Abstract
Dear Editors of JHL,
We are writing to express our concerns regarding the article entitled ‘Safe Handling of Containers of Expressed Human Milk in all Settings During the SARS-CoV-2 (COVID-19)’ published April 3, 2020 (Marinelli & Lawrence, 2020). Our concerns are as follows:
The authors lead readers to believe that breastmilk is contaminated with SARS-CoV-2; however, standard Holder Pasteurization techniques utilized by Human Milk Banking Association of North America milk banks reach temperatures that kill the virus (Chin et al., 2020). In addition, milk banks employ strict handling policies that prevent transmission of pathogens to recipients of donor milk (HMBANA, n.d.). The authors do not cite evidence for why they feel bottles of donor milk should be cleaned differently now than in the past.
The authors do not provide evidence to corroborate why they believe transmission of the SARS-CoV-2 will occur via bottles of breastmilk. No reports exist regarding an asymptomatic mother handling bottles of breastmilk and subsequently infecting her infant or other people. If an asymptomatic mother washes her hands prior to pumping and does not cough, no evidence exists that she would transmit SARS-CoV-2 to external surfaces of bottles (CDC, 2020).
The authors discuss their concerns regarding surface contamination. However, the Centers for Disease Control states clearly that the virus spreads via respiratory droplets from direct person-to-person contact. The CDC emphasizes that the virus does not preferentially spread through surfaces (CDC, 2020). If an asymptomatic mother is otherwise caring for her infant without a face mask, no evidence exists that she should wear a mask only while pumping milk.
The authors do not cite any recommendations that reflect those of the Human Milk Banking Association of North America (HMBANA), the World Health Organization (WHO), or the Centers for Disease Control (CDC).
Overall, no evidence exists that the measures recommended by the authors would reduce the transmission of SARS-CoV-2. Unfortunately, their recommendations may create undue alarm regarding the known safety of lifesaving donor milk. Increased formula use may follow, causing unnecessary long-term harm to mothers and babies.
Footnotes
Author’s note
Ms. Weinstein has recently relocated to Arizona from New Mexico, where her previous affiliation was Dar a Luz Birth and Health Center. She currently is on maternity leave and does not yet have a local affiliation in Arizona.
Declaration of Conflicting Interests
The authors have no conflict of interest to report. Dr. Mitchell is on the board of the Ventura Coast Milk Bank. Ms. Weinstein’s previous place of employment is a collection site for the Mother’s Milk Bank.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
