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Aşcı Ö, Demirgöz Bal M, Ergin A. The breastfeeding experiences of COVID-19-positive women: A qualitative study in Turkey. Jpn J Nurs Sci 2021; 19:e12453. [PMID: 34476899 PMCID: PMC8646522 DOI: 10.1111/jjns.12453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/13/2021] [Accepted: 07/29/2021] [Indexed: 01/04/2023]
Abstract
Aim The aim of the study was to determine the breastfeeding experiences of COVID‐19‐positive women. Methods This was a qualitative study of 14 women diagnosed with COVID‐19. One‐to‐one telephone interviews were conducted and recorded. The data were analyzed thematically. Results Three main themes were identified. Theme 1 was “increased emotional load,” outlining the emotional effects of the disease in the women, such as feeling sad and inadequate, in addition to anxiety and fear. Theme 2 was “breastfeeding during the disease,” which illustrated the effects of the treatment process on the women, the disease‐related symptoms, their influence on breastfeeding attitudes and behavior, and the effects of social media and television. Theme 3 was “perceived social support and need,” defining the social support perceived and expected by the women during isolation with needs. Conclusion Women who could not get the professional support they expected had to face the difficult choice between taking medical treatment and breastfeeding. Many women refused drug treatment for COVID‐19 and continued to breastfeed with all the resultant emotional and physical difficulties, as they believed in the benefits of mother's milk. The experiences of the women were discussed with an approach that enabled developing health care services further. It was concluded that Turkish health care professionals need to develop an evidence‐based and female‐centered approach for COVID‐19 management in breastfeeding women.
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Affiliation(s)
- Özlem Aşcı
- Division of Midwifery, Niğde Ömer Halisdemir University, Niğde Zübeyde Hanım School of Health, Niğde, Turkey
| | - Meltem Demirgöz Bal
- Faculty of Health Sciences, Division of Midwifery, Marmara University, Istanbul, Turkey
| | - Ayla Ergin
- Faculty of Health Sciences, Division of Midwifery, Kocaeli University, Kocaeli, Turkey
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152
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Kostenzer J, Hoffmann J, von Rosenstiel-Pulver C, Walsh A, Zimmermann LJ, Mader S. Neonatal care during the COVID-19 pandemic - a global survey of parents' experiences regarding infant and family-centred developmental care. EClinicalMedicine 2021; 39:101056. [PMID: 34401688 PMCID: PMC8355909 DOI: 10.1016/j.eclinm.2021.101056] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic restrictions affect provision and quality of neonatal care. This global study explores parents' experiences regarding the impact of the restrictions on key characteristics of infant and family-centred developmental care (IFCDC) during the first year of the pandemic. METHODS For this cross-sectional study, a pre-tested online survey with 52 questions and translated into 23 languages was used to collect data between August and November 2020. Parents of sick or preterm infants born during the pandemic and receiving special/intensive care were eligible for participation. Data analysis included descriptive statistics and statistical testing based on different levels of restrictive measures. FINDINGS In total, 2103 participants from 56 countries provided interpretable data. Fifty-two percent of respondents were not allowed to have another person present during birth. Percentages increased with the extent of restrictions in the respondents' country of residence (p = 0·002). Twenty-one percent of total respondents indicated that no-one was allowed to be present with the infant receiving special/intensive care. The frequency (p < 0·001) and duration (p = 0·001) of permitted presence largely depended on the extent of restrictions. The more restrictive the policy measures were, the more the respondents worried about the pandemic situation during pregnancy and after birth. INTERPRETATION COVID-19 related restrictions severely challenged evidence-based cornerstones of IFCDC, such as separating parents/ legal guardians and their newborns. Our findings must therefore be considered by public health experts and policy makers alike to reduce unnecessary suffering, calling for a zero separation policy. FUNDING EFCNI received an earmarked donation by Novartis Pharma AG in support of this study.
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Affiliation(s)
- Johanna Kostenzer
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
| | - Julia Hoffmann
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
| | | | - Aisling Walsh
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
| | - Luc J.I. Zimmermann
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
- Department of Paediatrics, Research School Oncology and Development, Maastricht UMC+, Maastricht, the Netherlands
| | - Silke Mader
- European Foundation for the Care of Newborn Infants (EFCNI), Scientific Affairs, Hofmannstrasse 7A, Munich 81379, Germany
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153
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Indrio F, Pettoello Mantovani M, Salatto A, Rinaldi M, Nadia Dargenio V, Cristofori F, Marchese F, Paolo Bianchi F, Nappi L, Maffei G. Retrospective Study on Breastfeeding Practices by SARS-COV-2 Positive Mothers in a High Risk Area for Coronavirus Infection. Turk Arch Pediatr 2021; 56:479-484. [PMID: 35110118 PMCID: PMC8849628 DOI: 10.5152/turkarchpediatr.2021.21156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND During the pandemic of SARS-Cov-2, among other clinical and public health issues, a major concern raised by SARS-CoV-2 is the possibility of transmission of the infection from mother to child in the perinatal period. This has placed a question mark on the safety of breastfeeding, with ambiguity on the joint management of SARS-CoV-2 positive or suspected mothers and their children. It was aimed to evaluate breastfeeding rates for newborns of asymptomatic SARS-CoV-2 positive mothers who were temporarily separated from their babies at birth, compared to those who were not separated. RESULTS Babies who were not isolated from their mothers at delivery were significantly more likely to be breastfed and were at no higher risk of infection with SARS-CoV-2. CONCLUSION Following the World Health Organization (WHO) recommendations and strict hand and mask hygiene measures, breastfeeding practices can be established and maintained through rooming-in, thus promoting the mother-child bond without compromising the safety of the newborn.
