.: DERLEME
COVID-19 ve Emzirme: Klinik Uygulamaya Yönelik Bir Derleme
COVID-19 and Breastfeeding: A Review for Clinical Practice
Turkiye Klinikleri J Health Sci. 2021;6(3):675-81
doi: 10.5336/healthsci.2020-80014
Makale Dili: TR
Tam Metin
ÖZET
Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], tüm dünyaya hızlı yayılımı ve milyonlarca insanın ölümüne neden olması sebebiyle pandemi olarak ilan edilmiştir. Gebelikte ve emzirme döneminde anneden, fetüs-yenidoğana COVID-19 virüsünün, vertikal yolla geçişinin (amniyon sıvısı, umbilikal kord kanı, anne sütü) olduğuna dair henüz bir kanıt bulunmamaktadır. Anne sütünde bulunan antikorların ve immünolojik bileşenlerin, enfeksiyonlara karşı koruduğu bilinmektedir. Literatürde, anne sütünde bulunan whey proteininin, anne sütüne geçen COVID-19'un etkisini azalttığı belirtilmektedir. Bebeklerin, ilk 6 ay sadece anne sütü ile beslenmesini ve emzirmenin 2 yaşa kadar süründürülmesini öneren Dünya Sağlık Örgütü, pandemi sürecinde de anne sütü ile beslemeyi desteklemektedir. COVID-19 pozitif ve şüphesi olan annelerin, gerekli koruyucu önlemler alarak bebeklerini emzirmeleri önerilmektedir. Emzirmenin mümkün olmadığı durumlarda, sütün sağılması konusunda annenin, ebe ve hemşire başta olmak üzere tüm sağlık profesyonellerince desteklenilmesi, COVID-19 pandemi sürecindeki anne ve bebeğinin sağlığının korunması ve geliştirilmesine katkı sağlayacaktır. Bu derlemenin amacı; COVID-19 ve emzirme konusunda güncel veriler ışığında bilgi sunmak ve bu konuda ebe, hemşire, anne ve yenidoğan bakımını üstlenen bakım vericinin sorumluluğunu ortaya koymaktır.
Anahtar Kelimeler: COVID-19; emzirme; anne sütü; ebe; hemşire
Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], tüm dünyaya hızlı yayılımı ve milyonlarca insanın ölümüne neden olması sebebiyle pandemi olarak ilan edilmiştir. Gebelikte ve emzirme döneminde anneden, fetüs-yenidoğana COVID-19 virüsünün, vertikal yolla geçişinin (amniyon sıvısı, umbilikal kord kanı, anne sütü) olduğuna dair henüz bir kanıt bulunmamaktadır. Anne sütünde bulunan antikorların ve immünolojik bileşenlerin, enfeksiyonlara karşı koruduğu bilinmektedir. Literatürde, anne sütünde bulunan whey proteininin, anne sütüne geçen COVID-19'un etkisini azalttığı belirtilmektedir. Bebeklerin, ilk 6 ay sadece anne sütü ile beslenmesini ve emzirmenin 2 yaşa kadar süründürülmesini öneren Dünya Sağlık Örgütü, pandemi sürecinde de anne sütü ile beslemeyi desteklemektedir. COVID-19 pozitif ve şüphesi olan annelerin, gerekli koruyucu önlemler alarak bebeklerini emzirmeleri önerilmektedir. Emzirmenin mümkün olmadığı durumlarda, sütün sağılması konusunda annenin, ebe ve hemşire başta olmak üzere tüm sağlık profesyonellerince desteklenilmesi, COVID-19 pandemi sürecindeki anne ve bebeğinin sağlığının korunması ve geliştirilmesine katkı sağlayacaktır. Bu derlemenin amacı; COVID-19 ve emzirme konusunda güncel veriler ışığında bilgi sunmak ve bu konuda ebe, hemşire, anne ve yenidoğan bakımını üstlenen bakım vericinin sorumluluğunu ortaya koymaktır.
