Breastfeeding, COVID-19, And Milk Banking: Can the Effects Be Recovered?


Human milk banking are facing challenges with collection of breast milk donors

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Milk banks store breastmilk for newborns whose mums can’t breastfeed them. Usually, the banks collect expressed breastmilk from pre-screened mums, who have a plentiful milk supply.

The collected breastmilk is pasteurised. It is then ready to be given to babies who most need the benefits of breastmilk. The babies who need it may be unwell, premature, or unable to breastfeed. Or their mums may not have enough breastmilk. This pathway has contributed to a life saving route to compromised infants. It also has benefited mothers who have had a pregnancy loss.

There are 17 milk banks across the UK. Each one is a member of the United Kingdom Association for Milk Banking (UKAMB).(PAID LINK)

How Has Covid-19 Affected Milk Banking?

The world of human milk banking has been heavily affected by COVID-19. As underlined in the articles of Marinelli (2020) and Furlow (2020), COVID-19 is having a negative influence on human milk donation and the human milk banking system. Donations are decreasing and the volume of milk collected from human milk banks during this period is low.

Donors’ supplies have become a concern due to the global lockdown and travel restrictions. As a consequence, parents cannot go out to bring milk to the banks, even if theoretically this can be considered an action having social value. During this period, mothers prefer to stay as far away as possible from hospitals, especially those dedicated to COVID-19.

What Is The Alternative To Human Milk Banking In Hospital?

Nowadays home milk banking is the chosen method

Since most persons are more comfortable at home the alternative is home milk collection by the milk bank staff; however, this activity has also been reduced due to the efforts required by hospitals devoted to care for people infected by COVID-19. In Italy, a special service for home milk collection, called the Human Milk Link, has been active for two of the three human milk banks in Milan (Mangiagalli Hospital and San Giuseppe Hospital), along with the Human Milk Bank of Turin. It is operated by a midwife, specialized in lactation, who has organized all the required activities to make the service work (e.g., driving the car, collecting the milk, sealing the bottles) and providing breastfeeding advice to mothers. (PAID LINK)

During 2019, this service collected 813L of human milk from 160 donors in Milan, and 99 liters from 20 donors in Turin. Human Milk Link’s activities ceased on March 9, 2020, when the lockdown started in Italy. The donation of human milk in Milan has been completely interrupted. Fortunately, a few positive exceptions exist, for example the Human Milk Bank in Rome, Italy. This milk bank is still sending its drivers (less frequently than before) to collect milk directly at the donors’ door, without entering the residence, while wearing protective equipment. In this way, they collected 49L of human milk during the month of March, 2020 (De Rose et al., 2020b).

Did SARS-CoV-2 Pasteurization Affect Human Milk?

The effect of pasteurization on SARS-CoV-2 virus inactivation in human milk banks has still to be determined. Researchers have documented complete heat inactivation of genetically similar viruses (e.g., SARS and MERS) by treatment at 60°C for 15–30 min. (Darnell & Taylor, 2006Rabenau et al., 2005van Doremalen et al., 2014). Recently, Chin et al. (2020) reported that SARS-CoV-2 is inactivated by heating in a dose-dependent manner, with viral inactivation at a temperature of 56°C for 30 min, or at 70°C for 5 min. However, their study simulated pasteurization in small aliquots, a procedure that does not fit human milk bank protocols. Therefore, these results should be replicated in a human milk bank setting.

Taking into account the available information, a milk bank should suspend, for 2 weeks, the recruitment of mothers who are suspected or have a probable case of COVID-19, in order to ensure they do not become ill during this period (European Milk Bank Association [EMBA], 2020). If an already established donor develops clinical signs of a COVID-19 infection, a rhinopharyngeal swab is recommended. Donation should be temporarily discontinued until the result of the swab is available. If the culture is positive for COVID-19, donation should be interrupted until two consecutive negative cultures are present, then donation can restart (EMBA, 2020).(PAID LINK). The question is asked can the effects be recovered? The answer is no one knows at this time. All we can do is hope that things get back to normal as soon as possible.