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Affiliation(s)
- Flavia Indrio
- Department of Medical and Surgical Science, University of Foggia, Italy,Corresponding author:Flavia Indrio ✉
| | | | - Alessia Salatto
- Department of Medical and Surgical Science, University of Foggia, Italy
| | - Matteo Rinaldi
- Department of Neonatology and NICU, Ospedali Riuniti, Foggia, Italy
| | - Vanessa Nadia Dargenio
- Department of Medical and Surgical Science, University of Foggia, Italy,Department of Biomedical Sciences and Human Oncology, “A. Moro” University, Bari, Italy
| | - Fernanda Cristofori
- Department of Biomedical Sciences and Human Oncology, “A. Moro” University, Bari, Italy
| | - Flavia Marchese
- Department of Medical and Surgical Science, University of Foggia, Italy
| | | | - Luigi Nappi
- Department of Medical and Surgical Science, University of Foggia, Italy
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154
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Aragona E, West D, Loyal J. Well-Newborn Unit Director Experiences During the COVID-19 Pandemic: A BORN Study. Hosp Pediatr 2021; 11:e170-e181. [PMID: 34376484 DOI: 10.1542/hpeds.2021-005862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND As coronavirus disease 2019 (COVID-19) spread across the country, well-newborn unit medical directors developed newborn care plans as guidelines and evidence evolved. We chose to examine approaches to newborn care during these early phases of the COVID-19 pandemic. METHODS An electronic survey was administered to well-newborn unit directors in a national network of US well-newborn units in May 2020. Respondents were asked about their approaches to testing, infection prevention, routine newborn care, discharge planning, breastfeeding, rounding, and teaching. RESULTS Of 107 sites, 65 (61%) respondents completed the survey. Respondents estimated a 1% positivity rate of 1198 newborns tested for COVID-19. Most sites (86%) performed universal maternal COVID-19 testing, and most (82%) tested newborns of COVID-19-positive mothers at 24 hours of life (75%). Infection prevention and visitation policies varied. Of respondents, in COVID-19-positive mothers, 28% permitted no visitors, 54% recommended rooming-in with the newborn, 55% encouraged breastfeeding at the breast, 38% deferred routine circumcisions of the newborn, 74% initiated immediate bathing of the newborn, 68% continued standard newborn screening, and 55% modified newborn follow-up plans. Medical directors reported adjustments to rounding and teaching workflow. Content analysis of free-text responses revealed themes related to challenges with changing recommendations, discomfort with mother-infant separation recommendations, innovations, and stress management. CONCLUSIONS Well-newborn units quickly adopted universal maternal testing and testing of exposed newborns. Despite guidelines, we identified variation in the care of newborns of COVID-19-positive mothers. Further investigation of these differences and newborn outcomes is warranted to develop best practices.
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Affiliation(s)
- Elena Aragona
- Department of Pediatrics, Yale University, New Haven, Connecticut
| | - Dennis West
- Academic Pediatric Association, McLean, Virginia
| | - Jaspreet Loyal
- Department of Pediatrics, Yale University, New Haven, Connecticut
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155
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Geddes DT, Gridneva Z, Perrella SL, Mitoulas LR, Kent JC, Stinson LF, Lai CT, Sakalidis V, Twigger AJ, Hartmann PE. 25 Years of Research in Human Lactation: From Discovery to Translation. Nutrients 2021; 13:3071. [PMID: 34578947 PMCID: PMC8465002 DOI: 10.3390/nu13093071] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023] Open
Abstract
Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.
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Affiliation(s)
- Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Sharon Lisa Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Leon Robert Mitoulas
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
- Medela, AG, Lättichstrasse 4b, 6340 Baar, Switzerland
| | - Jacqueline Coral Kent
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Lisa Faye Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Vanessa Sakalidis
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | | | - Peter Edwin Hartmann
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
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156
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Muñoz-Amat B, Pallás-Alonso CR, Hernández-Aguilar MT. Good practices in perinatal care and breastfeeding protection during the first wave of the COVID-19 pandemic: a national situation analysis among BFHI maternity hospitals in Spain. Int Breastfeed J 2021; 16:66. [PMID: 34454539 PMCID: PMC8402959 DOI: 10.1186/s13006-021-00407-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the positive effects of good clinical quality standards in perinatal care and breastfeeding support for women, newborns and families have been already demonstrated, many of these practices were disrupted during the COVID-19 pandemic. The objective of this study was to analyse the impact of the COVID-19 pandemic on perinatal care and breastfeeding support practices offered by the Spanish maternity hospitals committed to the UNICEF Baby-friendly Hospital Initiative (BFHI), to women with and without COVID-19. METHODS Implementation of perinatal practices was assessed by a cross-sectional survey conducted in May 2020 using an online questionnaire. Comparison with pre-pandemic situation and level of commitment to BFHI practices was performed. RESULTS Response rate was 50% (58/116). Mothers with COVID-19 suffered greater restrictions in the practices compared to women without COVID-19, with lower rates of companion of choice during labour (84% vs 100%; p = 0.003), skin-to-skin contact (32% vs 52%; p = 0.04), rooming-in (74% vs 98%; p < 0.001), companion of choice during hospital stay (68% vs 90%; p = 0.006), and breastfeeding support (78% vs 94%; p = 0.02). Practices were significantly less prevalent in COVID-19 mothers compared to pre-pandemic situation. A lower accompaniment rate was observed in non-COVID-19 group during delivery (24% vs 47.9%; p < 0.01). Hospitals with higher commitment to BFHI practices reported higher rates of skin-to-skin contact (45.2% vs 10.5%; p = 0.01) and rooming-in (83.9% vs 57.9%; p < 0.05) in COVID mothers. Fewer restrictions were observed in hospitals located in the regions where the pandemic hit harder. In these regions there was a significantly higher level of BFHI commitment of the hospitals, but no significant differences were observed in the average size of the hospital. All the practices suffered even more restrictions during the first weeks of the pandemic. CONCLUSION All mothers suffered restrictions in perinatal care during the COVID-19 pandemic. Women with COVID-19 infection suffered more restrictions in perinatal practices than women without infection. The degree of commitment to WHO-UNICEF perinatal quality standards, integrated into the BFHI, was associated with maintenance of good clinical practices.
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Affiliation(s)
- Barbara Muñoz-Amat
- Neonatal Intensive Care Department, 12 de Octubre University Hospital, Madrid, Spain.
