the first 1000 days of a child’s life, including Republic Act (RA) 11148 or the Kalusugan at Nutrisyon ng Mag-Nanay Act, RA 11210 or the Expanded Maternity Leave Act, RA 10028 or the Expanded Breastfeeding Promotion Act, RA10821 or the Children’s Emergency Relief and Protection Act, and the Executive Order 51 or the Philippine Milk Code.

DOH, WHO, and UNICEF call for the firm and continuous enforcement of these legislations, particularly the Philippine Milk Code, the strict regulation of milk donation, and the implementation of Essential Infant and Newborn Care (EINC) or “Unang Yakap” during the time of COVID-19.