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Since the Covid-19 pandemic arrived, headlines have been fluid: droplets are sprayed when we communicate or cough, runny nose secretions, and blood is tested for antibodies, but some scientists have focused on another framework product: breast milk.
Unlike others, milk is a liquid made to share, raising urgent questions about its protection from the crisis, either for moms feeding their young children or for the milk banks that manage donations. When an advisory committee of the Australian Red Cross Lifeblood, which administers milk banks and blood donations, met in March, “there were many things that were still unknown about the Covid-19,” wrote Laura Klein, the organization’s researcher. by email. ” We didn’t know then whether the virus can simply be transmitted through “breast milk,” as some other viruses, such as HIV and cytomegalovirus, can.
If the virus is hidden in breast milk, do swollen moms give formula to their young children?There were more unknowns, did the milk banks have to take additional precautions with donations?Did the breast milk of inflamed women in the past include antibodies, and is it possible that these antibodies protect young children, or perhaps others?
With more than 250 articles on Covid-19 and infant feeding published since February, researchers are beginning to answer those questions, while at the same time contributing to the misunderstood box of breast milk science in general. , breast milk is not a liquid worth fearing.
In the early stages of the pandemic, however, governments were very wary of breast milk. In China, where the new coronavirus first appeared, an organization of doctors and researchers developed an expert consensus on how to manage inflamed mothers. the document said that inflamed mothers, and even those suspected of contagion, do not breastfeed their babies.
Like the virus around the world, other countries were equally cautious. As a component of an unpublished research, a team of researchers added Experts from Alive
Another barrier to breastfeeding has emerged in the United States, where the Centers for Disease Control and Prevention first recommended separating swollen moms from their newborns; if moms seek it, they can simply express milk for someone else to feed their baby. The CDC no longer recommends separation, Cashin said the original position influenced the rules of other countries.
The authors of some clinical articles published this spring also stated that women with Covid-19 deserve not necessarily to breastfeed. This caution came despite little evidence of danger, the assistant professor and medical anthropologist at the University of North Carolina Aunchalee Palmquist and her co-authors wrote in an observation for the American Journal of Human Biology.
“Scientists make recommendations without false evidence and many start from a problematic hypothesis,” Palmquist wrote in an email, meaning that any virus option in milk means that women avoid breastfeeding. “The truth is, it’s not that simple. “
She and others compare the existing pandemic to the HIV epidemic in the 1980s. At the beginning of this pandemic, researchers discovered the virus in breast milk and were soon begged for inflamed mothers around the world who did not breastfeed. in emerging countries, where many young children die of diarrhoea due to dirty water, making the formula a difficult choice. Because HIV is rarely transmitted to young children through milk, avoiding breastfeeding has done more harm than smart in emerging countries, according to researchers.
Today, the World Health Organization warns that even when mothers have Covid-19, “the benefits of breastfeeding outweigh the potential dangers of transmission. “
This recent warning about breast milk is due to the fact that there are still many things we don’t know. At the University of California, San Diego, researchers are collecting breast milk in a biorearium for clinical research. Her ongoing paintings attempt to answer a wide variety of unanswered questions, said Christina Chambers, a perinatal epidemiologist and professor of pediatrics at the university. For example, how does the nutrient content of breast milk vary, what drugs can pass into milk and what are they for nursing mothers?How are immune parts of breast milk replaced when your baby is sick?
With their existing networks, scientists were well positioned to begin answering the question of whether SARS-CoV-2 can spread through the breast milk of inflamed women. Previous case studies had discovered extracts from the genetics of the new coronavirus in breast milk. last spring, there was no evidence that milk contained a live virus that could simply make a bavia sick.
Chambers and his co-authors collected 18-year-old milk that had tested positive for Covid-19. Volunteers provided breast milk around the time they first tested positive, and many gave repeated samples thereafter, for a total of 64 samples.
When researchers tested milk for coronavirus, they discovered its genetics in only one of 64 patterns. A donor had collected this milk the day their symptoms began, but the pattern did not involve any live viruses that might have inflamed someone. The findings were published in the Journal of the American Medical Association.