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157
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Piankusol C, Sirikul W, Ongprasert K, Siviroj P. Factors Affecting Breastfeeding Practices under Lockdown during the COVID-19 Pandemic in Thailand: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168729. [PMID: 34444479 PMCID: PMC8391455 DOI: 10.3390/ijerph18168729] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
A COVID-19 lockdown and restrictive order has had a large impact on the lives of people. This cross-sectional study was conducted to identify factors affecting breastfeeding among mothers living in Thailand during the lockdown. Data were collected from 903 mothers with infants ages 0–12 months from 17 July 2020 to 17 October 2020 after the first nationwide COVID-19 lockdown period by an online platform and interview questionnaire survey. Multivariable logistic regression analysis was used to investigate the association between the effect of lockdown and breastfeeding practices with potential confounder adjustment including maternal age, ethnicity, newborn age <6 months, family income below $16,130 per annum, education below undergraduate level, and working status. Mothers changed breastfeeding practices in this period (n = 39, 4.32%) including having changed from exclusive breastfeeding to combined breastfeeding with formula milk (n = 22, 2.44%), and having reduced the frequency when compared to before the pandemic (n = 13, 1.44%). The associated factors of changing breastfeeding practices were “contact with healthcare services” (aOR = 0.46, 95% CI 0.22 to 0.96, p = 0.04), “infant feeding support from health personnel” (aOR = 0.39, 95% CI 0.16 to 1.94, p = 0.035), and “lack family support and help with feeding your baby after lockdown” (aOR = 7.04, 95% CI 1.92 to 25.84, p = 0.003). In conclusion, this study showed a slight decrease in breastfeeding in the sampled mothers during the COVID-19 lockdown in Thailand. A long-term national surveillance system for maintenance of breastfeeding should be established. Health care service interventions and additional information are needed to support mothers and families for breastfeeding during pandemics.
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158
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Fry HL, Levin O, Kholina K, Bianco JL, Gallant J, Chan K, Whitfield KC. Infant feeding experiences and concerns among caregivers early in the COVID-19 State of Emergency in Nova Scotia, Canada. MATERNAL & CHILD NUTRITION 2021; 17:e13154. [PMID: 33619906 PMCID: PMC7995067 DOI: 10.1111/mcn.13154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/24/2020] [Accepted: 01/20/2021] [Indexed: 11/28/2022]
Abstract
The global emergency caused by the novel coronavirus (COVID-19) pandemic has impacted access to goods and services such as health care and social supports, but the impact on infant feeding remains unclear. Thus, the objective of this study was to explore how caregivers of infants under 6 months of age perceived changes to infant feeding and other food and health-related matters during the COVID-19 State of Emergency in Nova Scotia, Canada. Four weeks after the State of Emergency began, between 17 April and 15 May 2020, caregivers completed this online survey, including the Perceived Stress Scale. Participants (n = 335) were 99% female and mostly White (87%). Over half (60%) were breastfeeding, and 71% had a household income over CAD$60,000. Most participants (77%) received governmental parental benefits before the emergency, and 59% experienced no COVID-19-related economic changes. Over three quarters of participants (77%) scored moderate levels of perceived stress. Common themes of concern included social isolation, COVID-19 infection (both caregiver and infant), and a lack of access to goods, namely, human milk substitutes ('infant formula'), and services, including health care, lactation support, and social supports. Most COVID-19-related information was sought from the internet and social media, so for broad reach, future evidence-based information should be shared via online platforms. Although participants were experiencing moderate self-perceived stress and shared numerous concerns, very few COVID-19-related changes to infant feeding were reported, and there were few differences by socio-economic status, likely due to a strong economic safety net in this Canadian setting.
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Affiliation(s)
- Hillary L. Fry
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Olga Levin
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Ksenia Kholina
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Jolene L. Bianco
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Jelisa Gallant
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Kathleen Chan
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
| | - Kyly C. Whitfield
- Department of Applied Human NutritionMount Saint Vincent UniversityHalifaxNova ScotiaCanada
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159
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Moon H, Woo K. An integrative review on mothers' experiences of online breastfeeding peer support: Motivations, attributes and effects. MATERNAL & CHILD NUTRITION 2021; 17:e13200. [PMID: 33960665 PMCID: PMC8189189 DOI: 10.1111/mcn.13200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/27/2021] [Accepted: 04/13/2021] [Indexed: 12/02/2022]
Abstract
Information on the experiences surrounding online breastfeeding peer support among breastfeeding mothers and its effects on breastfeeding outcomes is growing yet to be synthesized. The aim of this review was to synthesize the evidence of mothers' experiences of online breastfeeding peer support. An integrative review was conducted. Five electronic databases were searched. Two reviewers independently screened the articles for inclusion. The inclusion criteria were (1) involved original data focusing on mothers' experiences of online breastfeeding peer support, (2) participants who were mothers who were breastfeeding or had experiences of breastfeeding and (3) studies focusing on interaction and communication among mothers through online communities. In total, 14 publications met the inclusion criteria. Breastfeeding mothers turned to online groups when they felt isolated, lacked professional support or preferred online support over face-to-face support. Online breastfeeding peer support was characterized as a virtual community, with easy access, availability and a wealth of resources from actual experiences of mothers. It empowered breastfeeding mothers and resulted in changes in breastfeeding outcomes and perceptions. The positive aspects of online breastfeeding peer support have recently garnered more attention. This review provided baseline data and evidence to supplement and improve the current breastfeeding support system for breastfeeding mothers. The evidence on the effectiveness of online breastfeeding peer support for influencing breastfeeding outcomes remains inconclusive. Further empirical studies with rigorous study designs are warranted.
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Affiliation(s)
- Hyojeong Moon
- College of NursingSeoul National UniversitySeoulSouth Korea
| | - Kyungmi Woo
- The Research Institute of Nursing Science, College of NursingSeoul National UniversitySeoulSouth Korea
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160
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Veenendaal NR, Deierl A, Bacchini F, O’Brien K, Franck LS. Supporting parents as essential care partners in neonatal units during the SARS-CoV-2 pandemic. Acta Paediatr 2021; 110:2008-2022. [PMID: 33772861 PMCID: PMC8250667 DOI: 10.1111/apa.15857] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/23/2021] [Indexed: 12/18/2022]
Abstract
AIM To review the evidence on safety of maintaining family integrated care practices and the effects of restricting parental participation in neonatal care during the SARS-CoV-2 pandemic. METHODS MEDLINE, EMBASE, PsycINFO and CINAHL databases were searched from inception to the 14th of October 2020. Records were included if they reported scientific, empirical research (qualitative, quantitative or mixed methods) on the effects of restricting or promoting family integrated care practices for parents of hospitalised neonates during the SARS-CoV-2 pandemic. Two authors independently screened abstracts, appraised study quality and extracted study and outcome data. RESULTS We retrieved 803 publications and assessed 75 full-text articles. Seven studies were included, reporting data on 854 healthcare professionals, 442 parents, 364 neonates and 26 other family members, within 286 neonatal units globally. The pandemic response resulted in significant changes in neonatal unit policies and restricting parents' access and participation in neonatal care. Breastfeeding, parental bonding, participation in caregiving, parental mental health and staff stress were negatively impacted. CONCLUSION This review highlights that SARS-CoV-2 pandemic-related hospital restrictions had adverse effects on care delivery and outcomes for neonates, families and staff. Recommendations for restoring essential family integrated care practices are discussed.
