Breastfeeding And Ebola: Knowledge Gaps Endanger Mothers And Babies

(MENAFN- The Conversation) Breastfeeding is so important for child health that the World Health Organization (WHO) and Unicef recommend that babies should be breastfed within an hour of birth, be exclusively breastfed for the first six months of life, and then continue breastfeeding in combination with other foods for two years or more.

Infectious disease emergencies can threaten breastfeeding and the lives of mothers and babies. Depending on the disease, there is a risk of passing infection to the baby by close contact or (rarely) through breastmilk. There is also the risk of harm to breastfed infants from medication or vaccination of their mothers.

But separating mothers and babies or stopping breastfeeding also poses risks.

Mothers need proper guidance on the best course of action during an Ebola outbreak.

Threat to mothers and babies

The symptoms of Ebola include fever, tiredness, muscle pain, headache and sore throat followed by vomiting, diarrhoea, rash and, later, bleeding from any part of the body.

Ebola viruses are extremely contagious and people who become infected are at very high risk of death. Pregnant women and infants are more vulnerable and at greater risk than others.

Ebola outbreaks most often occur in countries where breastfeeding is vital for child survival. They have occurred in several African countries and on 30 January 2025 Uganda declared an outbreak , the latest in several the country has endured.

Breastmilk contains many ingredients that help to prevent and fight infection and that strengthen the baby's own immune system. Replacing breastmilk with other foods or liquids (including infant formula) removes this protection from babies and makes them more likely to become seriously ill.

Read more: Ebola: how a vaccine turned a terrifying virus into a preventable disease

Protection or harm?

It's important to know which actions protect or harm babies and their mothers during outbreaks. Recommendations on infectious diseases must weigh up the risks related to the disease, medical treatments and the risks of not-breastfeeding.

The World Health Organization has published guidelines on how to care for breastfeeding mothers and their infants when one or both have Ebola, but these recommendations are based on“very low quality” evidence, they are mostly expert opinion rather than research-based knowledge.

Women and children have been largely neglected in Ebola research. More is known about Ebola and semen than Ebola and breastmilk.

In a paper just published in the Lancet Global Health , we have outlined a roadmap for research on Ebola and breastfeeding so that mothers and babies can be protected.

Read more: Ebola in Uganda: why women must be central to the response

What we don't know

We know that Ebola is easily transmitted by close contact between people. So the close contact of breastfeeding is a risk to an uninfected baby or mother if one of them has Ebola.

However:

• We don't know if breastmilk can be infectious and, if it is, for how long.

• We don't know whether expressed breastmilk can be treated so that it is safe.

• We don't know whether, if both mother and baby are infected, it is better for the baby if the mother keeps breastfeeding, if she is able to.

• We don't know if vaccinating mothers against Ebola helps to protect their breastfed infants from the virus.

• We don't know if there are any risks for breastfed infants if their mothers are infected.

The result of this lack of knowledge is that decisions may be taken that increase risk and suffering for mothers and their babies.

For example, mothers may refuse vaccination because they are fearful that it is risky for their baby. But by refusing vaccination they'd be making themselves vulnerable to Ebola.

Alternatively, they may get vaccinated and stop breastfeeding, making their baby vulnerable to other serious infections.

If mothers and babies who both have Ebola are separated and breastfeeding is stopped, it could reduce the chances of survival.

Mothers and babies deserve better than this.

No more excuses

For many years people have called for more research on Ebola, breastmilk and breastfeeding, but this research has not been undertaken. It is not acceptable that women and children are deprived of breastfeeding because the needed research has not been done.

Our experience providing medical care in Ebola outbreaks , developing guidance for breastfeeding mothers in emergencies and researching medications and breastfeeding prompted us to develop a plan to fill this research gap.

In our paper , we describe the different groups of breastfeeding women affected by Ebola who must be included in research:

• vaccine recipients

• mothers who are ill with Ebola

• mothers recovering from Ebola

• mothers who are infected with Ebola, but have no symptoms

• the wider population of breastfeeding mothers in communities experiencing Ebola outbreaks.

The roadmap also includes the research questions that need answering and the study designs that would enable these questions to be answered.

It is up to governments, pharmaceutical companies, researchers, funders and health organisations to act.

Following the Ebola and breastfeeding research roadmap will not necessarily be easy. It is difficult to do research in the middle of an emergency.

But research on vaccination safety can be done outside outbreaks. Putting research plans in place and gaining approvals before outbreaks will also make things easier.

Closing the female data gap

Women have the right to societal, family and health support to enable them to breastfeed.

Lack of research is part of a problem called the“female data gap”, where knowledge of women's bodies, experiences and needs is lacking.

The Universal Declaration of Human Rights says,“Motherhood and childhood are entitled to special care and assistance.”

There just needs to be a commitment to make this research happen.

MENAFN07022025000199003603ID1109180766