[to be localized] COVID-19: Information concerning pregnant and breastfeeding mums

Pregnancy

I am pregnant. Will it hurt the baby if I have COVID-19 during the pregnancy?

According to the CDC, at this time, there is not enough evidence to determine whether the virus is transmitted from a mother to her baby during pregnancy, or the potential impact this may have on the baby. This is currently being investigated.at this time. A small number of problems with pregnancy or delivery (e.g. preterm birth) have been reported in babies born to mothers who tested positive for COVID-19 during their pregnancy. However, it is not clear if these outcomes were actually related to maternal infection or not.

I am pregnant. Is it easier for pregnant women to become ill with COVID-19?

The Royal College of Obstetricians and Gynaecologists state that pregnant women do not appear to be more susceptible to the consequences of infection with COVID-19 than the general population. Pregnant women experience changes in their bodies that may increase their risk of some infections. It is known that with viruses from the same family as COVID-19, and other viral respiratory infections, such as influenza, women have had a higher risk of developing severe illness. This is why the CDC says it is always important for pregnant women to protect themselves from illnesses.

I am pregnant. How do I protect myself from COVID-19 during the pregnancy?

Pregnant women should do the same things as the general public to avoid infection. Please see the answer to the question How can I protect myself and others? in the section for General questions.

What if I am pregnant and meet with somebody who has the virus, will I be able to breastfeed?

Yes. Breast milk is the best nutrition for most infants. Breast milk provides protection against many illnesses. According to the Academy of Breastfeeding Medicine, WHO and the CDC, if you intend to breastfeed or provide milk to your baby, even if you have been exposed to the coronavirus or have symptoms, you are encouraged to breastfeed. If you could be infectious, you must however apply all the necessary precautions to avoid spreading the virus to your infant, including washing your hands before holding your baby, and wearing a face mask when in close contact with your baby as, for example, during direct breastfeeding.

What happens when a woman with COVID-19 gives birth?

According to AAP new guidance on July 22, 2020 regarding separation of mums and babies, it is possible for mothers with suspected or confirmed COVID-19 to room-in with their newborns when precautions are taken to protect the infants from maternal infectious respiratory secretions.
According to the CDC, if there is need for prolonged temporary separation, primarily because the mother needs medical care for herself, providing the baby with expressed breast milk is recommended. If possible, a dedicated breast pump should be provided. If it is not possible to dedicate a breast pump to a COVID-19 positive mother, the mother can use a multi user breast pump. Special care must be taken to clean and disinfect the breast pump prior to it being used by another mother. Please see the answer to the question What is the recommendation for use of Medela equipment if a mother is hospitalised due to coronavirus disease? in the section for Using breast pumps and other products questions. Johns Hopkins Medicine states that once the mother’s symptoms improve and she and her baby are ready to be discharged home, it is possible for her to either continue using expressed breast milk or to breastfeed, taking the necessary precautions to avoid spreading the virus to her infant. These include washing hands before holding her baby, and wearing a face mask when in close contact with her baby.

Breastfeeding

Can I breastfeed if I am diagnosed with COVID-19?

UNICEF, the Academy of Breastfeeding Medicine, WHO and the CDC state that considering the benefits of breastfeeding and the insignificant role of breast milk in the transmission of other respiratory viruses, the mother can continue breastfeeding, while applying all the necessary precautions. There is limited evidence for the presence of viral RNA in breast milk, while there is neither evidence for active virus in breast milk nor transmission via breast milk.  Currently, the primary concern is not whether the virus can be transmitted through breast milk, but rather whether an infected mother can transmit the virus through respiratory droplets during the period of breastfeeding. Precautions to avoid spreading the virus to your infant include washing hands before holding your baby, and wearing a face mask when in close contact with your baby as, for example, during direct breastfeeding. Consult with your health care provider if you have questions or concerns.