Bottom Line

During this period of declining donations to human milk banks all around the world, we have to realize that the resources may need to be rationed. The low volume of donor human milk available should be allocated to the smallest and most at risk preterm infants (e.g., birth weight < 1500 grams or a gestational age < 30 weeks) to prevent NEC and other severe illnesses occurring in these extremely fragile infants. For these infants, human milk really makes the difference!

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Breastfeeding And Water :Everything You Should Know


Staying hydrated while breastfeeding is so essential

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Water, water, water! We all gatta have it! pregnant or not. When a mother is pregnant it becomes even more important. She no doubt has to increase her fluid volume due to the mass demand of the fetus circulatory system, the placenta, amniotic fluid, and you will loose some blood. After your baby is born you will have some shedding of fluid volume. A pregnant woman who was at a healthy weight before conceiving typically gains 25 to 30 pounds. Yes mama, and you are intending to breastfeed? Breastfeeding is 90% water! Water, water, water, Mama you gatta have it!

Staying hydrated is a very important factor because when you stay hydrated, you are actually taking good care of you nd your baby. Did you know that breast milk is about 90% water. Although research has found that nursing mothers do not need to drink more fluids than what’s necessary to satisfy their thirst,1 experts recommend about 128 ounces per day.

Now I know that sounds like too much water. A great way to do it is to drink one 8-ounce glass of water before and after each feeding, as well as with meals, you should be able to hit that 128-ounce goal. Some women complain that they cannot drink too much water. You can try the flavored fruity water sometimes. After birth, your body naturally shed water from the baby’s delivery.(PAID LINK)

And remember that total fluid consumption is a combination of what you drink (water and beverages like tea, milk, and fruit juice) and what you eat (water-rich foods like many fruits and vegetables).

How Hydration Affects Milk Supply

Water is so good for breastfeeding. One thing is certain, a breastfeeding mama will get thirsty. I remember when I was pregnant I used to be very thirsty. I kept my water bottle nearby and I advised you do the same. To prevent your breastmilk depletion try drinking more water and other fluids will help to give it a boost. However, research on the effect of extra fluid for breastfeeding mothers on milk production, supply, and infant growth hasn’t shown that drinking more than your usual amount of fluids will increase milk supply. Getting too little liquid, however, can cause milk production to lag and dry.

Never let your body get dehydrated

What’s more important than meeting a goal of a set number of ounces is making sure you don’t become dehydrated. Staying hydrated by getting plenty of water and other fluids throughout the day is vital to your health, no matter what stage of life you’re in (trying to conceive, pregnancy, breastfeeding, etc.).

If you don’t get enough water and other fluids, you risk becoming dehydrated, which can lead to some unpleasant side effects such as:

  • Constipation
  • Dizziness
  • Dry mouth and chapped lips
  • Fatigue and a lack of energy
  • Headache
  • Moodiness
  • Muscle cramps
  • Nausea (especially during the first trimester)

Know How to Get SUFFICIENT Fluids

Your top indicator of whether you need more fluids is thirst. A good rule of thumb is to drink enough water so that you’re not thirsty, otherwise known as “drinking to thirst.” Thirst is your body’s way of telling you that you need to drink more, so do your best to pay attention to your body. By the time you’re physically craving water, your body is already depleted of fluid.(PAID LINK)

Normally, an adult needs about 8, 8 ounce glasses of water per day. 64 ounces. During pregnancy and breastfeeding this average intake obviously increases. During breastfeeding we should drink an extra quart, or 32 ounces, per day. Roughly, we should be drinking around 100 ounces of water per day. Around 3/4 ths of a gallon of water.

Soon after starting to nurse, you will notice that you feel thirsty more often. This is triggered by oxytocin, a hormone released during breastfeeding, which naturally affects your thirst cues to encourage you to drink enough water to hydrate yourself and make breast milk.

The color of your urine is a telling clue about your level of hydration.2 If your pee is dark, it isn’t being diluted enough by what you drink. Look for a pale yellow or almost clear color to your urine, which indicates you’re getting enough fluids.