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Affiliation(s)
- Nicole R. Veenendaal
- Department of Pediatrics/Neonatology OLVG Amsterdam The Netherlands
- Department of Pediatrics, Emma Children's Hospital Amsterdam UMC, Vrije Universiteit, University of Amsterdam Amsterdam The Netherlands
| | - Aniko Deierl
- Department of Neonatology Imperial College Healthcare NHS Trust London UK
| | | | - Karel O’Brien
- Department of Pediatrics Mount Sinai Hospital Toronto Ontario Canada
| | - Linda S. Franck
- School of Nursing University of California San Francisco San Francisco CA USA
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161
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Esteban-Gonzalo S, Caballero-Galilea M, González-Pascual JL, Álvaro-Navidad M, Esteban-Gonzalo L. Anxiety and Worries among Pregnant Women during the COVID-19 Pandemic: A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6875. [PMID: 34206849 PMCID: PMC8297358 DOI: 10.3390/ijerph18136875] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 01/19/2023]
Abstract
Background. Several studies have identified pregnant women as a vulnerable group during the COVID-19 pandemic. The perinatal period has been identified as a stage of great risk for the mental health of pregnant women, due to a large increase in mental pathologies during this period. In this context, the objective of the present study was to assess the associations between socioeconomic and demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic in pregnant Spanish women. Method. The sample of this cross-sectional study was comprised of 353 pregnant women, aged 18 or older and residing in Spain. Data collection was carried out from 1 June to 30 September 2020. Participants were recruited from Quirónsalud University Hospital of Madrid. Multilevel regression models were built to value the associations between demographic factors, health concerns and health information management, and anxiety level during the COVID-19 pandemic among pregnant women. Results. Reduced working hours and income due to the COVID-19 pandemic were related to increased anxiety levels, as was the level of concern about COVID-19 symptoms, potential complications, contagion and consequences for the baby. Worries caused by restrictive measures adopted against COVID-19 and resulting isolation, delivery, postpartum and breastfeeding were also associated with increased anxiety levels. Being a separated or divorced woman and being informed to a greater extent by a midwife were related to lower anxiety levels. An increase in the degree of information obtained about COVID-19 symptoms, complications, contagion and consequences for the baby, restrictive measures and isolation adopted against COVID-19, delivery, postpartum and breastfeeding, were also related to decreased anxiety levels. Conclusions. The most vulnerable future mothers in terms of anxiety levels are those with reduced working hours and income due to the COVID-19 pandemic, those with a higher level of concern and who had access to a lesser degree of information about COVID-19 (symptoms and complications, contagion and consequences on the baby, restrictive measures and isolation, delivery, postpartum and breastfeeding), as well as pregnant women who have obtained information about COVID-19 during pregnancy from TV.
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Affiliation(s)
- Sara Esteban-Gonzalo
- Psychology Department, Faculty of Biomedicine, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - María Caballero-Galilea
- Nursing Department, Faculty of Biomedicine, Universidad Europea de Madrid, 28670 Madrid, Spain; (M.C.-G.); (J.L.G.-P.); (L.E.-G.)
| | - Juan Luis González-Pascual
- Nursing Department, Faculty of Biomedicine, Universidad Europea de Madrid, 28670 Madrid, Spain; (M.C.-G.); (J.L.G.-P.); (L.E.-G.)
| | - Miguel Álvaro-Navidad
- Obstetrics and Gynecology Department, Faculty of Medicine, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
- Department of Obstetrics and Gynecology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Laura Esteban-Gonzalo
- Nursing Department, Faculty of Biomedicine, Universidad Europea de Madrid, 28670 Madrid, Spain; (M.C.-G.); (J.L.G.-P.); (L.E.-G.)
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Asiodu IV, Bugg K, Palmquist AE. Achieving Breastfeeding Equity and Justice in Black Communities: Past, Present, and Future. Breastfeed Med 2021; 16:447-451. [PMID: 33979550 PMCID: PMC8418442 DOI: 10.1089/bfm.2020.0314] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Breastfeeding is protective of maternal and infant health across the life course. Increasing breastfeeding rates in Black communities is an important public health strategy to address maternal and infant mortality and morbidity. Methods: Data trends for the past 10 years suggest that Black-led community efforts; local, state, and national initiatives; and maternity care practices that are supportive of breastfeeding have been effective in improving and increasing breastfeeding rates among Black women. Results: Yet breastfeeding disparities and inequities in Black communities persist. Systemic and structural barriers, such as racism, bias, and inequitable access to lactation resources and support continue to be issues in the United States. Conclusion: Going forward, significant investments are needed to decolonize breastfeeding research and clinical practice. Public health and policy priorities need to center on listening to Black women, and funding Black, Indigenous, and People of Color (BIPOC) organizations and researchers conducting innovative projects and research.
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Affiliation(s)
- Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Kimarie Bugg
- Reaching Our Sisters Everywhere, Lithonia, Georgia, USA
| | - Aunchalee E.L. Palmquist
- Department of Maternal and Child Health, Gillings School of Global Health, University of North Carolina, Chapel Hill, North Carolina, USA
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163
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Supporting Breastfeeding in 2021 and Beyond-Lessons from the Pandemic. Pediatr Rep 2021; 13:289-301. [PMID: 34205900 PMCID: PMC8293422 DOI: 10.3390/pediatric13020037] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/14/2021] [Accepted: 05/17/2021] [Indexed: 01/20/2023] Open
Abstract
The COVID-19 pandemic has affected maternal and infant health globally both directly from infection with the SARS-CoV-2 virus and indirectly from changes in health care resulting from social, economic, and health care policies unique to each country. The developing countries have to share the disproportionate burden on maternal and infant health. In this review, we discuss the uncertainties resulting from SARS-CoV-2 infection in pregnancy, vertical transmission of the virus, and its effects on breastfeeding of the newborn. The problems of families and communities caring for mothers with COVID-19 and its impact on breastfeeding in newborns are discussed. The challenges posed by the pandemic have forced us to think and devise innovative solutions, including telemedicine help for antenatal counseling, breastfeeding education, and lactation support. Optimal utilization of resources and technology to find creative solutions at the individual and the community level will help in facilitating maternal-infant bonding soon after birth. Appropriate health care policies to support pregnant and lactating mothers will go a long way in meeting healthy child development goals.