Recent research has shown specific benefits of providing breast milk relevant to the COVID-19 situation. Researchers in China and in USA have recently found antibodies against the new coronavirus in the milk of mothers who had previously had COVID-19, further supporting the recommendation to continue breastfeeding.

Can COVID-19 be transmitted through breast milk?

UNICEF, the Academy of Breastfeeding Medicine, WHO and the CDC report that the limited studies on breastfeeding women with COVID-19 and other coronavirus infections have not detected the virus in breast milk.  There is limited evidence for the presence of viral RNA in breast milk, while there is neither evidence for active virus in breast milk nor transmission via breast milk. Currently, the primary concern is not whether the virus can be transmitted through breast milk, but rather whether an infected mother can transmit the virus through respiratory droplets. Precautions to avoid spreading the virus to the infant include the mother washing hands before holding her baby, and wearing a face mask when in close contact with her baby. Consult with your health care provider if you have questions or concerns.

Recent research has shown specific benefits of providing breast milk relevant to the COVID-19 situation. Researchers in China and in USA have recently found antibodies against the new coronavirus in the milk of mothers who had previously had COVID-19, further supporting the recommendation to continue breastfeeding.

Should mothers with COVID-19 be separated from their infants while infected with the virus and provide their babies expressed breast milk instead of feeding them directly at the breast?

The American Academy of Pediatrics (AAP) has issued a new guidance on July 22, 2020 regarding separation of mums and babies, based on the latest evidence. It is possible for mothers with suspected or confirmed COVID-19 to room-in with their newborns when precautions are taken to protect the infants from maternal infectious respiratory secretions.

As stated by UNICEF, the Academy of Breastfeeding Medicine, WHO and the CDC, if the mother and baby are able to remain together, breastfeeding at the breast is encouraged. Currently, the primary concern is not whether the virus can be transmitted through breast milk, but rather whether an infected mother can transmit the virus through respiratory droplets. Therefore, the CDC recommends the mother wear a mask and use good hand hygiene before and after breastfeeding. 

Is breastfeeding safe considering the risk that I could get COVID-19? Should I switch to formula?

UNICEF states that breastfeeding is the safest, most reliable method of infant feeding in an emergency. An article in the Harvard Medical School Trends in Medicine mentions that given the risk that COVID-19 can spread through formula manufacturer factories and delivery warehouses, there is a risk of supply chain interruption if these factories and warehouses need to shut down. 

Recent research has shown specific benefits of providing breast milk relevant to the COVID-19 situation. Researchers in China and in USA have recently found antibodies against the new coronavirus in the milk of mothers who had previously had COVID-19, further supporting the recommendation to continue breastfeeding.

Considering the benefits of breastfeeding and the current evidence of the insignificant role of breast milk in the transmission of other respiratory viruses, as stated by UNICEF, the Academy of Breastfeeding Medicine, WHO and the CDC, you can continue breastfeeding. 

If I have COVID-19 and am too unwell to breastfeed or have been separated from my baby for a period of time, can I restart breastfeeding?

If you have been separated from your baby for a period of time and breastfeeding has been interrupted, re-establishing lactation when you are together with your baby again is generally possible and worth trying even if a return to full breastfeeding is not always achievable. The UNICEF UK guidelines can help you to re-establish your milk supply and continue breastfeeding. This is called re-lactation. 

The WHO and UNICEF UK recommend the following essential measures for management of breastfeeding for re-lactation:

• Start actions to increase hormonal response, including plenty of skin-to-skin contact, nuzzling at the breast and breast massage. 
• Breast massage and hand/pump expression (8-10 times in 24 hours) may help when separated from baby or in-between feeds 
• The baby should suckle frequently from both breasts at least 8-12 times in 24 hours, at least 15 minutes on each breast. Consider night feeds. 
• Try having the baby also at the breast while pumping. 
• The baby should be well attached to the breast for effective suckling and to avoid nipple trauma. 
• Monitor baby's stool and urine output 
• Contact an Infant Feeding Specialist to receive additional guidance and support to re-establish your milk production and control your baby's growth. 

