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Maternal and neonatal health at risk during pandemic

Monday, 18th May 2020

It is easy to lose focus of lifesaving services such as sexual, reproductive, maternal, newborn and child healthcare when readying our healthcare system for the peak of the COVID-19 pandemic in South Africa. As we observe World Breastmilk Donation Day on Tuesday, 19 May, maternal and neonatal health partners call for greater focus on their sector. 

A key component in the management of any infectious disease outbreak includes care of the most-at-risk and vulnerable populations. Although the clinical course and effect of COVID-19 amongst mothers and their newborns in South Africa remains to be described, pregnant women, breastfeeding mothers, newborns and young children have been affected by the COVID-19 lockdown and regulations issued when COVID-19 was declared a national disaster.

Last month, the National Department of Health (NDoH) released the COVID-19 Maternal & Newborn Care Guidelines, which clearly outline how mothers and their infants can be supported during this pandemic. The Association for Dietetics in South Africa (ADSA), South African Certified Lactation Consultants (SACLC) and South African Breastmilk Reserve (SABR) urge stakeholders in healthcare to train staff and implement the guidelines with specific attention to the uninterrupted access of babies to their mothers and breastmilk.

“There needs to be a prioritisation of essential and quality sexual, reproductive, maternal, newborn and child health services during the current global crisis. COVID-19 preparedness plans and interventions should not disrupt or compromise these,” says Professor Ameena Goga, PhD, a paediatrician and researcher at the South African Medical Research Council, with Masters degrees in Mother and Child Health, and Epidemiology.

According to Professor Goga: “Many hospitals now have limited lodger facilities for mothers with hospitalised babies. To limit the risk of exposure to the virus, many facilities have confined the visiting times for mothers to once a day or less, and family visits for hospitalised mother-baby pairs are also restricted,” she says.

Staša Jordan, Executive Director at the SABR, explains that if mothers are not able to establish breast milk production for themselves, considerable pressure is exerted on human milk banking facilities to compensate for the shortage of Mother’s Own Milk (MOM) during this time. The support of breastfeeding, particularly, is critical for infant and child survival. Essential maternal and neonatal services have been developed through great effort over the last two decades, and the gains of these efforts should not be lost in the context of COVID-19.

Direct breastfeeding and MOM, as well as skin-to-skin contact, have innumerable lifesaving benefits for hospitalised and non-hospitalised babies. “Breastfeeding is particularly effective against infectious diseases because it strengthens the immune system by directly transferring antibodies from the mother. There is no evidence to show that COVID-19 is transmitted through breastmilk even if the mother has tested positive for the virus,” Says Carey Haupt, ADSA and SACLC representative.

“It is only through the continued commitment to lactation support for all mothers that human milk banks can assist infants who do not have access to MOM. Human milk banks are not a replacement for maternal lactation. They are an emergency intervention that offers support in the first few critical days of the life of an infant. World Breastmilk Donation Day, observed this Tuesday, 19 May, reminds us of the critical role that breastfeeding plays in promoting maternal and neonatal health,” adds Jordan.  

“Initiatives run by the NDoH and its stakeholders ensure the best start for mothers and babies. Over the last two decades, great inroads have been made in upscaling and improving maternal and neonatal health. We cannot allow the COVID-19 pandemic to undo the lifesaving gains that we’ve achieved. The uninterrupted access of mothers to their babies and health services such as immunisations are vital and should be promoted,” concludes Dr Manala Makua, Chief Director of Maternal and Reproductive Health at the NDoH.