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164
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Conti MG, Natale F, Stolfi I, Pedicino R, Boscarino G, Ajassa C, Cardilli V, Ciambra GL, Guadalupi L, Favata P, Repole P, De Luca F, Zacco G, Brunelli R, Terrin G. Consequences of Early Separation of Maternal-Newborn Dyad in Neonates Born to SARS-CoV-2 Positive Mothers: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5899. [PMID: 34072815 PMCID: PMC8199070 DOI: 10.3390/ijerph18115899] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/18/2022]
Abstract
As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues its spread all over the world, data on perinatal management of the maternal-infant dyad are urgent. We performed an observational study to describe the effects of the early separation of the maternal-infant dyad, in case of maternal SARS-CoV-2 infection. We reported the medical records for 37 neonates born to 37 SARS-CoV-2 positive mothers in a setting of separation of the dyad after birth. Data on neonatal infection, clinical condition, and breastfeeding rate were recorded until the first month of life. No maternal deaths were recorded; 37.8% of women had at least one pregnancy-related complication. We reported a high adherence to recommended safety measures after discharged with 84.8% of the mothers using at least one personal protective device and 51.5% using all the protective devices. We reported one case of vertical transmission and no cases of horizontal transmission. However, the separation of the dyad had a negative impact on breastfeeding because only 23.5% of the newborns received exclusively human milk during the first month of life. Despite early separation of the dyad protecting the newborns from possible horizontal transmission of SARS-CoV-2, it negatively affects breastfeeding during the first months of life.
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Affiliation(s)
- Maria Giulia Conti
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
- Department of Molecular Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Fabio Natale
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Ilaria Stolfi
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Roberto Pedicino
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Giovanni Boscarino
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Camilla Ajassa
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Viviana Cardilli
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Giovanni Luca Ciambra
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Laura Guadalupi
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Paola Favata
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Paola Repole
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Francesca De Luca
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Giulia Zacco
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Roberto Brunelli
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Gianluca Terrin
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
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Sakalidis VS, Rea A, Perrella SL, McEachran J, Collis G, Miraudo J, Prosser SA, Gibson LY, Silva D, Geddes DT. Wellbeing of Breastfeeding Women in Australia and New Zealand during the COVID-19 Pandemic: A Cross-Sectional Study. Nutrients 2021; 13:1831. [PMID: 34072039 PMCID: PMC8230305 DOI: 10.3390/nu13061831] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 01/17/2023] Open
Abstract
During the COVID-19 pandemic, breastfeeding women have experienced restricted access to support, placing them at increased risk of mental health concerns and limited breastfeeding assistance. This study investigated the effect of the pandemic on feeding choices and maternal wellbeing amongst breastfeeding mothers living in Australian and New Zealand. We conducted a cross-sectional online survey that examined feeding methods, maternal mental wellbeing, worries, challenges, and positive experiences during the pandemic. Most women were exclusively breastfeeding (82%). Partial breastfeeding was associated with perceived low milk supply and longer pregnancy duration during the pandemic. Reduced mental health and wellbeing was associated with lower levels of family functioning, increased perceived stress, and perinatal anxiety. Longer pregnancy duration during the pandemic was associated with lower mental health wellbeing scores, while higher perceived stress scores were reported for regions with higher COVID-19 infection rates and women with perceived low milk supply. Women reported that the pandemic resulted in less pressure and more time for family bonding, while worries about the pandemic, family health, and parenting challenges were also cited. Mental health concerns of breastfeeding women appear to be exacerbated by COVID-19, highlighting a critical need for access to mental health and broader family support during the pandemic.
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Affiliation(s)
- Vanessa S. Sakalidis
- Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland;
- University of Basel, 4001 Basel, Switzerland
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Perth, WA 6150, Australia;
| | - Sharon L. Perrella
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | - Jacki McEachran
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
| | - Grace Collis
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | | | - Stuart A. Prosser
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | - Lisa Y. Gibson
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
- The University of Western Australia, Perth, WA 6009, Australia
- School of Health and Medical Sciences, Edith Cowan University, Perth, WA 6027, Australia
| | - Desiree Silva
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
- Health and Medical Sciences, The University of Western Australia, Perth, WA 6009, Australia
- Joondalup Health Campus, Perth, WA 6027, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
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166
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Vilar-Compte M, Gaitán-Rossi P, Rhodes EC, Cruz-Villaba V, Pérez-Escamilla R. Breastfeeding Media Coverage and Beliefs During the COVID-19 Pandemic in Mexico: Implications for Breastfeeding Equity. RESEARCH SQUARE 2021:rs.3.rs-528093. [PMID: 34031652 PMCID: PMC8142664 DOI: 10.21203/rs.3.rs-528093/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Breastfeeding offers short- and long- term health benefits to mothers and children and constitutes a priority for public health. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are presumably contained in breastmilk of mothers with history of COVID-19 infection or vaccination. Direct breastfeeding is the preferred infant feeding option during the pandemic, but conflicting practices have been adopted, which could widen existing disparities in breastfeeding. This study aims to describe how was information about breastfeeding communicated in Mexican media during the pandemic and assess Mexican adults' beliefs regarding breastfeeding among mothers infected with COVID-19. METHODS A retrospective content analysis of media coverage on breastfeeding in Mexico between March 1 and September 24, 2020, excluding advertisements, was done. For the content analysis, both a sentiment analysis and an analysis based on strengths, weaknesses, opportunities and threats for breastfeeding promotion were performed. Also, we incorporated a descriptive analysis from the July 2020 wave of the ENCOVID-19 survey, which included questions on beliefs about breastfeeding. This information was stratified by gender, age, and socioeconomic status. RESULTS 1014 publications on breastfeeding were identified in internet, newspapers, TV, and magazines. Most information was published during World Breastfeeding Week, celebrated in August. Based on the sentiment analysis, 57.2% of all information was classified as positive, and based on the SWOT analysis, most information was classified either as strengths or opportunities for breastfeeding promotion. However, the ENCOVID-19 data showed that 67.3% of people living in households with children under 3 years of age believe that mothers with COVID-19 should not breastfeed, and 19.8% stated that they simply didn't know. These beliefs showed differences both by gender and by socioeconomic status. CONCLUSIONS While the Mexican government endorsed the recommendations on breastfeeding during the COVID-19 pandemic, communication of those messages was sporadic, inconstant and unequal across types of media. Moreover, there were also negative messages for breastfeeding circulating on the media. There continues to be a widespread notion that mothers with COVID-19 should not breastfeed and, due to differences on beliefs by socioeconomic status, health inequities could be exacerbated.