Using breast pumps and other products

What are the storage guidelines for breast milk if I have COVID-19?

The Academy of Breastfeeding Medicine states that although it is still unknown whether mothers with COVID-19 can transmit the virus via breast milk, limited studies on breastfeeding women with COVID-19 and other coronavirus infections have not detected the virus in breast milk. From that perspective, you can follow the regular breast milk storage guidelines (ABM and HMBANA).

If you have expressed breast milk cleanly and safely, you can store it at room temperature, in the fridge, or in the freezer, depending on how soon you want to use it.

* Very clean conditions means rigorously following the guidance in our article on cleaning and sanitising your breast pump and those of the CDC. These guidelines for storing and defrosting breast milk are a recommendation – contact your lactation consultant or breastfeeding specialist for further information.

If your baby is in a neonatal intensive care unit (NICU) or special care ward, your hospital may have stricter recommendations for cleaning and storage.

If you’re refrigerating or freezing expressed milk, always label the bottles or bags with the amount and the date it was pumped, so you can track and manage your stored milk.

Can NICU infants receive donor milk? Is this safe regarding COVID-19?

The limited studies on breastfeeding women with COVID-19 and other coronavirus infections have not detected the virus in breast milk. It is not known whether mothers with COVID-19 can transmit the virus via their breast milk.

Donor human milk is pasteurised in most countries and it is known that other coronaviruses are destroyed by pasteurisation. However, at the moment there is no evidence to inform whether the virus causing COVID-19, SARS-CoV-2, (if present) would be similarly destroyed.

Further information is available from in the European Milk Bank Association position statement and the Human Milk Banking Association of North America.

Could I get COVID-19 from a contaminated rental pump?

Trained employees perform the cleaning and servicing of rental pumps. The pumps are cleaned with water and soap and then disinfected before they can be used by another mother. There are many disinfectants, including commonly used hospital disinfectants, that are active against enveloped viruses, like the new coronavirus. Currently WHO recommendations include the use of:

• 70% ethanol to disinfect reusable dedicated equipment (e.g., thermometers) between uses
• Sodium hypochlorite at 0.5% (equivalent 5000ppm) for disinfection of frequently touched surfaces in homes or healthcare facilities

Alcohol-based disinfectants are approved for Symphony and have proven effective against SARS-CoV-2.

When using a breast pump to express breast milk, whether it is a rental pump or a store bought personal use pump, wash your hands before touching any pump or bottle parts and follow the CDC recommendations for proper pump kit cleaning after each use.

When it is time to return the Symphony pump to the rental station, please kindly disinfect the pump and the case using an alcohol-based disinfectant.

What is the recommendation for use of Medela equipment if a mother is hospitalised due to Coronavirus disease?

According to the Academy of Breastfeeding Medicine, mothers who intend to breastfeed / continue breastfeeding should be encouraged to express their breast milk to initiate and build / maintain milk supply. If possible, a dedicated breast pump should be provided by the hospital. Prior to expressing breast milk, before touching any pump or bottle parts, mothers should wash their hands appropriately and take the necessary precautions such as wearing a face mask for at least 5-7 days until cough and respiratory secretions are dramatically improved. After each pumping session, all parts that come into contact with breast milk should be thoroughly washed following hospital recommendations for proper pump kit cleaning and the exterior of the entire pump should be properly disinfected using 70% ethanol or another alcohol-based disinfectant that is active against SARS-CoV-2.

How long is Coronavirus stable on surfaces such as pumps/kits/accessories?

According to a new study from National Institutes of Health, CDC, UCLA and Princeton University scientists in The New England Journal of Medicine the authors found that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detectable as follows:

How should I clean my pumping equipment if I have COVID-19?

