The World Health Organization (WHO) has provided detailed guidance on the care of infants of women who are persons under investigation (PUI) or confirmed to have COVID-19. The guidance supports immediate post-partum mother-infant contact and breastfeeding with appropriate respiratory precautions. Although many countries have followed WHO guidance, others have implemented infection prevention and control (IPC) policies that impose varying levels of post-partum separation and discourage or prohibit breastfeeding or provision of expressed breast milk. These policies aim to protect infants from the potential harm of infection from their mothers, yet they may fail to fully account for the impact of separation. Global COVID-19 data are suggestive of potentially lower susceptibility and a typically milder course of disease among children, although the potential for severe disease in infancy remains. Separation causes cumulative harms, including disrupting breastfeeding and limiting its protection against infectious disease, which has disproportionate impacts on vulnerable infants. Separation also presumes the replaceability of breastfeeding-a risk that is magnified in emergencies. Moreover, separation does not ensure lower viral exposure during hospitalizations and post-discharge, and contributes to the burden on overwhelmed health systems. Finally, separation magnifies maternal health consequences of insufficient breastfeeding and compounds trauma in communities who have experienced long-standing inequities and violence, including family separation. Taken together, separating PUI/confirmed SARS-CoV-2-positive mothers and their infants may lead to excess preventable illnesses and deaths among infants and women around the world. Health services must consider the short-andlong-term impacts of separating mothers and infants in their policies.

中文翻译：

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当分离不能解决问题时：受 COVID-19 影响的母乳喂养母亲和婴儿。

世界卫生组织 (WHO) 提供了有关接受调查 (PUI) 或确诊感染 COVID-19 的女性婴儿护理的详细指南。该指南支持产后立即进行母婴接触和母乳喂养，并采取适当的呼吸道预防措施。尽管许多国家遵循了世卫组织的指导，但其他国家也实施了感染预防和控制 (IPC) 政策，强制实行不同程度的产后隔离，并阻止或禁止母乳喂养或提供挤出的母乳。这些政策旨在保护婴儿免受母亲感染的潜在危害，但它们可能未能充分考虑分离的影响。全球 COVID-19 数据表明，儿童的易感性可能较低，病程通常较轻，但婴儿期出现严重疾病的可能性仍然存在。分离会造成累积性伤害，包括扰乱母乳喂养并限制其对传染病的保护，这对脆弱的婴儿产生了不成比例的影响。分离还假定母乳喂养是可以替代的——这种风险在紧急情况下会被放大。此外，隔离并不能确保住院期间和出院后减少病毒暴露，反而会加重不堪重负的卫生系统的负担。最后，分离加剧了母乳喂养不足对产妇健康的影响，并加剧了经历了长期不平等和暴力（包括家庭分离）的社区的创伤。总而言之，将 PUI/确诊的 SARS-CoV-2 阳性母亲及其婴儿分开可能会导致世界各地婴儿和妇女出现过多的可预防疾病和死亡。卫生服务部门必须在其政策中考虑将母亲和婴儿分开的短期和长期影响。