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167
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Dembiński Ł, Huss G, Radziewicz-Winnicki I, Grossman Z, Mazur A, del Torso S, Barak S, Carrasco Sanz A, Hadjipanayis A. EAP and ECPCP Statement Risks for Children's Health During the COVID-19 Pandemic and a Call for Maintenance of Essential Pediatric Services. Front Pediatr 2021; 9:679803. [PMID: 34046377 PMCID: PMC8146905 DOI: 10.3389/fped.2021.679803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/16/2021] [Indexed: 12/19/2022] Open
Abstract
The COVID-19 pandemic and global lockdown have had drastic socioeconomic and psychological effects on countries and people, respectively. There has been limited access to health care and education. These negative consequences have had a significant impact on the well-being of children and adolescents. Therefore, the EAP and the ECPCP are requesting state, health, and education authorities as well as European pediatric societies and the healthcare professionals that special attention be given to this population and the problems they face as a result of the pandemic.
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Affiliation(s)
- Łukasz Dembiński
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Gottfried Huss
- The European Confederation of Primary Care Paediatricians (ECPCP), Lyon, France
- Kinder-Permanence Spital Zollikerberg, Zollikerberg, Switzerland
| | | | - Zachi Grossman
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Adelson School of Medicine, Ariel University, Ariel, Israel
- Maccabi Health Services, Tel Aviv, Israel
| | - Artur Mazur
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- Medical Faculty, University of Rzeszow, Rzeszów, Poland
| | - Stefano del Torso
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- ChildCare WorldWide, Padova, Italy
| | - Shimon Barak
- The European Confederation of Primary Care Paediatricians (ECPCP), Lyon, France
- Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Angel Carrasco Sanz
- The European Confederation of Primary Care Paediatricians (ECPCP), Lyon, France
- Madrid Health Service, Servicio Madrileño de Salud, Madrid, Spain
| | - Adamos Hadjipanayis
- The European Academy of Paediatrics, EAP, Brussels, Belgium
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus
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168
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Ransing R, Kukreti P, Mahadevaiah M, Raghuveer P, Karkal R, Rana S, Yadav R, Choudhary V, Patil I, Sonkar S, Deshpande SN. COVID-19 Pandemic and Stepped Care Model for Perinatal Depression in Rural India: Lessons Learned and the Way Forward. Indian J Psychol Med 2021; 43:246-251. [PMID: 34345101 PMCID: PMC8287401 DOI: 10.1177/02537176211005017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Ramdas Ransing
- Dept. of Psychiatry, BKL Walawalkar
Rural Medical College, Sawarde, Ratnagiri, Maharashtra, India
| | - Prerna Kukreti
- Dept. of Psychiatry, Lady Hardinge
Medical College, New Delhi, Delhi, India
| | - Mahesh Mahadevaiah
- Dept. of Psychiatry, Dharwad Institute
of Mental Health and Neurosciences (DIMHANS), Dharwad, Karnataka, India
| | - Pracheth Raghuveer
- Dept. of Community Medicine, Yenepoya
Medical College, Mangalore, Karnataka, India
| | - Ravichandra Karkal
- Dept. of Psychiatry, Yenepoya Medical
College, Mangalore, Karnataka, India
| | - Sumit Rana
- Dept. of Psychiatry, Lady Hardinge
Medical College, New Delhi, Delhi, India
| | - Reena Yadav
- Dept. of Obs and Gyne, Lady Hardinge
Medical College, New Delhi, Delhi, India
| | - Vinod Choudhary
- Dept. of Pediatrics, BKL Walawalkar
Rural Medical College, Sawarde, Ratnagiri, Maharashtra, India
| | - Ishwar Patil
- Dept. of Psychiatry, BKL Walawalkar
Rural Medical College, Sawarde, Ratnagiri, Maharashtra, India
| | - Suruchi Sonkar
- Dept. of Psychiatry, Dharwad Institute
of Mental Health and Neurosciences (DIMHANS), Dharwad, Karnataka, India
| | - Smita N. Deshpande
- Dept. of Psychiatry, De-Addiction
Services and Resource Center for Tobacco Control, Centre of Excellence in Mental
Health, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia
Hospital, New Delhi, Delhi, India
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169
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Sirajuddin S, Sirajuddin S, Razak A, Ansariadi A, Thaha RM, Sudargo T. The intervention of maternal nutrition literacy has the potential to prevent childhood stunting: Randomized control trials. J Public Health Res 2021; 10. [PMID: 33855419 PMCID: PMC8129741 DOI: 10.4081/jphr.2021.2235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Stunting is the impaired growth and development of children due to poor nutrition, repeated infection, and inadequate psychological stimulation. This research aims to examine the impact of maternal nutritional literacy (MNL) in increasing the height or score of a stunted child. Design and Methods: This study is a randomized control trial, which uses a sample size of 85 participants, 43 interventions and 42 controls, an 80% stress test and a 95% confidence level. The intervention group of the MNL consists of families with children under the age of five, focused on the mother’s ability to perform breastfeeding, hygiene activities, care, and intervention for 3 months. Result: The status of stunting was determined by the different distribution of stunting before and after the intervention in both the intervention and control groups. There was a decrease of about 9.3% of MNL in the intervention group, while in the control group it decreased by just 2.4% (p<0.05). Conclusions: It can be concluded that MNL has an effect in preventing stunting, and it is recommended that preventive measures should focus more on normal children, while stunted children should be provided with breastfeeding as the core of MNL. Significance for public health Preventing stunting requires an effort based on the family potential, and the nutritional literacy of the maternal is the most appropriate measure in achieving the preventive goals. This article shows that the maternal nutrition literacy interventions are very good in such a way that they become a reference for improving the nutrition and public health.
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Affiliation(s)
- Sirajuddin Sirajuddin
- Student Doctoral Public Health, Hasanuddin University, Makassar; Department of Dietetic and Nutrition, Health Polytechnic of Makassar.
| | - Saifuddin Sirajuddin
- Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
| | - Amran Razak
- Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
| | - Ansariadi Ansariadi
- Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
| | - Ridwan M Thaha
- Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
| | - Toto Sudargo
- Faculty Public Health Hasanuddin University, Makassar.