When using a breast pump to express breast milk, wash your hands before touching any pump or bottle parts and follow the CDC recommendations for proper pump kit cleaning after each use.  Recommendations encourage that someone who is not sick feed the expressed breast milk to the infant.

Is it still safe to use Medela 24-hour pump kits following manufacturer guidance to wash and dry between each use?

Medela one-day pump kits are single user products. As they are not used by more than one person there is no risk of cross contamination from multiple users. A new Symphony One-Day Pump Set is required after a maximum of 8 pumping sessions within 24 hours or after 24 hours.

When pumping breast milk, wash your hands before touching any pump or bottle parts and follow the CDC recommendations for proper pump kit cleaning after each use.

What is the recommendation for using reusable pump sets during the pandemic?

It is wise to take a single user approach. Use by more than one mother without adequate reprocessing may be a health risk and could cause cross-contamination.

Can I use cold water sterilisation such as Milton for sanitising my breastfeeding equipment?

Milton Fluid is made of an aqueous solution of sodium hypochlorite and 16.5% sodium chloride. It is suitable for sanitising breastfeeding equipment and feeding devices. According to the manufacturer it is effective on Coronavirus. Virucidal proof of efficacy according to European norms: in 15 minutes NF T72-180 - effective on Rotavirus and Coronavirus.

To sanitise infant feeding and breastmilk equipment immersion for a minimum period of 15 minutes is required as per manufacturer's instructions. However, Medela products have not been validated for cold wated sterilisation.

Will Medela be able to supply products? Will there be a plentiful supply of milk collection sets?

We are carefully managing our entire supply chain and have built a dedicated COVID-19 team continuously assessing the situation and working with our suppliers and partners to ensure timely delivery of our products and continued safe manufacturing. While some delays of individual products can currently not be ruled out, we are presently not expecting any major impact on our ability to supply our customers with the desired products. The situation remains of course very dynamic and we will be updating this information as needed.

How is Medela rental equipment safely used when in isolation at home due to Coronavirus disease?

• If you have rented a Symphony pump for use at home, please note that all pumps are cleaned with water and soap and then disinfected with commonly used disinfectants that are active against coronaviruses.
• When using a breast pump to express breast milk, whether it is a rental pump or a store-bought personal use pump, wash your hands before touching any pump or bottle parts and follow the CDC recommendations for proper pump kit cleaning after each use.  Recommendations encourage that someone who is not sick feed the expressed breast milk to the infant.
• If you are returning a rental pump to the rental station, please kindly disinfect the pump and the case using an alcohol-based disinfectant.

I have an underlying medical condition and have been advised to self isolate but am expressing for my NICU baby. What can I do?

Congratulations on continuing to express breast milk for your NICU infant!

The Academy of Breastfeeding Medicine recommends that prior to expressing breast milk, before touching any pump or bottle parts, you should wash your hands appropriately and take the necessary precautions, such as wearing a face mask for at least 5-7 days until cough and respiratory secretions are dramatically improved. After each pumping session, all parts that come into contact with breast milk should be thoroughly washed following the CDC recommendations for proper pump kit cleaning and the exterior of the entire pump should be properly disinfected using 70% ethanol or another disinfectant that is active against coronavirus.

Your hospital’s neonatal intensive care unit (NICU) may provide you with collection containers to express and store your expressed breast milk.  Clean containers made of food-grade, BPA free, hard plastic or glass are acceptable for the storage of human milk. Containers should have leak proof lids. You should follow the breast milk storage guidelines for NICU and High Risk Infants (HMBANA) or those directed by your NICU. Follow your NICU’s guidelines for labelling your expressed milk.

Expressed breast milk should be refrigerated or frozen as soon as it is collected. Ensure collected milk remains at the either refrigerated or frozen state while transporting to the NICU. Place containers in an insulated container, appropriate for transport, with frozen gel packs.  Frozen gel packs are more suitable than ice cubes to keep milk cold or frozen.  

Can drip milk from Breast Shells be used?

