Breastfeeding importance and its therapeutic potential against SARS‐CoV‐2

Abstract

During postnatal development, colostrum and breastmilk are sequentially the first sources of nutrition with protein components and bioactive molecules that confer protection and immunostimulatory function to the gut. Caseins, whey proteins, secretory immunoglobulin A (sIgA), mucins, tryptophan, and growth factors are among milk‐borne elements that are directly important in the control of mucosa development and protection. Consequently, breastfeeding is associated with the low incidence of gastrointestinal inflammation and with the decrease in respiratory diseases during postnatal period. The novel coronavirus (SARS‐CoV‐2) binds to angiotensin II‐converting enzyme (ACE2) on the cell membrane, allowing virus entrance, replication, and host commitment. ACE2 is expressed by different cell types, which include ciliated cells in the lungs and enterocytes in the intestine. Such cells are highly active in metabolism, as they internalize molecules to be processed and used by the organism. The disruption of ACE2 impairs leads to intestinal inflammation and decreased synthesis of serotonin, affecting motility. By reviewing the effects of SARS‐CoV‐2 in the gastrointestinal and respiratory tracts in infants, and gut responses to breastfeeding interruption, we suggest that it is important to maintain breastfeeding during SARS‐CoV‐2 infection, as it might be essential to protect newborns from gastrointestinal‐associated disorders and relieve disease symptoms.

Breast Milk and COVID-19: From Conventional Data to “Omics” Technologies to Investigate Changes Occurring in SARS-CoV-2 Positive Mothers

“…The current evidence seems to sustain the beneficial effects of BM also in the case of mothers affected by SARS-COV-2, who should continue to breastfeed [ 24 , 107 , 108 ].…”

“…Therapeutic perspectives have been proposed by the use of specific antibodies from BM, since specific IgA and other classes of antibodies seems to persist during lactation in affected/immunized mothers for at least seven months [ 109 ]. In fact, antibodies could be potentially collected, purified and used to prevent SARS-CoV-2 infection or to reduce symptoms in infected subjects [ 24 ], although specific data on anti-SARS-CoV-2 titers duration are not available.…”

“…Subsequently, some studies showed SARS-CoV-2 in BM in few cases [ 2 , 22 , 23 , 24 ], although this is not currently considered the principal source of viral transmission [ 25 ].…”

“…Already from the colostrum, the newborn receives bioactive factors, including IgA, mucins, tryptophan, lactoferrin, α-lactalbumin, and growth factors, providing immunomodulation, anti-infective protection, and promoting gut mucosal development [ 24 ].…”

“…Due to the potential effects of SARS-CoV-2 on intestinal mucosa and on the respiratory system, most authors currently recommend breastfeeding even in mothers positive for the virus, as interrupting it would be more dangerous [ 1 , 3 , 24 , 29 ].…”