Jim Thornton, an obstetrician and professor at the University of Nottingham in the UK who co-wrote a review of evidence about mothers transmitting SARS-CoV-2 to newborns in June, said the laboratory effects were consistent with what is happening in the genuine world. “In fact, we see very, very few inflamed babies, ” said Thornton. “It’s almost actually for breastfeeding. “
The result is reassuring. Still, “that’s not the definitive answer,” Chambers said. For Covid-19, “as knowledge evolves, there are surprises everywhere. “These 18 women took breast milk, but this does not turn out that the virus can never be present Researchers plan to repeat their survey with a greater number of samples, as well as look for antibodies in the milk.
First, non-profit milk banks, which supply breast milk to premature hospitalized babies, were unsure of the precautions to be taken. In general, after collecting milk from donors, banks heat milk to 144. 5 degrees Fahrenheit for 30 minutes to kill germs – a procedure known as Pasteurization Holder.
It has been assumed that this procedure would kill SARS-CoV-2, although some microbes would possibly heat up. Australian researchers have made the decision to answer the question definitively. Klein said they used frozen milk for the study that they may also simply not give to babies, such as milk from donors who were taking certain medications. They also contacted some existing donors and asked for some freshly extracted breast milk.
Scientists then enriched the milk samples with the live SARS-CoV-2 virus. Some of the swollen milk chilled or frozen to reflect how moms would keep it at home. Other milks have been pasteurized Holder. The cooling garage has not eliminated the virus. Scientists have discovered it, but pasteurization has erased it. The team’s findings were published in the Journal of Pediatrics and Child Health.
“The effects were what we expected to see,” Klein says. Milk is based on the global use of Pasteurization Holder because it kills many types of viruses, he said, and added the guilty coronaviruses of SARS and MERS. You can be sure that pasteurization would kill any amount of viruses that might be in the breast milk that occurs in the genuine world. “
Before babies begin to expand their own immune reaction to viruses and other threats, they get a pattern of antibodies from their mother to counteract them. These antibodies pass first through the mother’s placenta and then into milk if she breastfeeds. Most antibodies in milk are of a type called secreting IgA. They give young children what is called passive immunity: disease transitory resistance that is restored at every meal.
When the coronavirus pandemic began, doctors and scientists wondered if inflamed mothers would transmit SARS-CoV-2 antibodies through milk that might be only for their babies. “We needed to know,” said Rebecca Powell, a breast milk immunologist and assistant professor at Icahn School of Medicine in Mount Sinai, New York.
The study consultation was an herbal pivot of his recent paintings on the immune reaction of breast milk to seasonal influenza. And since his city was the epicenter of the disease at the time, prospective study participants were everywhere. Powell started Facebook to recruit nursing mothers who had become inflamed with Covid-19. To date, he has recruited some 800 donors and is following six hundred other volunteers who are at increased risk of infection.
In a recent peer-reviewed paper, Powell and his co-authors analyzed the milk of 15 of these donors for SARS-CoV-2 antibodies and discovered antibodies in some of the samples, Powell said.
Powell says it’s too early to know what protection, if any, these antibodies provide to breastfed babies, but Powell is also interested in removing those antibodies from milk and using them as a remedy for Covid-19. Researchers are already doing something similar, involving cured patients, transferring their antibody-rich blood plasma to those who are sick.
It is envisioned using antibodies in respiratory treatment that patients can simply inhale, as a treatment for asthma, for example, by delivering antibodies directly to the site of infection Secretive IgA antibodies, such as those in milk, are packaged Through the framework to be Powell says this allows them to do it in settings like airlines or the digestive tract. In the blood, the non-unusual peak antibodies are a less durable type called IgG. This may make breast milk antibodies a more useful prospective treatment than convalescent plasma, Powell speculated.
Genevieve Fouda, a pediatric immunologist and associate professor at Duke University in North Carolina, wrote in an email that the use of breast milk antibodies as a treatment is an interesting, if unproven, idea. “But first of all it would be to fully characterize serve as those antibodies, ” he said. “Can you neutralize the virus?”
Powell will now answer other questions: what percentage of inflamed women have anti-SARS-CoV-2 antibodies in milk afterwards?How long do antibodies last after infection?What if the mom is in poor health and recovers well before having a baby?
Research can reveal whether breast milk is not only safe, but also useful in this pandemic. Powell will want many other people and their milk to collect enough data, but it’s feasible, he says, because of the large number of volunteers who have come to help her with her project. “The reaction was overwhelming,” he said. I mean, viral, really. “
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