The Medela Breast Shells are helpful breastfeeding products designed for breastfeeding women who have sore nipples or leaky breasts. They protect sore nipples from further chafing and allow for collection of milk leaking between feedings.  Milk collected in the shells should be discarded and not fed to the baby.

I am symptomatic in hospital and need to express for my preterm infant. Can I do this?

Yes. According to the Academy of Breastfeeding Medicine, WHO and the CDC if you have COVID-19 and intend to breastfeed or provide milk to your baby, you are encouraged to express your milk to initiate, build and maintain your milk supply. UNICEF UK states that promotion, protection and support of breastfeeding should continue for all sick and preterm babies either in transitional or neonatal care. According to Professor Paula Meier and Associate Professor Aloka Patel, in the NICU, mother’s milk is even more important because it reduces the risk of all types of infections.

Recent research has shown specific benefits of providing breast milk relevant to the COVID-19 situation. Researchers in China and in USA have recently found antibodies against the new coronavirus in the milk of mothers who had previously had COVID-19, further supporting the recommendation to continue breastfeeding.

We recommend that you discuss with the hospital staff and follow your NICU's specific recommendations and policies on milk expression, labelling, refrigerating or freezing breast milk and transporting it to the NICU.

Please also see the answer to the question Can I use the hospital's pump / a rental pump if I have COVID-19? in the section for Using breast pumps and other products questions.

Does a dishwasher destroy the virus on milk collection sets for expressing mums?

While we still do not know much about this new coronavirus, SARS-CoV-2, most other viruses are believed to be deactivated at boiling temperatures. When using a breast pump to express breast milk, wash your hands before touching any pump or bottle parts and follow the CDC recommendations for proper pump kit cleaning after each use.

For extra germ removal, sanitise pump parts at least once daily after they have been cleaned. Items can be sanitised using steam, boiling water, or a dishwasher with a sanitise setting.

I want to use a disposable kit for my rental Symphony. Can I purchase a hospital kit?

No. The disposable pumping kits are hospital products and are not sold in retail.

Can I purchase the disposable hospital Symphony kits for use with my Medela personal use pump at home?

No. The hospital Symphony pumping kit is only compatible with the Symphony pump.

The Calma bottle/ nipple shields /feeding devices / pacifiers are to be washed after use. Can they be sanitised more frequently?

Infant feeding devices, bottles, teats and pacifiers should be cleaned after use following the CDC cleaning recommendations for infant feeding items.

For extra germ removal, at least once daily after the items have been cleaned, items should be sanitised using steam, boiling water, or a dishwasher with a sanitise setting.

If your baby is hospitalised, follow your health care provider’s instructions for cleaning infant feeding items.

Does boiling pump accessories in water kill coronavirus?

While we still do not know much about COVID-19, most other viruses are believed to be deactivated at boiling temperatures. When using a breast pump to express breast milk, wash your hands before touching any pump or bottle parts and follow the CDC recommendations for proper pump kit cleaning after each use.

For extra germ removal, sanitise pump parts, wash basin, and bottle brush at least once daily after they have been cleaned. Items can be sanitised using steam, boiling water, or a dishwasher with a sanitise setting.

Is dry air storage of pumping accessories between expressions safe?

Yes. After each pumping session, all parts that come into contact with breast milk should be thoroughly washed following CDC recommendations for proper pump kit cleaning which state that clean pump parts, bottle brushes and wash basins should be allowed to air-dry thoroughly before storing to help prevent germs and mould from growing. Once completely dry, the items should be stored in a clean, protected area to prevent contamination during storage.

Can I bring milk pumped at home into the NICU for my baby?

Breast milk is the best source of nutrition for most infants and provides protection against many illnesses. But, as the CDC notes, there is much unknown about COVID-19 virus.

