Bibliographic Info
Recommendation
Recommended in favor
Strong
Certainty of evidence
Very low
Children without confirmed Ebola virus infection who are exposed to the breastmilk of women with confirmed Ebola virus disease should be considered contacts. The child should stop breastfeeding and should undergo close monitoring for signs and symptoms of Ebola virus disease for 21 days. The child should be given a breastmilk substitute as needed. Post-exposure prophylaxis for Ebola virus disease can be considered for children exposed to the breastmilk of Ebola virus-infected women on a case-by-case basis and in accordance with existing research protocols
Notes and Remarks
- 1.The recommendation to discontinue breastfeeding in the event that both the breastfeeding woman and the breastfed child have acute EVD is based off a hypothetical risk of viral ‘boosting’ between two infected individuals. This viral boosting could theoretically increase disease severity through additional viremic exposure. Evidence to directly support this recommendation is lacking
- 2.Infants younger than 6 months of age should be provided with a breastmilk substitute (eg, ready-to-use infant formula) that is acceptable, feasible, affordable, sustainable, and safe. Infants and young children between 6 months and 23 months of age should be provided with a ready-to use infant formula or ultra-high temperature full-cream (or whole) cow’s milk along with complementary feeding (this food can be supplemented with micronutrient powders if the nutrient content is expected to be inadequate).
- 3.Rapid testing of breast milk of women with recovered EVD, who would like to continue to breastfeed, should be prioritized.
- 4.Women’s choices related to stopping breastfeeding, or continuing after EVD recovery and testing of breast-milk, should be respected and supported by health care workers to facilitate the choice
Also Featured In
This recommendation also appears in the following guidelines:
Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease