Possibility of Coronavirus Disease 2019 Transmission Through Breast Milk: A Systematic Review

Context: Coronavirus disease 2019 (COVID-19) and the infection control strategies have affected breastfeeding and mother-newborn contact due to the fear of disease transmission to the baby. Objectives: This study aimed to evaluate the possibility of CPVID-19 transmission by reviewing the currently published articles. Methods: In this systematic review, 296 articles were first retrieved from IranMedex, SID, IranDoc, Magiran, Iranian Registry of Clinical Trials (IRCT), PubMed, ProQuest, Scopus, Science Direct, Medline, and Google Scholar search engine using the keywords "breastfeeding", "breast", "vertical transfer", "breast milk", "colostrum", "corona", and "COVID-19". Of the 296 retrieved articles, 16 were eligible for the review. Results: Reviewed articles included four retrospective cross-sectional studies, one cohort study, eight case reports, and three case series. Overall, the studies reported 237 RT-PCR tests on breast milk and/or nasopharyngeal or oropharyngeal swabs from mother or baby, and 156 serum antibody measurements in mother or baby. The overall findings indicated a low risk for COVID-19 transmission from mother to infant through breastfeeding, while breastfeeding was detected to transfer the antibodies to the newborn. Conclusions: Due to the low transmission risk, it was recommended that mothers with mild to moderate symptoms should breastfeed their infants with infection control measurements, while mothers with severe symptoms should use pumped breastmilk for feeding their infants.