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Kersting M, Sievers E, Hockamp N, Kalhoff H, Lücke T. Getting breastfeeding started under pandemic visiting restrictions: lessons learned in Germany. Int Breastfeed J 2024; 19:64. [PMID: 39272188 PMCID: PMC11401266 DOI: 10.1186/s13006-024-00664-7] [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: 11/08/2023] [Accepted: 08/09/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic contact restrictions considerably changed maternal visiting contacts during the time in which breastfeeding is initiated. We wanted to know how maternity ward staff and mothers rated the conditions of starting breastfeeding under contact restrictions. METHODS In the Breastfeeding in North Rhine-Westphalia (SINA) study, Germany, 2021/22, chief physicians as well as ward staff from 41 (out of 131) maternity hospitals (82 members of the healthcare sector in total) were surveyed by telephone concerning structural and practical conditions for breastfeeding support before and during the pandemic; 192 (out of 426 eligible) mothers answered an online-questionnaire about their breastfeeding experiences at 2 weeks and 2 months after birth. RESULTS In almost all of the hospitals, visits were restricted due to the pandemic, with the exception of the primary support person. After more than one year of pandemic experience, the ward staff were convinced that the restrictions were mostly positive for the mothers (97.6%) and for the ward staff themselves (78.0%). A total of 80.5% of the ward staff would maintain the restrictions beyond the pandemic. The mothers themselves mostly rated the restrictions in the hospital as being just right; moreover, many mothers voluntarily maintained the restrictions at home, at least in part. CONCLUSIONS The unprecedented visiting restrictions in hospitals during the pandemic were like an "experiment" born out of necessity. Restricting visiting arrangements may be an underestimated beneficial component for the development of the mother-infant dyad in perinatal breastfeeding care, particularly in healthcare systems where almost all births occur in the maternity hospital. TRIAL REGISTRATION German Clinical Trials Register (DRKS) (DRKS00027975).
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Affiliation(s)
- Mathilde Kersting
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany.
| | | | - Nele Hockamp
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany
| | - Hermann Kalhoff
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany
- Pediatric Clinic Dortmund, Dortmund, Germany
| | - Thomas Lücke
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany
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Marks KJ, Gosdin L, O'Connor LE, Hamner HC, Grossniklaus DA. Changes in maternity care policies and practices that support breastfeeding as measured by the Ten Steps to Successful Breastfeeding - United States, 2018-2022. BMC Pregnancy Childbirth 2024; 24:475. [PMID: 38997658 PMCID: PMC11241842 DOI: 10.1186/s12884-024-06672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Experiences during the birth hospitalization affect a family's ability to establish and maintain breastfeeding. The Ten Steps to Successful Breastfeeding (Ten Steps) describe evidence-based hospital policies and practices shown to improve breastfeeding outcomes. We aim to describe hospitals' implementation of the Ten Steps, changes over time, and hospitals' implementation of a majority (≥ 6) of the Ten Steps by hospital characteristics and state. METHODS The biennial Maternity Practices in Infant Nutrition and Care (mPINC) survey assesses all hospitals in the United States (including the District of Columbia and territories) that routinely provide maternity care services. We analyzed data from 2018, 2020, and 2022 survey cycles to describe trends in the prevalence of hospitals implementing maternity care policies and practices that are consistent with the Ten Steps. Differences were calculated using the absolute difference in percentage-points between 2018 and 2022. RESULTS Between 2018 and 2022, the percentage of hospitals that implemented Step 2: Staff Competency and Step 5: Support Mothers with Breastfeeding increased 12 and 8 percentage points, respectively. The percentage of hospitals that implemented Step 6: Exclusive Breastfeeding Among Breastfed Infants was 7 percentage points lower in 2022 than 2018. Implementation of the remaining seven steps did not change by more than 5 percentage points in either direction between 2018 and 2022. Nationally, the percentage of hospitals that implemented ≥ 6 of the Ten Steps increased from 44.0% in 2018 to 51.1% in 2022. Differences were seen when comparing implementation of ≥ 6 of the Ten Steps by hospital characteristics including state, hospital size, and highest level of neonatal care offered. CONCLUSIONS Nationally, maternity care policies and practices supportive of breastfeeding continued to improve; however, certain practices lost progress. Differences in implementation of the Ten Steps were observed across states and by certain hospital characteristics, suggesting more work is needed to ensure all people receive optimal breastfeeding support during their delivery hospitalization.
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Affiliation(s)
- Kristin J Marks
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA.