Anahtar Kelimeler: COVID-19; emzirme; anne sütü; ebe; hemşire
ABSTRACT
Coronavirus disease-2019 (COVID-19) has been declared a pandemic in terms of its rapid spread and causing death of millions of people all over the world. There is no evidence that the vertical transmission of the virus (amniotic fluid, umbilical cord blood, breast milk) from the mother to the fetus or newborn during pregnancy and lactation. It is known that antibodies and immunological components found in breast milk protect against infections. In the literature, it is stated that whey protein in breast milk reduces the effect of COVID-19 that passes into breast milk. The World Health Organization, which recommends that babies be fed with breast milk for the first 6 months and breastfeeding should be continued until the age of two, also supports breastfeeding during the pandemic process. It is recommended that mothers with positive or suspected COVID-19 breastfeed their babies by taking necessary precautions. In cases where breastfeeding is not possible, supporting the mother in terms of milking by all health professionals, especially midwives and nurses, will contribute to the protection and improvement of the health of the mother and her baby in the COVID-19 pandemic process. The purpose of this review is; to provide information on COVID-19 and breastfeeding in the light of current data and to reveal the responsibility of the midwife, nurse, mother and caregiver taking care of the newborn.
Keywords: COVID-19; breastfeeding; breast milk; midwife; nurse
Coronavirus disease-2019 (COVID-19) has been declared a pandemic in terms of its rapid spread and causing death of millions of people all over the world. There is no evidence that the vertical transmission of the virus (amniotic fluid, umbilical cord blood, breast milk) from the mother to the fetus or newborn during pregnancy and lactation. It is known that antibodies and immunological components found in breast milk protect against infections. In the literature, it is stated that whey protein in breast milk reduces the effect of COVID-19 that passes into breast milk. The World Health Organization, which recommends that babies be fed with breast milk for the first 6 months and breastfeeding should be continued until the age of two, also supports breastfeeding during the pandemic process. It is recommended that mothers with positive or suspected COVID-19 breastfeed their babies by taking necessary precautions. In cases where breastfeeding is not possible, supporting the mother in terms of milking by all health professionals, especially midwives and nurses, will contribute to the protection and improvement of the health of the mother and her baby in the COVID-19 pandemic process. The purpose of this review is; to provide information on COVID-19 and breastfeeding in the light of current data and to reveal the responsibility of the midwife, nurse, mother and caregiver taking care of the newborn.
Keywords: COVID-19; breastfeeding; breast milk; midwife; nurse
REFERANSLAR:
- Karimi-Zarchi M, Neamatzadeh H, Dastgheib SA, Abbasi H, Mirjalili SR, Behforouz A, et al. Vertical transmission of coronavirus disease 19 (COVID-19) from infected pregnant mothers to neonates: a review. Fetal Pediatr Pathol. 2020;39(3):246-50. [Crossref] [PubMed] [PMC]
- Ma K, Chen T, Han MF, Guo W, Ning Q. [Management and clinical thinking of coronavirus disease 2019]. Zhonghua Gan Zang Bing Za Zhi. 2020;28(0):E002. Chinese. [PubMed]
- Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol. 2020;222(5):415-26. [Crossref] [PubMed] [PMC]
- Lubbe W, Botha E, Niela-Vilen H, Reimers P. Breastfeeding during the COVID-19 pandemic - a literature review for clinical practice. Int Breastfeed J. 2020;15(1):82. [Crossref] [PubMed] [PMC]
- Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr. 2020;9(1):51-60. [Crossref] [PubMed] [PMC]
