SARS-CoV-2 detection in human milk: a systematic review

Area of Science:

• Virology
• Neonatal Health
• Lactation Studies

Background:

• The presence of SARS-CoV-2 RNA in human milk is a concern for neonatal health.
• Understanding potential transmission routes is crucial for infant feeding recommendations.

Purpose of the Study:

• To synthesize evidence on SARS-CoV-2 RNA in human milk of mothers with COVID-19.
• To assess the potential role in neonatal SARS-CoV-2 infection.

Main Methods:

• Systematic search of PubMed, EMBASE, and Web of Science (Dec 2019–Oct 2020).
• Included peer-reviewed studies reporting RT-PCR for SARS-CoV-2 RNA in human milk.
• Performed proportion meta-analysis of case series and cohort studies.

Main Results:

• 34 studies (116 lactating women) were included.
• SARS-CoV-2 RNA was detected in human milk in 10 cases (6.7% of tested women).
• Pooled proportion of RNA detection in cohort studies was 2.16%; no conclusion on infectivity or infant impact.

Conclusions:

• Limited, low-quality evidence indicates extremely low SARS-CoV-2 RNA detection in human milk.
• Current evidence is insufficient to determine infectivity or impact on infants.
• Exclusive breastfeeding is recommended unless contraindicated, aligning with WHO guidance.