Last update: March 23, 2018

Ebola Virus Disease

High Risk for breastfeeding


Poorly safe. Evaluate carefully.
Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives).
Read the Comment.

Ebola virus has shown to be present in the breast milk. Mechanism of transmission to the infant is unknown, whether it occurs through the milk or the close contact with other body fluids of infected mother is uncertain. Although most mothers and breastfed infants died during the current and previous outbreaks in West Africa, there have been reported cases of survival among breastfed infants of infected mothers and others who were not infected at all.

A high proportion of infected pregnant women suffered abortion and died. No survivors are known among those women who could reach to birth. Nor infants survived for longer than 2-3 weeks.

In the context of Ebola outbreak the UNICEF, WHO, CDC, ENN recommendations are:

EVIDENCE to date indicates that the mortality rates of Ebola infection far outweighs the morbility and mortality associated with not breastfeeding in the West Africa context.

BREASTFED INFANT WITH A MOTHER INFECTED BY EBOLA. ASYMTOMATIC INFANT: separate the infant from the mother. Offer replacement feeding. Keep mother's breast pumping and throw away the milk (pump-and-dump). Psychological support to the mother. Follow-up the infant as a “healthy contact” for 21 days.

BREASTFED INFANT WITH A MOTHER INFECTED BY EBOLA. SUSPICIOUS OR SYMTOMATIC INFANT: continue breastfeeding if the mother still asymptomatic. Take a confirmatory test from the infant.

NEWBORN INFANT WITH A MOTHER INFECTED BY EBOLA: support and initiate breastfeeding whenever the mother is on stable condition.

ORFAN INFANTS YOUNGER THAN 24 MONTHS: replacement feeding is recommended. In the context of current Ebola outbreak, the safest replacement feeding for infants younger than 6 months is Ready-to-Use infant formula.

Wet nursing is not recommended since the transmission risk of infection is high (from a wet-nurse to infant and vice versa)

Mothers who should not breastfeed their babies because of high risk of transmission, expression of breast is mandatory in order to prevent plethora and keep milk production.

When to resume breastfeeding? There is evidence on persistence of virus in the milk beyond disappearance in the serum. Checking the milk every 2-3 days after disappearance of virus in the blood should be done. Two consecutive negative tests in the milk are required before resuming breastfeeding.

If testing is not possible, waiting for 8 weeks after recovering of the mother is recommended.

Alternatives

We do not have alternatives for Ebola Virus Disease.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Ebola Virus Disease is also known as


References

  1. UNICEF, WHO, CDC, ENN. Infant feeding in the context of Ebola. Updated guidance. 2014 Full text (link to original source) Full text (in our servers)
  2. CDC. Recommendations for \ Breastfeeding/Infant Feeding in the \ Context of Ebola. 2014 Full text (link to original source) Full text (in our servers)
  3. Jamieson DJ, Uyeki TM, Callaghan WM, Meaney-Delman D, Rasmussen SA. What Obstetrician-Gynecologists Should Know About Ebola: A Perspective From the Centers for Disease Control and Prevention. Obstet Gynecol. 2014 Abstract
  4. OMS. Clinical management of patients with Viral Haemorrhagic Fever: A pocket guide for the front-line health worker. 2014 Full text (link to original source) Full text (in our servers)
  5. Escrivá Cholbi L. \No se sabe si el ébola se transmite por la leche materna o por el contacto directo con la madre infectada\. Blog de APILAM. 2014 Full text (link to original source)
  6. Ayoya MA, Golden K, Ngnie-Teta I, Moreaux MD, Mamadoultaibou A, Koo L, Boyd E, Beauliere JM, Lesavre C, Marhone JP. Protecting and improving breastfeeding practices during a major emergency: lessons learnt from the baby tents in Haiti. Bull World Health Organ. 2013 Abstract Full text (link to original source) Full text (in our servers)
  7. Bausch DG, Towner JS, Dowell SF, Kaducu F, Lukwiya M, Sanchez A, Nichol ST, Ksiazek TG, Rollin PE. Assessment of the risk of Ebola virus transmission from bodily fluids and fomites. J Infect Dis. 2007 Abstract Full text (link to original source) Full text (in our servers)
  8. Francesconi P, Yoti Z, Declich S, Onek PA, Fabiani M, Olango J, Andraghetti R, Rollin PE, Opira C, Greco D, Salmaso S. Ebola hemorrhagic fever transmission and risk factors of contacts, Uganda. Emerg Infect Dis. 2003 Abstract Full text (link to original source) Full text (in our servers)
  9. WHO,UNICEF, IBFAN, ENN. Infant feeding in emergencies. Emergency Nutrition Network. 2001 Full text (link to original source) Full text (in our servers)
  10. Seal A, Taylor A, Gostelow L, McGrath M. Review of policies and guidelines on infant feeding in emergencies: common ground and gaps. Disasters. 2001 Abstract
  11. [No authors listed] Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Lancet. 2000 Abstract
  12. Mupapa K, Mukundu W, Bwaka MA, Kipasa M, De Roo A, Kuvula K, Kibadi K, Massamba M, Ndaberey D, Colebunders R, Muyembe-Tamfum JJ. Ebola hemorrhagic fever and pregnancy. J Infect Dis. 1999 Abstract Full text (link to original source) Full text (in our servers)
  13. Mitchell SW, McCormick JB. Physicochemical inactivation of Lassa, Ebola, and Marburg viruses and effect on clinical laboratory analyses. J Clin Microbiol. 1984 Abstract Full text (link to original source) Full text (in our servers)
  14. [No authors listed] Ebola haemorrhagic fever in Zaire, 1976. Bull World Health Organ. 1978 Abstract Full text (link to original source) Full text (in our servers)

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