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170
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Baker N, Potts L, Jennings S, Trevillion K, Howard LM. Factors Affecting Infant Feeding Practices Among Women With Severe Mental Illness. Front Glob Womens Health 2021; 2:624485. [PMID: 34816188 PMCID: PMC8593974 DOI: 10.3389/fgwh.2021.624485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The health benefits of breastfeeding are well-established but for mothers with severe mental illness (SMI), the decision to breastfeed can be complex. Very few prior studies have investigated the infant feeding choices of women with SMI, or the factors associated with this. Our aims were to examine antenatal infant feeding intentions and infant feeding outcomes in a cohort of women admitted for acute psychiatric care in the first postpartum year. We also aimed to examine whether demographic and clinical characteristics associated with breastfeeding were similar to those found in previous studies in the general population, including age, employment, education, BMI, mode of delivery, smoking status, and social support. Methods: This study was a mixed-methods secondary analysis of a national cohort study, ESMI-MBU (Examining the effectiveness and cost-effectiveness of perinatal mental health services). Participants had been admitted to acute care with SMI in the first postpartum year. Infant feeding outcomes were retrospectively self-reported by women during a 1-month post-discharge interview. Free-text responses to questions relating to infant feeding and experience of psychiatric services were also explored using thematic analysis. Results: 144 (66.1%) of 218 women reported breastfeeding (mix feeding and exclusive breastfeeding). Eighty five percentage of the cohort had intended to breastfeed and of these, 76.5% did so. Factors associated with breastfeeding included infant feeding intentions, employment and non-Caucasian ethnicity. Although very few women were taking psychotropic medication contraindicated for breastfeeding, over a quarter (n = 57, 26.15%) reported being advised against breastfeeding because of their medication. Women were given this advice by psychiatry practitioners (40% n = 22), maternity practitioners (32.73% n = 18) and postnatal primary care (27.27% n = 15). Most women stopped breastfeeding earlier than they had planned to as a result (81.1% n = 43). Twenty five women provided free text responses, most felt unsupported with infant feeding due to inconsistent information about medication when breastfeeding and that breastfeeding intentions were de-prioritized for mental health care. Conclusion: Women with SMI intend to breastfeed and for the majority, this intention is fulfilled. Contradictory and insufficient advice relating to breastfeeding and psychotropic medication indicates that further training is required for professionals caring for women at risk of perinatal SMI about how to manage infant feeding in this population. Further research is required to develop a more in-depth understanding of the unique infant feeding support needs of women with perinatal SMI.
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Affiliation(s)
- Natasha Baker
- Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Laura Potts
- Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Stacey Jennings
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University London, London, United Kingdom
| | - Kylee Trevillion
- Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Louise M. Howard
- Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
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Ceulemans M, Foulon V, Panchaud A, Winterfeld U, Pomar L, Lambelet V, Cleary B, O’Shaughnessy F, Passier A, Richardson JL, Allegaert K, Nordeng H. Vaccine Willingness and Impact of the COVID-19 Pandemic on Women's Perinatal Experiences and Practices-A Multinational, Cross-Sectional Study Covering the First Wave of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073367. [PMID: 33805097 PMCID: PMC8038007 DOI: 10.3390/ijerph18073367] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/11/2021] [Accepted: 03/22/2021] [Indexed: 12/13/2022]
Abstract
The COVID-19 pandemic may be of particular concern for pregnant and breastfeeding women. We aimed to explore their beliefs about the coronavirus and COVID-19 vaccine willingness and to assess the impact of the pandemic on perinatal experiences and practices. A multinational, cross-sectional, web-based study was performed in six European countries between April and July 2020. The anonymous survey was promoted via social media. In total, 16,063 women participated (including 6661 pregnant and 9402 breastfeeding women). Most responses were collected from Belgium (44%), Norway (18%) and the Netherlands (16%), followed by Switzerland (11%), Ireland (10%) and the UK (3%). Despite differences between countries, COVID-19 vaccine hesitancy was identified among 40–50% of the respondents at the end of the first wave of the pandemic and was higher among pregnant women. Education level and employment status were associated with vaccine hesitancy. The first wave had an adverse impact on pregnancy experiences and disrupted access to health services and breastfeeding support for many women. In the future, access to health care and support should be maintained at all times. Evidence-based and tailored information on COVID-19 vaccines should also be provided to pregnant and breastfeeding women to avoid unfounded concerns about the vaccines and to support shared decision making in this population.
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Affiliation(s)
- Michael Ceulemans
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
- Teratology Information Service, Pharmacovigilance Centre Lareb, 5237 MH ‘s Hertogenbosch, The Netherlands;
- Correspondence: ; Tel.: +32-1637-7227
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service de Pharmacologie Clinique, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
| | - Léo Pomar
- Materno-Fetal and Obstetrics Research Unit, Lausanne University Hospital, 1011 Lausanne, Switzerland; (L.P.); (V.L.)
| | - Valentine Lambelet
- Materno-Fetal and Obstetrics Research Unit, Lausanne University Hospital, 1011 Lausanne, Switzerland; (L.P.); (V.L.)
| | - Brian Cleary
- Rotunda Hospital, D01 P5W9 Dublin, Ireland; (B.C.); (F.O.)
- School of Pharmacy, Royal College of Surgeons Ireland, D02 VN51 Dublin, Ireland
| | - Fergal O’Shaughnessy
- Rotunda Hospital, D01 P5W9 Dublin, Ireland; (B.C.); (F.O.)
- School of Pharmacy, Royal College of Surgeons Ireland, D02 VN51 Dublin, Ireland
| | - Anneke Passier
- Teratology Information Service, Pharmacovigilance Centre Lareb, 5237 MH ‘s Hertogenbosch, The Netherlands;
| | - Jonathan Luke Richardson
- UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4AB, UK;
| | - Karel Allegaert
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
- Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Department of Clinical Pharmacy, Erasmus MC Sophia Children’s Hospital, 3000 CA Rotterdam, The Netherlands
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway;
- Department of Child Health and Development, Norwegian Institute of Public Health, 0213 Oslo, Norway
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Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel) 2021; 11:34. [PMID: 33799384 PMCID: PMC7999784 DOI: 10.3390/bs11030034] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022] Open
Abstract
The COVID-19 pandemic has altered the normal course of life, with measures to reduce the virus spread impacting motherhood expectations and, in particular, breastfeeding practices. This study aimed to review evidence regarding the impact of COVID-19 on breastfeeding plans and how these relate to women's psychological outcomes. Searches were conducted on PubMed and Web of Science for studies in English, Spanish, and Portuguese between January 2020 and January 2021. All study designs and pre-prints were considered. Twelve studies were included. Reports suggest that COVID-19 impacts differently on breastfeeding plans, which in turn leads to distinctive mental health outcomes. Positive breastfeeding experiences have been observed when mothers perceive that they have more time for motherhood, which may be associated with better mental health outcomes. Negative breastfeeding experiences have been observed when mothers are separated from their newborns, when mothers struggle with breastfeeding, or when mothers perceive decreased family and professional support, which seems to be associated with worse mental health outcomes. These preliminary results highlight the need for further research into the association between COVID-19, breastfeeding expectations, and maternal mental health. Filling this gap will foster the development of guidelines and interventions to better support mothers experiencing the obstacles of COVID-19 pandemic.
