Bibliographic Info
GuidelineWHO recommendations on maternal health: guidelines approved by the WHO Guidelines Review Committee, second edition. Geneva: World Health Organization; 2025
Year of Publication2023
Issuing InstitutionWorld Health Organization
Recommendation
Status
Maintained
Recommended in favor
Strong
Certainty of evidence
Very low
If a lactating woman and her breastfeeding child are both diagnosed with Ebola virus disease, breastfeeding should be discontinued, the pair should be separated, and appropriate breastmilk substitutes should be provided. However, if the child is under six months of age and does not have safe and appropriate breastmilk substitutes, or the child cannot be adequately cared for, then the option to not separate and continue breastfeeding can be considered
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:
Originally Developed
Guideline
Guidelines for the management of pregnant and breastfeeding women in the context of Ebola virus disease
Year2020
InstitutionWHO