Practical information on coronavirus (COVID-19) and bottle-feeding
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases, evidence shows that the coronavirus is transmitted through human to human direct contact.1
The Royal College of Obstetricians and Gynaecologists (RCOG) and other UK maternity health bodies have published guidance on coronavirus (COVID-19) in pregnancy, breastfeeding and bottle-feeding2. This article focuses on advice to give parents who are bottle-feeding.
For coronavirus and breastfeeding advice find more information in our article on managing coronavirus in pregnancy and advice on breastfeeding.
Advice on coronavirus and bottle-feeding
If you have a mother who has suspected or confirmed Covid-19, a discussion should take place about the benefits and risks of infant feeding. There is no evidence that the virus can be transmitted through breast milk. The main risk of feeding is close contact between the mother and baby and potentially infecting the baby.
The following precautions are recommended for mothers with suspected or confirmed Covid-19: 4
- Wash your hands before touching your baby, breast pump or bottles
- Try to avoid coughing or sneezing on your baby while feeding at the breast or from a bottle
- Consider wearing a mask or face covering while feeding
- Follow recommendations for pump/bottle cleaning after each use
- Consider asking someone who is well to feed your expressed breast milk or formula milk to your baby.
Babies should not wear masks or other face coverings as they may risk suffocation.
General bottle feeding advice
Bottle-feeding includes formula feeding, feeding expressed breast milk (EBM) or combination feeding. Combination feeding is when breastfeeding is supplemented with bottle-feeding– using formula or expressed breast milk.3.
Parents’ bottle-feeding hygiene should include making sure they wash their hands with soap and water (for at least 20 seconds) before touching their baby4 and before they handle the formula or bottle. They should carefully follow the manufacturer’s instructions on making up formula feeds and current guidance on washing and sterilising of feeding equipment.4
Sterilising baby bottles and equipments
If a parent is formula feeding or feeding EBM to their baby, they should be washing and sterilising baby bottles and all their feeding equipment carefully before each use and strictly adhering to manufacturer’s instructions on washing and sterilisation.4 You can use our unbranded helpsheet on steam sterilising with parents.
Making up formula feeds
Parents who are formula feeding should carefully follow manufacturer’s instructions4 on using the right amount of formula and water and preparing each feed in individual bottles when required. We have created helpsheet on preparing and giving a bottle which will provide more information for parents on how to correctly prepare a feed.
Expressing breast milk
If a parent is expressing breast milk to provide through a bottle to their baby, they should be advised to always wash their hands thoroughly before touching the breast, breast pump and bottles. Also clean the breast pump and it’s parts before and after a pumping session according to the manufacturer’s instructions.4 Find our helpsheet on expressing breast milk by hand here.
Parents should maintain all the above advice on hand washing, equipment washing and sterilising of baby bottles and feeding equipment to safely feed their baby. You will find information on combination feeding here.
If a parent is too unwell to feed their baby, they should ask someone else to help with feeding duties making sure they still follow the same hygiene rules. At the same time, it is important that parents continue to interact with baby as much as possible. Parents who are asymptomatic should not be required to wear masks when interacting with their baby.5
If women have suspected or confirmed Covid-19, the World Health Organisation recommends that they should wear a mask when handling the baby but should be enabled to remove it and interact visually with the baby at a safe distance6
For further practical support and advice, you can contact our SMA Nutrition Careline team.
Royal college of obstetricians and gynaecologists, Coronavirus (COVID-19) Infection in Pregnancy version 12:Published 14 OCT 2020. Available at https://www.rcog.org.uk/globalassets/documents/guidelines/2020-04-17-coronavirus-covid-19-infection-in-pregnancy.pdf. Accessed November 2020.
Royal college of obstetricians and gynaecologists, Coronavirus Infection in Pregnancy, information for preganant women and their families. Available at https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/. Accessed November 2020.
How to combine breast and bottle feeding. Available at https://www.nhs.uk/conditions/pregnancy-and-baby/combining-breast-and-bottle/. Accessed November 2020
Start 4 life, Coronavirus (Covid-19): Advice for parents. Available at https://www.nhs.uk/start4life/baby/coronavirus-covid19-advice-for-parents/. Accessed November 2020.
UNICEF UK Baby friendly initiative, statement on infant feeding during the coronavirus (covid-19) outbreak. Available at https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2020/04/Unicef-UK-Baby-Friendly-Initiative-statement-on-infant-feeding-during-the-Covid-19-outbreak.pdf. Accessed November 2020.
WHO, connecting the world to combat coronavirus, healthy at home. Available at https://www.who.int/news-room/campaigns/connecting-the-world-to-combat-coronavirus/healthyathome/healthyathome---healthy-parenting?gclid=CjwKCAjw4871BRAjEiwAbxXi25AquzBkCsQV6jxRIYTxHfTDQ7r2Pyc7AyNdoVMS5Ny651C-gQJzLRoC7pwQAvD_BwE. Accessed November 2020
The World Health Organisation (WHO) has recommended that pregnant women and new mothers be informed on the benefits and superiority of breastfeeding – in particular the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for, and maintenance of, lactation, with special emphasis on the importance of a well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle-feeding or other foods and drinks should be discouraged since it will have a negative effect on breastfeeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breastfeed. Before advising a mother to use an infant formula, she should be advised of the social and financial implications of her decision: for example, if a baby is exclusively bottle-fed, more than one can (400 g) per week will be needed, so the family circumstances and costs should be kept in mind. Mothers should be reminded that breast milk is not only the best, but also the most economical food for babies. If a decision to use an infant formula is taken, it is important to give instructions on correct preparation methods, emphasising that unboiled water, unsterilised bottles or incorrect dilution can all lead to illness.