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Affiliation(s)
- Francisca Pacheco
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (F.P.); (M.S.); (R.G.)
| | - Mónica Sobral
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (F.P.); (M.S.); (R.G.)
| | - Raquel Guiomar
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (F.P.); (M.S.); (R.G.)
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Centre for Biomedical Research in Mental Health (CIBERSAM), 28040 Madrid, Spain;
| | - Rafael A. Caparros-Gonzalez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
| | - Ana Ganho-Ávila
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (F.P.); (M.S.); (R.G.)
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173
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Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. MATERNAL & CHILD NUTRITION 2021; 17:e13088. [PMID: 32969184 PMCID: PMC7537017 DOI: 10.1111/mcn.13088] [Citation(s) in RCA: 169] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic and subsequent lockdown and social distancing led to changes to breastfeeding support available to women in the United Kingdom. Face-to-face professional support was reduced, and face-to-face peer support was cancelled. Anecdotal media accounts highlighted practices separating some mothers and babies in hospitals, alongside inaccurate stories of the safety of breastfeeding circulating. Meanwhile, new families were confined to their homes, separated from families and support networks. Given that we know breastfeeding is best supported by practices that keep mother and baby together, high-quality professional and peer-to-peer support, and positive maternal well-being, it is important to understand the impact of the pandemic upon the ability to breastfeed. To explore this, we conducted an online survey with 1219 breastfeeding mothers in the United Kingdom with a baby 0-12 months old to understand the impact of the pandemic upon breastfeeding duration, experiences and support. The results highlighted two very different experiences: 41.8% of mothers felt that breastfeeding was protected due to lockdown, but 27.0% of mothers struggled to get support and had numerous barriers stemming from lockdown with some stopped breastfeeding before they were ready. Mothers with a lower education, with more challenging living circumstances and from Black and minority ethnic backgrounds were more likely to find the impact of lockdown challenging and stop breastfeeding. The findings are vital in understanding how we now support those women who may be grieving their loss of breastfeeding and are affected by their negative experiences and how we can learn from those with a positive experience to make sure all breastfeeding women are better supported if similar future events arise.
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Affiliation(s)
- Amy Brown
- Department of Public Health, Policy and Social SciencesSwansea UniversitySwanseaUK
- Centre for Lactation, Infant Feeding and TranslationSwansea UniversitySwanseaUK
| | - Natalie Shenker
- Department of Surgery and CancerImperial College LondonLondonUK
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Baker R, Evans E, Fielden A, Arnott B. Healthcare professionals' perspectives on infant feeding support in paediatric inpatients: single-centre qualitative study. BMJ Paediatr Open 2021; 5:e001247. [PMID: 34746446 PMCID: PMC8559122 DOI: 10.1136/bmjpo-2021-001247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/03/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To provide information on baseline knowledge, skills and attitudes (KSA) of paediatric staff to formulate a plan for improving infant feeding support in hospitals. DESIGN Semistructured interviews assessed baseline infant feeding KSA and experiences in 14 paediatric health professionals of various grades (medical students, healthcare assistants, ward nurses and specialist nurses). Audio recordings were transcribed verbatim and underwent thematic analysis. An online questionnaire gathered descriptive statistics about participants. SETTING A single large hospital trust, North East England. RESULTS Seven major themes were identified in KSA: culture and trends, roles and working practice, training and resources, the health professional, understanding the parent, effective communication and the challenges of feeding the ill child.Staff discussed various organisational and personal barriers to acquiring infant feeding support training and experience, and to delivering feeding support. Staff were keen to support families with feeding but often felt constrained by a belief that this required specialist knowledge and skills. Although staff believed they actively promoted breastfeeding-friendly messages, it was evident that marketing communications and personal experiences inadvertently influenced their approach to families. CONCLUSIONS The development of clear, evidence-based infant feeding education and training for paediatric staff delivered by experienced mentors is warranted. Training should cover background theory, delivering practical support, communication skills and creating a baby-friendly hospital environment. UNICEF Baby Friendly Standards would be suitable to inform content. Training is likely to be received positively by staff and benefit women and babies in this setting.
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Affiliation(s)
- Rosie Baker
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Amy Fielden
- Newcastle University, Newcastle upon Tyne, UK
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175
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Maternal mental health and well-being during the COVID-19 pandemic in Beijing, China. World J Pediatr 2021; 17:280-289. [PMID: 34170504 PMCID: PMC8231088 DOI: 10.1007/s12519-021-00439-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/14/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The aim of this study is to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on breastfeeding women and to identify predictors of maternal mental health and coping. METHODS Mothers aged ≥ 18 years with a breast-fed infant ≤ 18 months of age during the COVID-19 pandemic in Beijing, China, completed a questionnaire. Descriptive analysis of lockdown consequences was performed and predictors of these outcomes were examined using stepwise linear regression. RESULTS Of 2233 participants, 29.9%, 20.0% and 34.7% felt down, lonely, and worried, respectively, during the lockdown; however, 85.3% felt able to cope. Poorer maternal mental health was predicted by maternal (younger age, higher education) and infant (older age, lower gestation) characteristics, and social circumstances (husband unemployed or working from home, receiving advice from family, having enough space for the baby, living close to a park or green space). Conversely, better maternal mental health was predicted by higher income, employment requiring higher qualifications, more personal space at home, shopping or walking > once/week and lack of impact of COVID-19 on job or income. Mothers with higher education, more bedrooms, fair division of household chores and attending an online mother and baby group > once/week reported better coping. CONCLUSION The findings highlight maternal characteristics and circumstances that predict poorer mental health and reduced coping which could be used to target interventions in any future public health emergencies requiring social restrictions.
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