The Academy of Breastfeeding Medicine states that in limited studies on women with COVID-19 and another coronavirus infection, the virus has not been detected in breast milk. It is important to observe rigorous cleaning practices when using a breast pump to express breast milk, wash your hands before touching any pump or bottle parts and follow the CDC recommendations for proper pump kit cleaning after each use.

We recommend that you look at the CDC’s guidance and follow your NICU recommendations and policies regarding labelling, refrigerating or freezing breast milk and transporting it to the NICU.

Is it safe to share a Symphony pump with other mums if I don't have one that is dedicated at my bedside?

Symphony pumps are designed to be used by multiple mothers. The pumps are cleaned and disinfected by the hospital staff before they can be used by another mother. In addition, when using a breast pump to express breast milk, wash your hands before touching any pump or bottle parts and follow the CDC recommendations for proper pump kit cleaning after each use.

General

How can I protect myself and others?

Official bodies like WHO and UNICEF recommend

• washing our hands frequently and thoroughly with water and soap or sanitiser and avoiding close contact with people who are ill. Furthermore, not touching your eyes, nose and mouth with unwashed hands
• catching coughs and sneezes in a tissue, binning it in a sealed waste bin and washing your hands as all this helps minimise the risk of infection and disease spreading.
• avoid shaking hands, hugging or kissing people while greeting.
• avoiding close contact with people who are obviously ill.
• social distancing (keep enough distance to other people).
• stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.

How do I protect my baby against COVID-19?

Breast milk is the best source of nutrition for most infants, and provides protection against many illnesses. But, as the CDC notes, there is much unknown about this virus. If you are pregnant or breastfeeding, we recommend that you look at the CDC’s guidance and connect with your healthcare provider if you have any specific concerns.

• Clean hands often using soap and water or alcohol-based hand sanitiser
• Avoid people who are sick (coughing and sneezing)
• Clean and disinfect high-touch surfaces daily in household common areas (e.g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks)
• Launder items including washable plush toys as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from an ill person can be washed with other people’s items.

A complete review of the CDC guidelines regarding COVID-19 can be found at: www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-guidance-breastfeeding.html.

In addition, UNICEF's recommendations can be found at:
www.unicef.org/stories/novel-coronavirus-outbreak-what-parents-should-know

Consult with your health care provider if you have further questions or concerns.

How does Coronavirus (COVID-19) spread?

Much is still unknown about how the disease is spread. UNICEF, CDC and WHO state that person-to-person spread occurs mainly by breathing in respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory pathogens spread. These respiratory droplets also land on objects or surfaces and people touching surfaces contaminated with the virus can get infected by touching their eyes, nose or mouth with their contaminated hands. The COVID-19 virus may survive on surfaces for several hours, but simple disinfectants can kill it.

What are the symptoms of a coronavirus infection?

The main symptoms include

• fever (>37.8 °C / >100.0 °F),
• cough, i.e. acute (newly developed) cough and/or
• shortness of breath or breathing difficulties and/or tiredness

For Healthcare Professionals

What should Healthcare professionals inform mothers about cleaning their pumps at home (Symphony or retail pumps) during the pandemic?

The Symphony is a multi-user, hospital grade breast pump used in in-patient, out-patient, and home settings and is designed to be used by multiple mothers. Symphony pumps are available for rent at pharmacies/rental stations and are serviced, cleaned and disinfected before they can be used by another mother.

Personal use pumps such as Freestyle Flex or Pump-in-Style are designed to be used by only one mother. For performance issues and hygienic or possible contamination concerns these should not be shared between mothers. Think of a toothbrush, it is also a personal use device.

While using either a multi-user or personal use breast pump, after each pumping session, all parts that come into contact with breast milk should be thoroughly washed following the CDC recommendations for proper pump kit cleaning.

What are the recommendations for handling containers of human milk after milk is expressed by COVID-19 positive or suspected positive mothers in the hospital setting?

