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Marín Gabriel MÁ, Martín Lozoya S, de Las Heras Ibarra S, Domingo Comeche L, González Carrasco E, Lalaguna Mallada P, Villó Sirerol N, García Fernández L, Jiménez Martínez J, Royuela Vicente A. Association of the presence of a COVID-19 infection at the time of birth and the rates of exclusive breastfeeding upon discharge in BFHI hospitals: a multicenter, prospective cohort study. Int Breastfeed J 2023; 18:54. [PMID: 37794406 PMCID: PMC10552201 DOI: 10.1186/s13006-023-00590-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Very few studies have assessed the association between COVID-19 infection and the rates of exclusive breastfeeding (EBF) upon discharge following the first waves of the pandemic and after initiation of vaccination. The primary objective of this study is to compare the rates of EBF since birth upon discharge in mothers diagnosed with COVID-19 infection at the time of the delivery versus a group of non-infected mothers in maternity hospitals with Baby Friendly Hospital Initiative (BFHI) accreditation. The secondary objectives include determining the rates of any breastfeeding at three and six months of life in both groups, as well as determining the possible factors associated with EBF rates observed upon discharge. METHODS An observational, Spanish multi-center hospital, prospective cohort study conducted from 1 to 2021 to 31 March 2022 and with follow-up during the first six months of life. Follow-up was performed via telephone contact with calls performed at three and six months. A multivariate logistic regression analysis model was used to identify the factors related to a lower probability of EBF upon discharge. RESULTS 308 mother-infant pairs participated in the study, 111 in the cohort of women with COVID infection and 197 in the comparison group. EBF upon discharge was 62.7% in the COVID group vs. 81.2% in the comparison group (p = 0.002); at three months; 52.4% vs. 57.0% (p = 0.33) were performing EBF, with the rates of EBF at six months being 43.0% vs. 39.3% (p = 0.45), respectively. Exposure to COVID-19 at delivery (AOR 5.28; 95% CI 2.01, 13.86), not practicing BF previously (AOR 36.3; 95% CI 7.02, 187.74), birth via Cesarean section (AOR 5.06; 95% CI 1.62, 15.79) and low birth weight of the newborn (AOR 1.01; 95% CI 1.01, 1.01) were associated with a greater risk of not performing EBF upon discharge. CONCLUSIONS Mothers with a mild or asymptomatic COVID-19 infection at the time of the delivery were less likely to have exclusively breastfed during their hospital stay than other mothers in these BFHI-accredited hospitals. However, there were no differences in breastfeeding rates between the groups at three and six months postpartum.
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Affiliation(s)
- Miguel Ángel Marín Gabriel
- Department of Pediatrics, Puerta de Hierro-Majadahonda University Hospital, BFHI Hospital-Coordinator, Majadahonda, Madrid, Spain.
| | - Sergio Martín Lozoya
- Department of Pediatrics, Puerta de Hierro-Majadahonda University Hospital, BFHI Hospital-Coordinator, Majadahonda, Madrid, Spain
| | | | - Laura Domingo Comeche
- Department of Neonatology, Fuenlabrada University Hospital, Fuenlabrada, Madrid, Spain
| | | | | | | | | | | | - Ana Royuela Vicente
- Biostatistics Unit, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA. CIBERESP, ISCIII., Madrid, España
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Walsh A, Pieterse P, Mishra N, Chirwa E, Chikalipo M, Msowoya C, Keating C, Matthews A. Improving breastfeeding support through the implementation of the Baby-Friendly Hospital and Community Initiatives: a scoping review. Int Breastfeed J 2023; 18:22. [PMID: 37061737 PMCID: PMC10105160 DOI: 10.1186/s13006-023-00556-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/26/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Improved breastfeeding practices have the potential to save the lives of over 823,000 children under 5 years old globally every year. The Baby-Friendly Hospital Initiative (BFHI) is a global campaign by the World Health Organization and the United Nations Children's Fund, which promotes best practice to support breastfeeding in maternity services. The Baby-Friendly Community Initiative (BFCI) grew out of step 10, with a focus on community-based implementation. The aim of this scoping review is to map and examine the evidence relating to the implementation of BFHI and BFCI globally. METHODS This scoping review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. Inclusion criteria followed the Population, Concepts, Contexts approach. All articles were screened by two reviewers, using Covidence software. Data were charted according to: country, study design, setting, study population, BFHI steps, study aim and objectives, description of intervention, summary of results, barriers and enablers to implementation, evidence gaps, and recommendations. Qualitative and quantitative descriptive analyses were undertaken. RESULTS A total of 278 articles were included in the review. Patterns identified were: i) national policy and health systems: effective and visible national leadership is needed, demonstrated with legislation, funding and policy; ii) hospital policy is crucial, especially in becoming breastfeeding friendly and neonatal care settings iii) implementation of specific steps; iv) the BFCI is implemented in only a few countries and government resources are needed to scale it; v) health worker breastfeeding knowledge and training needs strengthening to ensure long term changes in practice; vi) educational programmes for pregnant and postpartum women are essential for sustained exclusive breastfeeding. Evidence gaps include study design issues and need to improve the quality of breastfeeding data and to perform prevalence and longitudinal studies. CONCLUSION At a national level, political support for BFHI implementation supports expansion of Baby-Friendly Hospitals. Ongoing quality assurance is essential, as is systematic (re)assessment of BFHI designated hospitals. Baby Friendly Hospitals should provide breastfeeding support that favours long-term healthcare relationships across the perinatal period. These results can help to support and further enable the effective implementation of BFHI and BFCI globally.
