Model of Practice, Research

Guidelines on the management of pregnant and breastfeeding women in the context of Ebola virus disease

ICM
19 February 2020

The Ebola outbreak in DRC, and other countries, continues.

WHO would be grateful if you could circulate these important new “Guidelines on the management of pregnant and breastfeeding women in the context of Ebola virus disease” . The Guidelines provide the details and evidence on caring for pregnant, childbearing and breastfeeding women during an Ebola outbreak.

https://www.who.int/news-room/detail/10-02-2020-pregnancy-and-breastfeeding-during-an-ebola-virus-outbreak

The Ebola outbreak in DRC, and other countries, continues.

There are 4 key messages:

  1. Ebola virus disease does increase the risk of miscarriage and early labour, requiring close clinical management at Ebola treatment centres. Ebola and pregnancy-related symptoms can overlap. Pregnant women should be prioritised for testing to confirm an Ebola infection.

  2. Healthcare workers must protect themselves while caring for pregnant women with Ebola virus disease. This includes during induced labour or surgical procedures, which carry greater risk of transmission in cases of acute infection. Any invasive treatments should be carried out in full personal protective equipment (PPE).

  3. WHO recommends that women with suspected or confirmed Ebola immediately stop breastfeeding and are prioritised for diagnostic testing. Any child exposed to Ebola through breast milk should be placed into safe care, closely monitored for symptoms over a 21-day period and fed with an appropriate breast milk substitute.  The guidelines strongly recommend that breastfeeding is only restarted following two consecutive negative tests of breast milk, separated by 24 hours.A breast milk substitute should be used even if infection is confirmed for both the mother and her child. Exceptions can be made for infants under 6 months of age who are already infected, if breast milk substitutes are not feasible, affordable, sustainable or safe and separation cannot be implemented safely.

  4. A disease outbreak does not change women’s and adolescent girls’ fundamental human right to sexual and reproductive healthcare, including evidence-based care during pregnancy and childbirth.