key: cord-0911783-de5bm3i0
authors: Peroni, Diego G.; Fanos, Vassilios
title: Lactoferrin is an important factor when breastfeeding and COVID‐19 are considered
date: 2020-06-28
journal: Acta Paediatr
DOI: 10.1111/apa.15417
sha: eaff7a35475c1b5fc027180323f18c0bbf06658e
doc_id: 911783
cord_uid: de5bm3i0

The COVID-19 pandemic raises issues about breastfeeding when mothers have tested positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We don't know whether the virus can be passed to a foetus or baby during pregnancy or delivery and it has not been found in amniotic fluid or breastmilk (1). Separating babies from virus positive mothers make breastfeeding problematic and could prevent possible protection against viruses (2).

The COVID-19 pandemic raises issues about breastfeeding when mothers have tested positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We do not know whether the virus can be passed to a foetus or baby during pregnancy or delivery, and it has not been found in amniotic fluid or breast milk. 1 Separating babies from virus-positive mothers make breastfeeding problematic and could prevent possible protection against viruses. 2 Mothers who are too sick to feed could consider expressing milk or donor human milk. 1 Lactoferrin is a protective factor in mother's milk and a key component of the mammalian innate response to infections.

This whey protein has several biological functions, including binding and releasing iron. It also inhibits the growth of many pathogens, by mechanisms such as disrupting cell membranes, sequestering iron, inhibiting microbial adhesion to host cells and preventing biofilm formation. 3 Lactoferrin is very similar between species, and the homology between humans and cattle is 77%. It is produced and secreted by glandular epithelial cells, with a peak concentration in colostrum We believe that breast milk, particularly lactoferrin, demonstrates potential antiviral effects. The challenge is how effective they are at preventing viral infections, like coronaviruses. The way lactoferrin acts on cell receptors prevents viral anchoring, surface accumulation and cell entry. Further clinical evidence is needed, but we believe that early breastfeeding provides vital prevention during viral epidemics, due to the high value of colostrum and breast milk and the specific role of lactoferrin.

Reviewing the evidence on breast milk composition and immunological outcomes

Antiviral properties of lactoferrin-a natural immunity molecule

Italian Task Force for the Study and Prevention of Neonatal Fungal Infections, Italian Society of Neonatology. Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial

Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial

Inhibition of SARS pseudovirus cell entry by lactoferrin binding to heparan sulfate proteoglycans

From SARS to COVID-19: What we have learned about children infected with COVID-19