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Affiliation(s)
- Aisling Walsh
- RCSI, University of Medicine and Health Sciences, Dublin, Ireland.
| | | | | | - Ellen Chirwa
- Kamuzu University of Health Sciences, Blantyre, Malawi
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Cinquetti M, Marchiotto C, Fingerle M, Salani M, Adami A, Dainese D, Magaraggia S, Rigotti E, Piacentini G. Breastfeeding rates fell in an Italian baby friendly hospital during the 2020 COVID-19 pandemic year and difficulties increased. Acta Paediatr 2023; 112:770-775. [PMID: 36644949 DOI: 10.1111/apa.16674] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 12/22/2022] [Accepted: 01/13/2023] [Indexed: 01/17/2023]
Abstract
AIM Our aim was to evaluate the impact of the COVID-19 pandemic on breastfeeding at discharge in a Baby Friendly hospital in 2020. METHODS This study retrospectively compared healthy neonates born in 2019 with those born in 2020 at the Baby Friendly San Bonifacio Hospital in Verona, Italy. We also compared those born to mothers who tested negative and positive for the virus that causes COVID-19. Breastfeeding support practices, nationality and type of birth were evaluated. The outcomes were type of breastfeeding at discharge and the presence of breastfeeding difficulties. RESULTS We analysed 2171 healthy neonates, which was 83.5% of those born in the hospital in 2019 and 2020, and 20 were born to mothers with the virus. Exclusive breastfeeding rates were 4.6% lower in 2020 than 2019 and breastfeeding difficulties rose by 10.1%. Mixed feeding, at the mother's request, and formula feeding due to medical indications, increased by 5.9% and 18.1% respectively. Most of the Baby Friendly hospital practices were implemented, but prenatal and intrapartum support decreased. CONCLUSION Exclusive breastfeeding fell during the COVID-19 pandemic in 2020 and breastfeeding difficulties rose. These may have been due to the effect of maternal and healthcare factors during the pandemic.
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Affiliation(s)
- Mauro Cinquetti
- Maternal and Child Department, Azienda ULSS 9 Scaligera, Verona, Italy
| | - Carolina Marchiotto
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Michele Fingerle
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Marco Salani
- Maternal and Child Department, Azienda ULSS 9 Scaligera, Verona, Italy
| | - Anna Adami
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Daniela Dainese
- Maternal and Child Department, Azienda ULSS 9 Scaligera, Verona, Italy
| | - Silvia Magaraggia
- Maternal and Child Department, Azienda ULSS 9 Scaligera, Verona, Italy
| | - Erika Rigotti
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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Quinones C. "Breast is best"… until they say so. FRONTIERS IN SOCIOLOGY 2023; 8:1022614. [PMID: 36992698 PMCID: PMC10042138 DOI: 10.3389/fsoc.2023.1022614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 02/03/2023] [Indexed: 06/19/2023]
Abstract
In this autoethnographic article, I discuss the consequences of being exposed to two competing breastfeeding discourses during my first mothering experience-the "self-regulated dyad" and the "externally regulated dyad" discourse. The former represents the ideal scenario and the evidence-based practices recommended by the World Health Organization (i.e., breastfeeding on demand, internally regulated by the dyad). The externally regulated discourse refers to the standardized health interventions that take over when difficulties arise (e.g., weight gain deviations and latching issues). Building on Kugelmann's critique about our blind reliance on "standardized health," existing evidence, and my breastfeeding journey, I argue that unqualified and unindividualized breastfeeding interventions are highly counterproductive. To illustrate these points, I discuss the implications of the polarized interpretation of pain and the limited dyadically focused support. I then move on to analyze how ambivalent social positioning around breastfeeding impacts our experience. In particular, I found that I was highly regarded as a "good, responsible mum" up till my baby was 6 months, and how breastfeeding became increasingly challenged by others when my daughter was approaching her first birthday. Here, I discuss how performing attachment mothering identity work allowed me to navigate these challenges. Against this backdrop, I reflect upon feminist ambivalent positionings on breastfeeding and the complexity of balancing the promotion of women's hard-earned rights while supporting them to engage in whatever baby-feeding choice they feel appropriate. I conclude that unless we acknowledge the physical and social complexities of the process, and our healthcare systems seriously invest in allocating human resources and training them appropriately, breastfeeding rates may continue to suffer and women continue to interiorize it as their own failure.