All Liquids Count Towards Hydration

You can supplement your diet with so many foods that contain lots of water

Your fluids don’t have to all come from water, but it’s always a good choice. It’s sugar-free, caffeine-free, readily available, and you can enjoy it at any temperature. Plus, you can easily flavor your water with fruits or herbs when you want a change.

That said, any liquids you consume, along with any water-rich foods you eat, will contribute to your overall fluid intake. Some examples include:

  • Cow’s milk or nut milk by the glass or in your cereal
  • Decaffeinated coffee or tea (though a cup or two a day with caffeine is likely fine)
  • Fruit or vegetable juice
  • Fruits such as oranges, watermelon, and berries
  • Soup
  • Vegetables such as tomatoes, cucumbers, and lettuce

If you don’t care for cow’s milk, don’t worry. You don’t need it in your diet to make breast milk. Just be sure you are getting calcium from other sources, such as cheese, yogurt, green leafy vegetables, or calcium-fortified foods.

Hydrate When When Your Baby Drinks

Since newborns breastfeed about 8 to 12 times a day, having a glass of water before or after every feeding is a good way to get your daily quota without having to think about it. I always had my water next to me. Never breastfed without it.

Know, however, that consuming too much fluid (a good indicator of this is clear urine) can actually harm your milk supply. When overhydrated, your body works to restore its electrolyte balance by dumping excess water in your urine, which diverts water away from your breasts and can actually decrease your milk supply as a result.

Drink Healthy Liquids When Breastfeeding

Smoothies are a great source of dense nutrients in liquid form

It’s true that you’ll need to take in extra calories to support milk production while you’re nursing, but those calories should come from foods and beverages that are nutrient-dense. Experts recommend that you avoid or limit the following liquids when nursing.

Hydrate with Less Sugary Fluids

Beverages that contain a lot of sugar, such as soda, can actually reduce the amount of fluid that your body actually retains. This can further exacerbate dehydration, causing heat stress and putting pressure on the kidneys, according to a study that examined the effects of such beverages.3 The same can be said of fruit drinks that are high in sugar but low in fiber.

If you’re really craving a sweet drink, try adding fruits and berries to your water. If you are still missing that sweetness, you are better off adding a teaspoon of plain table sugar to your fruit-infused water than drinking a can of soda, which has about 9.5 teaspoons of sugar per can.

Despite the name, fruit drinks often contain little or no actual fruit juice. (These are the products often labeled as “drinks,” “coolers,” or “punches.”) These are different from 100% fruit juice, which is still a good choice for hydration.(PAID LINK)

What About Caffeinated Drinks

Watch the caffeine

Aside from caffeine passing into breast milk and affecting your baby’s mood and sleep, the stimulant is also a diuretic, which means it causes you to lose fluid and can have a dehydrating effect on your body.

Watch Your Salt Intake

Did you know that salt holds water in the body?  However, for every 400 milligrams of salt your body retains, 2 pounds of temporary water weight clings to your body, says Towson University. To avoid this effect, lay off the salt shaker and take a look at what kinds of foods you’re eating regularly.

Although processed, boxed or other convenience foods are helpful for an overwhelmed mother, they’re not good for your body. Instead, snack on fresh fruits and vegetables, high-protein options like Greek yogurt and fiber-rich grains.

Alcohol

There are many misconceptions regarding alcohol and breastfeeding, including that it will help to boost your milk supply. The truth is, alcohol is more likely to inhibit the letdown reflex.

It’s generally OK (with the go-ahead from your baby’s pediatrician and your own obstetrician) to have an occasional glass of wine or beer while you’re breastfeeding, but it’s best to stop there. If you’re in the mood for a cocktail, try adding a splash of no-sugar-added fruit juice to plain seltzer in a champagne flute.

Bottom Line

Keep in mind that water intake varies per individual and your needs may be more than the recommended 128 ounces a day, especially in hot weather or if you are more active than the average person. Drink to thirst and check your urine to determine the right amount of water for you. The key to knowing if you are attaining a good hydration status is to watch your urine. The lighter it is, the better is your hydration status. Thank you for stopping by today. May you continue or begin to have the best possible hydration status from the liquids you drink. I look forward to seeing you soon. Here is a video to watch to help you a bit further.