Bottle transfer technique

For full details please go to the HMBANA website

• During routine care, the nurse who cares for the mother performs hand hygiene and dons personal protective equipment.
• The nurse picks up the milk storage container(s) with one clean, gloved hand and opens the patient’s door with their other hand.
• The nurse simply drops the bottles into a clean storage bag being held open by a second “clean” nurse who is standing outside of the room.
• The "clean" nurse transports the bag to the nursery or caregiver for use.

HMBANA recommends that if your hospital’s infection control team requires additional precautions, the aseptic milk transfer technique be used to safely transfer milk to a new storage container. Please note, the bottle transfer technique is the preferred method to protect the quantity and quality of mother’s milk (e.g. potential fat loss when transferring colostrum).

Aseptic milk transfer technique

If your infection control team requires additional precautions, you may transfer milk from the original container into a new, clean container. This technique may be performed by one healthcare provider in the patient’s room. Please refer to the HMBANA website for detailed infographic.

• Before entering the mother's room, pack one large plastic storage bag with clean supplies. Perform hand hygiene and don personal protective equipment before entering room. Place bag on counter or table.
• Disinfect a workspace (bedside table or counter). Create “original” field. Open large plastic bag that contains new storage containers, but leave the containers inside. Perform hand hygiene and don new gloves. Create “new” (clean) field.
• Use clean paper towel from the new field to remove the cap from the mother's original bottle. Use paper towel to grab original bottle and pour contents into new, clean bottle. If milk volume is small, transfer milk into an oral feeding syringe.
• Transport clean storage bag with new milk storage containers to neonatal unit. Storage containers do not require any additional precautions. Do not apply chemical disinfectant to milk storage containers.

Chemical Disinfection

HMBANA recommends that it is unnecessary and unsafe to apply chemical disinfectants to milk storage containers. Hospital disinfectants provide broad antimicrobial action on medical equipment and high touch surfaces. Human milk containers, like other patient nutrition items, are NOT high touch surfaces. Generally speaking, disinfectants contain EPA registered labels that prohibit their use on food or food contact surfaces. HMBANA supports the CDC’s guidance, which instructs hospitals to use disinfectants on high touch surfaces (e.g. bed rails, IV pumps) and to clean food contact surfaces with routine sanitation procedures. If your infection control team requires the use of a chemical disinfectant, work with your nutrition and environmental health departments to identify a disinfectant that is safe to use on food contact surfaces.

Follow manufacturer’s guidelines for use. Some chemical disinfectants require a water rinse after application. High or intermediate concentrations of sodium hypochlorite (0.1%-0.5% bleach solution) should never be used on food contact surfaces.

Symphony cleaning and disinfecting instructions for home rental

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Symphony cleaning and disinfecting instructions for hospitals

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What disinfectants are approved for use with Symphony and have been proven effective against the virus causing COVID-19?

Most surface disinfectants for medical devices do not cause mechanical damage to the Symphony. The instructions and safety information of the supplier of surface disinfectants for medical devices must always be followed. Medela recommends using an alcohol-based surface disinfectant agent (minimum 70% alcohol or as per EPA guidance on disinfectants for use against SARS-CoV-2).

The following disinfectants are approved for Symphony and have proven effective against SARS-CoV-2 according to their manufacturers and/or available research. Availability may vary depending on your location.

• Meliseptol^® rapid (B. Braun)
• Hexaquart (B. Braun)
• Incidin™ Foam (Ecolab)
• perform^® (Schülke)
• CaviCide1 (Metrex)
• PDI^® Sani Cloth^® cleaner and/or wipes
• Isopropyl alcohol
• Hydrogen Peroxide 3% liquid or wipes
• Soap and water

The list of cleaning agents identifies which agents have been evaluated for cleaning compatibility with Symphony. Cleaning agents that have not been evaluated or have not passed material compatibility testing could have an unknown or harmful impact if used on the Symphony surface. Impacts may include degrading cosmetic or functional performance, damaging device surfaces or labels, causing immediate equipment failure or even causing longer term latent failures.