- Calil VMLT, Krebs VLJ, Carvalho WB. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. [Crossref] [PubMed]
- Wang L, Shi Y, Xiao T, Fu J, Feng X, Mu D, et al; Working Committee on Perinatal and Neonatal Management for the Prevention and Control of the 2019 Novel Coronavirus Infection. Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition). Ann Transl Med. 2020;8(3):47. [Crossref] [PubMed] [PMC]
- Zeng L, Xia S, Yuan W, Yan K, Xiao F, Shao J, et al. Neonatal early-onset infection with SARS-CoV-2 in 33 neonates born to mothers with COVID-19 in Wuhan, China. JAMA Pediatr. 2020;174(7):722-5. [Crossref] [PubMed] [PMC]
- Yang N, Che S, Zhang J, Wang X, Tang Y, Wang J, et al; COVID-19 Evidence and Recommendations Working Group. Breastfeeding of infants born to mothers with COVID-19: a rapid review. Ann Transl Med. 2020;8(10):618. [Crossref] [PubMed] [PMC]
- World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: interim guidance, 13 March 2020. Erişim tarihi: 6 Temmuz 2020. Erişim linki: [Link]
- UNICEF. Coronavirus disease (COVID-19): What parents should know. Erişim tarihi: 6 Temmuz 2020. Erişim linki: [Link]
- World Health Organization [Internet]. © WHO 2021 [Erişim tarihi: 6 Temmuz 2020]. Breastfeeding advice during the COVID-19 outbreak. Erişim linki: [Link]
- Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15. Erratum in: Lancet. 2020;395(10229):1038. Erratum in: Lancet. 2020;395(10229):1038. [Crossref] [PubMed] [PMC]
- Pereira A, Cruz-Melguizo S, Adrien M, Fuentes L, Marin E, Forti A, et al. Breastfeeding mothers with COVID-19 infection: a case series. Int Breastfeed J. 2020;15(1):69. [Crossref] [PubMed] [PMC]
- Alonso Díaz C, López Maestro M, Moral Pumarega MT, Flores Antón B, Pallás Alonso C. First case of neonatal infection due to COVID-19 in Spain. An Pediatr (Engl Ed). 2020;92(4):237-8. [Crossref] [PubMed] [PMC]
- Le HT, Nguyen LV, Tran DM, Do HT, Tran HT, Le YT, et al. The first infant case of COVID-19 acquired from a secondary transmission in Vietnam. Lancet Child Adolesc Health. 2020;4(5):405-6. [Crossref] [PubMed] [PMC]
- Fan C, Lei D, Fang C, Li C, Wang M, Liu Y, et al. Perinatal transmission of COVID-19 associated SARS-CoV-2: should we worry? Clin Infect Dis. 2020:ciaa226. [PubMed] [PMC]
- Dumpa V, Kamity R, Vinci AN, Noyola E, Noor A. Neonatal coronavirus 2019 (COVID-19) infection: a case report and review of literature. Cureus. 2020;12(5):e8165. [Crossref] [PubMed] [PMC]
- Wang S, Guo L, Chen L, Liu W, Cao Y, Zhang J, et al. A case report of neonatal 2019 coronavirus disease in China. Clin Infect Dis. 2020;71(15):853-7. [Crossref] [PubMed] [PMC]
- Chambers C, Krogstad P, Bertrand K, Contreras D, Tobin NH, Bode L, et al. Evaluation for SARS-CoV-2 in breast milk from 18 infected women. JAMA. 2020;324(13):1347-8. [Crossref] [PubMed] [PMC]
- Fan H, Hong B, Luo Y, Peng Q, Wang L, Jin X, et al. The effect of whey protein on viral infection and replication of SARS-CoV-2 and pangolin coronavirus in vitro. Signal Transduct Target Ther. 2020;5(1):275. [Crossref] [PubMed] [PMC]
- Covid-19 Salgını Sırasında Anne Sütü ile Beslenme Konusunda Dünya Sağlık Örgütü Önerileri. Erişim tarihi: 6 Temmuz 2020. Erişim linki: [Link]
- Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al; Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. [Crossref] [PubMed]
- Ng YPM, Low YF, Goh XL, Fok D, Amin Z. Breastfeeding in COVID-19: a pragmatic approach. Am J Perinatol. 2020;37(13):1377-84. [Crossref] [PubMed] [PMC]
- Centers for Disease Control and Prevention [Internet]. Care for breastfeeding women: interim guidance on breastfeeding and breast milk feeds in the context of COVID-19. Erişim tarihi: 3 Haziran 2020. Erişim linki: [Link]
- T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 ENFEKSİYONU) Erişkin Hasta Tedavisi. Erişim tarihi: 23.12.2020. Erişim linki: [Link]
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