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Affiliation(s)
- Cristina Quinones
- Department of People and Organisations, Faculty of Business and Law, The Open University, Milton Keynes, United Kingdom
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Llorca J, Dierssen-Sotos T, Carrasco-Marín E, Guerra-Díez JL, Lechosa-Muñiz C, Paz-Zulueta M, Gómez-Acebo I, Cabero-Perez MJ. Time of leaving work pregnancy results during COVID-19 pandemic. The MOACC-19 cohort from Spain. BMC Public Health 2023; 23:441. [PMID: 36882824 PMCID: PMC9990053 DOI: 10.1186/s12889-023-15357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 03/01/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND COVID-19 pandemic has changed the way pregnancies have been controlled as well as working conditions. In countries with paid leave of work, leaving earlier has been a relevant measure for controlling the pandemic. No study has been published on factors associated with earlier leaving work in pregnancy and the consequences it could have on pregnancy outcomes. OBJECTIVE We aimed to identify woman and pregnancy characteristics associated with leaving work earlier and its consequences on pregnancy results. METHOD A cohort study was carried out in Cantabria, Northern Spain, including 760 women who were pregnant in 2020 and were working at the beginning of their pregnancy. Data on pregnancy characteristics and results were obtained from medical records and gestational age at leaving work was self-reported. In a logistic regression analysis, leaving work before 26th week of pregnancy was the main effect variable. RESULTS Several factors were associated with lower probability of leaving work before 26th week, including university studies (OR = 0.49, 95% CI: 0.36, 0.68), having presential work (OR = 0.57, 95% CI: 0.40, 0.81), women born in non-European countries (OR = 0.55, 95% CI: 0.30, 1.01) and non-smokers (OR for smokers = 1.79, 95% CI: 1.12, 2.87). Neither type of delivery, gestational age at delivery nor other pregnancy results were associated with the gestational age of leaving work. CONCLUSION Several pregnancy and women characteristics were associated with leaving work earlier in the COVID-19 pandemic, although it was not associated with any pregnancy outcome.
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Affiliation(s)
- Javier Llorca
- Universidad de Cantabria- CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain
| | - Trinidad Dierssen-Sotos
- Universidad de Cantabria-IDIVAL-CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain. .,Facultad de Medicina, Universidad de Cantabria, Santander, 39792, Spain.
