Journal
PEDIATRIC RESEARCH
Volume 92, Issue 4, Pages 1140-1145Publisher
SPRINGERNATURE
DOI: 10.1038/s41390-021-01902-y
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Funding
- University of California Los Angeles (UCLA) AIDS Institute, UCLA CFAR [AI028697]
- James B. Pendleton Charitable Trust
- McCarthy Family Foundation
- University of California Office of the President Emergency COVID-19 Research Program
- National Institutes of Health (NIH) National Center for Advancing Translational Sciences (NCATS) [UL1TR001442]
- IMPAACT Network
- National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) [UM1AI068632, UM1AI068616, UM1AI106716]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- National Institute of Mental Health (NIMH)
- Family Larsson-Rosenquist Foundation
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This study found that SARS-CoV-2 RNA can be detected in breastmilk after recent infection, but there is no evidence of the presence of infectious virus. Breastfeeding does not appear to be a risk factor for transmitting the infection to infants.
Background Genomic RNA of severe acute respiratory syndrome-associated coronavirus type 2 (SARS-CoV-2) has been detected in the breast milk of lactating women, but its pathological significance has remained uncertain due to the small size of prior studies. Methods Breast milk from 110 lactating women was analyzed by reverse transcription-polymerase chain reaction (285 samples) and viral culture (160 samples). Those containing SARS-CoV-2 viral RNA (vRNA) were examined for the presence of subgenomic RNA (sgRNA), a putative marker of infectivity. Results Sixty-five women had a positive SARS-CoV-2 diagnostic test, 9 had symptoms but negative diagnostic tests, and 36 symptomatic women were not tested. SARS-CoV-2 vRNA was detected in the milk of 7 (6%) women with either a confirmed infection or symptomatic illness, including 6 of 65 (9%) women with a positive SARS-CoV-2 diagnostic test. Infectious virus was not detected in any culture and none had detectable sgRNA. In control experiments, infectious SARS-CoV-2 could be cultured after addition to breastmilk despite several freeze-thaw cycles, as it occurs in the storage and usage of human milk. Conclusions SARS-CoV-2 RNA can be found infrequently in the breastmilk after recent infection, but we found no evidence that breastmilk contains an infectious virus or that breastfeeding represents a risk factor for transmission of infection to infants. Impact This article goes beyond prior small studies to provide evidence that infectious SARS-CoV-2 is not present in the milk of lactating women with recent infection, even when SARS-CoV-2 RNA is detected. Recent SARS-CoV-2 infection or detection of its RNA in human milk is not a contraindication to breastfeeding.
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