Scarcity of research on breastfeeding and Ebola diseases is placing the lives of women and infants at risk: a call to specific action

Ebola virus outbreaks causing viral haemorrhagic fever occur predominantly in regions with high fertility, where breastfeeding is the only safe infant feeding option. Yet, there is a dearth of evidence to inform recommendations and decision making for breastfeeding mothers. Specific gaps in knowledge include whether or for how long replicable virus is present in breastmilk, whether mother-to-infant viral transmission can occur through breastmilk, and whether the interruption of breastfeeding would be beneficial if both mother and infant are infected. Furthermore, despite vaccine availability, there is no evidence regarding safety in mother-infant pairs. This inadequacy of evidence is long recognised, but a pathway to necessary knowledge has not previously been outlined. This Health Policy summarises existing data and delineates research priorities and methods to provide a research roadmap to protect breastfeeding women and their infants through research, rather than systematically excluding them, with the desire to protect them from theoretical risks of research in the context of Ebola.