| | | | | | | | | | - Inés Gómez-Acebo
- Universidad de Cantabria-IDIVAL-CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain
| | - María J Cabero-Perez
- Hospital Universitario Marqués de Valdecilla-Universidad de Cantabria, Santander, Spain
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Influence of the COVID-19 pandemic on labor and childbirth care practices in Brazil: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:91. [PMID: 36732728 PMCID: PMC9894737 DOI: 10.1186/s12884-023-05358-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND It has been hypothesized that the coronavirus disease 2019 (COVID-19) pandemic may have changed the conduct of obstetric practices at the time of labor, delivery, and birth. In Brazil, many practices lacking scientific evidence are implemented in this care, which is charcaterized by excessive use of unnecessary interventions. This scenario may have been worsened by the pandemic. Thus, we analyzed the effects of the pandemic on care during prenatal care and delivery by comparing the results of two surveys (one was administered before the pandemic and the other during the pandemic) in public hospitals in Belo Horizonte - Minas Gerais (MG), Brazil. METHODS This cross-sectional and comparative study analyzed preliminary data from the study "Childbirth and breastfeeding in children of mothers infected with SARS-CoV-2", which was conducted in three referral maternity hospitals in Belo Horizonte - MG during the pandemic in the first half of 2020 in Brazil. The final sample consisted of 1532 eligible women. These results were compared with data from 390 puerperae who gave birth in the three public hospitals in the study "Birth in Belo Horizonte: labor and birth survey", conducted before the pandemic to investigate the changes in practices of labor and delivery care for the mother and her newborn, with or without COVID-19 infection, before and during the pandemic. In this research, "Birth in Belo Horizonte: labor and birth survey", data collection was performed between November 2011 and March 2013 by previously trained nurses. Between study comparisons were performed using Pearson's chi-square test, with a confidence level of 95%, and using Stata statistical program. RESULTS We found a significant increase in practices recommended by the World Health Organization during the pandemic including the following: diet offering (48.90 to 98.65%), non-pharmacological pain relief (43.84 to 67.57%), and breastfeeding in the newborn´s first hour of life (60.31 to 77.98%) (p < 0.001). We found a significant reduction of non-recommended interventions, such as routine use of episiotomy (15.73 to 2.09%), the Kristeller maneuver (16.55 to 0.94%), oxytocin infusion misused (45.55 to 28.07%), amniotomy (30.81 to 15.08%), and lithotomy position during labor (71.23 to 6.54%) (p < 0.001). CONCLUSION Our study revealed a statistically significant increase in the proportion of use of recommended practices and a reduction in non-recommended practices during labor and delivery. However, despite advances in the establishment of World Health Organization recommended practices in labor, delivery, and birth, the predominance of interventionist and medicalized practices persists, which is worsened by events, such as the pandemic.
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Chertok IA, Artzi-Medvedik R, Arendt M, Sacks E, Otelea MR, Rodrigues C, Costa R, Linden K, Zaigham M, Elden H, Drandic D, Grylka-Baeschlin S, Miani C, Valente EP, Covi B, Lazzerini M, Mariani I. Factors associated with exclusive breastfeeding at discharge during the COVID-19 pandemic in 17 WHO European Region countries. Int Breastfeed J 2022; 17:83. [PMID: 36461061 PMCID: PMC9716162 DOI: 10.1186/s13006-022-00517-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates at discharge over time and to identify factors associated with exclusive breastfeeding during the pandemic. METHODS A cross-sectional survey was conducted among mothers who gave birth in a maternity care facility in the World Health Organization (WHO) European Region countries during the COVID-19 pandemic. The socio-ecological model was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with maternal report of exclusive breastfeeding at the time of discharge. RESULTS There were 26,709 participating mothers from 17 European Region countries who were included in the analysis. Among the mothers, 72.4% (n = 19,350) exclusively breastfed and 27.6% (n = 7,359) did not exclusively breastfeed at discharge. There was an overall decline in exclusive breastfeeding rates over time (p = 0.015) with a significantly lower rate following the publication of the WHO breastfeeding guidelines on 23 June 2020 (AOR 0.88; 95% CI 0.82, 0.94). Factors significantly associated with exclusive breastfeeding outcomes in the logistic regression analysis included maternal age, parity, education, health insurance, mode of birth, inadequate breastfeeding support, lack of early breastfeeding initiation, lack of full rooming-in, birth attendant, perceived healthcare professionalism and attention, facility room cleanliness, timing of birth, and location of birth. CONCLUSIONS Results from the study indicate the decline in exclusive breastfeeding rates in the WHO European Region during the COVID-19 pandemic. Using the socio-ecological model to identify factors associated with breastfeeding outcomes facilitates an integrated and holistic approach to address breastfeeding needs among women across the region. These findings demonstrate the need to augment breastfeeding support and to protect exclusive breastfeeding among mother-infant dyads, in an effort to reverse the declining exclusive breastfeeding rates. The study highlights the need to educate mothers and their families about the importance of exclusive breastfeeding, reduce maternal-infant separation, increase professional breastfeeding support, and follow evidence-based practice guidelines to promote breastfeeding in a comprehensive and multi-level manner. TRIAL REGISTRATION NUMBER Clinical Trials NCT04847336.
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Affiliation(s)
- Ilana Azulay Chertok
- grid.20627.310000 0001 0668 7841Ohio University, Athens, OH USA ,grid.443022.30000 0004 0636 0840Ruppin College, Emek Hefer, Israel
| | - Rada Artzi-Medvedik
- grid.20627.310000 0001 0668 7841Ohio University, Athens, OH USA ,grid.7489.20000 0004 1937 0511Ben-Gurion University of the Negev, Beersheva, Israel
| | - Maryse Arendt
- BLL Beruffsverband vun den Laktatiounsberoderinnen zu Lëtzebuerg, Luxembourg, Luxembourg
| | - Emma Sacks
- grid.21107.350000 0001 2171 9311Johns Hopkins University, Baltimore, MD USA
| | - Marina Ruxandra Otelea
- grid.8194.40000 0000 9828 7548Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Carina Rodrigues
- grid.5808.50000 0001 1503 7226Instituto de Saude Publica, Universidade Do Porto, Porto, Portugal
| | - Raquel Costa
- grid.5808.50000 0001 1503 7226Instituto de Saude Publica, Universidade Do Porto, Porto, Portugal
| | - Karolina Linden
- grid.8761.80000 0000 9919 9582Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mehreen Zaigham
- grid.411843.b0000 0004 0623 9987Skane University Hospital, Lund University, Lund, Sweden
| | - Helen Elden
- grid.8761.80000 0000 9919 9582Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Daniela Drandic
- Reproductive Rights Advocacy Program (RODA)- Parents in Action, Zagreb, Croatia
| | | | - Céline Miani
- grid.7491.b0000 0001 0944 9128School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Emanuelle Pessa Valente
- grid.418712.90000 0004 1760 7415Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Benedetta Covi
- grid.418712.90000 0004 1760 7415Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Marzia Lazzerini
- grid.418712.90000 0004 1760 7415Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Ilaria Mariani
- grid.418712.90000 0004 1760 7415Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy
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Marín Gabriel MÁ, Manzanares Gutiérrez L, Martín Lozoya S, Gómez de Olea Abad B. [COVID-19 and exclusive breastfeeding: Are they really related? Authors reply]. An Pediatr (Barc) 2022; 97:296. [PMID: 36212027 PMCID: PMC9526675 DOI: 10.1016/j.anpedi.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Miguel Ángel Marín Gabriel
- Unidad Neonatal, Departamento de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España
- Departamento de Pediatría, Universidad Autónoma de Madrid, Hospitales-IHAN, Madrid, España
| | | | - Sergio Martín Lozoya
- Departamento de Pediatría, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, España
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Milani GP, Porro A, Agostoni C, Giannì ML. Breastfeeding during a Pandemic. ANNALS OF NUTRITION & METABOLISM 2022; 78:1-9. [PMID: 35176736 DOI: 10.1159/000521349] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/05/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The current pandemic and the concerns of vertical transmission of SARS-CoV-2 have contributed to increasing the rate of breastfeeding interruption. This tendency has been associated with negative effects on the well-being of lactating mothers and their infants. The aim of this review is to summarize the evidence on the strategies to support breastfeeding during the COVID-19 pandemic and on the safety of breastfeeding during a SARS-CoV-2 infection or after COVID-19 vaccination. SUMMARY Available data show that the lack of support of lactating mothers during the pandemic has contributed to breastfeeding cessation worldwide. However, a few strategies have been proposed to overcome this issue. The risk of SARS-CoV-2 transmission from infected mothers to their offspring is extremely low. Furthermore, vaccination of lactating mothers is not associated with side effects in their infants. Key Messages: Increasing effort should be made to support breastfeeding during the COVID-19 pandemic. Mothers who are able to take care of their offspring and to adopt basic hygiene measures should not interrupt breastfeeding during a SARS-CoV-2 infection. Vaccination of lactating mothers might further strengthen the protective effect of breastfeeding against infections.
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Affiliation(s)
- Gregorio P Milani
- University of Milan, Department of Clinical Science and Community Health, Milan, Italy,
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy,
| | - Alessandro Porro
- University of Milan, Department of Clinical Science and Community Health, Milan, Italy
| | - Carlo Agostoni
- University of Milan, Department of Clinical Science and Community Health, Milan, Italy
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Pediatric Unit, Milan, Italy
| | - Maria Lorella Giannì
- University of Milan, Department of Clinical Science and Community Health, Milan, Italy
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Milan, Italy
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