- United States Public Health Service, 1101 Wootton Pkwy, Rockville, MD, 20852, USA.
| | - Lucas Gosdin
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA
| | - Lauren E O'Connor
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA
| | - Daurice A Grossniklaus
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA
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Roess AA, Robert RC, Kuehn D, Andrews CF, Vinjamuri S. The Impact of COVID-19 on Breastfeeding Initiation and Duration in a Low-Income Population, Washington, DC. Breastfeed Med 2024; 19:120-128. [PMID: 38386992 DOI: 10.1089/bfm.2023.0223] [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] [Indexed: 02/24/2024]
Abstract
Objective: To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on breastfeeding initiation (BFI) and duration among women enrolled in the Special Supplemental Nutrition Program for women, infants, and children (WIC) in Washington District of Columbia (DC). Materials and Methods: We used WIC program data from Washington DC to assess the pandemic's impact on BFI and duration among WIC recipients. t-Tests and unadjusted odds ratios compared breastfeeding outcomes before and during the pandemic. Multivariable logistic and linear regression models estimated the pandemic's impact on initiation and duration, respectively, while controlling for social determinants of health and other factors. Results: BFI was similar among women who gave birth before (61.4%) or during the pandemic (60.4%) (p = 0.359). However, the proportion of women who breastfed at 1 month decreased significantly from 56.1% (before pandemic) to 47.6% (during pandemic) (p < 0.0001). This pattern for duration continued at 3 and 6 months: 46.9% to 37.1% (p < 0.0001) at 3 months and 34.8% to 25.7% (p < 0.0001) at 6 months. On average, women who delivered during the pandemic breastfed 33.9 fewer days than those who delivered before (p < 0.0001). Conclusions: BFI among DC WIC recipients was similar for infants born before or during the pandemic, and determinants of initiation remained similar to previous reports (e.g., race/ethnicity, education). However, for women who initiated breastfeeding, average duration was significantly lower for infants born during the pandemic than before. Our findings suggest the importance of leveraging WIC and other breastfeeding supports to promote breastfeeding during pandemics and other emergencies.
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Affiliation(s)
- Amira A Roess
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Rebecca C Robert
- Conway School of Nursing, The Catholic University of America, Washington, District of Columbia, USA
| | - Doris Kuehn
- The District of Columbia (DC) Department of Health, DC Women Infant Child (WIC) State Agency, Washington, District of Columbia, USA
| | - Caroline F Andrews
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Swathi Vinjamuri
- The District of Columbia (DC) Department of Health, DC Women Infant Child (WIC) State Agency, Washington, District of Columbia, USA
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Cerceo E, Saxer K, Grossman L, Shapley-Quinn K, Feldman-Winter L. The Climate Crisis and Breastfeeding: Opportunities for Resilience. J Hum Lact 2024; 40:33-50. [PMID: 38158719 DOI: 10.1177/08903344231216726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
The climate crisis is an emerging global challenge that poses potential risks to breastfeeding practices and outcomes. There are multifaceted effects of climate change affecting the breastfeeding dyad across environmental, societal, and human health dimensions. Breastfeeding support in the face of climate change will require solutions at the structural level-healthcare, community, and workplace settings-and at the mother-infant dyad level. Breastfeeding can additionally be an adaptive response to crisis situations and can mitigate some of the environmental challenges associated with climate change. Despite the undeniable significance of climate change on breastfeeding (and vice versa), our perspective as experts in the field is that this topic has not been systematically addressed. Although we highlight some of the challenges, potential solutions, and co-benefits of breastfeeding in the context of climate change, there are numerous issues that could be further explored and necessitate additional preparedness planning.
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Affiliation(s)
- Elizabeth Cerceo
- Cooper University Healthcare, Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Lauren Grossman
- General Internal Medicine and Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Lori Feldman-Winter
- Cooper University Healthcare, Cooper Medical School of Rowan University, Camden, NJ, USA
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Simeone RM, Meghani M, Meeker JR, Zapata LB, Galang RR, Salvesen Von Essen B, Dieke A, Ellington SR. Differences in delivery hospitalization experiences during the COVID-19 pandemic by maternal race and ethnicity, Pregnancy Risk Assessment Monitoring System, 2020. J Perinatol 2024; 44:20-27. [PMID: 37660214 PMCID: PMC11197487 DOI: 10.1038/s41372-023-01763-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVE We investigated maternal COVID-19 related experiences during delivery hospitalizations, and whether experiences differed by maternal race and ethnicity. STUDY DESIGN Data from the Pregnancy Risk Assessment Monitoring System among women with live births between April-December 2020 were used. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) estimated associations between maternal race and ethnicity and COVID-19 related delivery experiences. RESULTS Among 12,879 women, 3.6% reported infant separation and 1.8% reported not being allowed support persons. Compared with non-Hispanic White women, American Indian/Alaska Native (AI/AN) (aPR = 2.7; CI: 1.2-6.2), Hispanic (aPR = 2.2; CI: 1.5-3.1), non-Hispanic Black (aPR = 2.4; CI: 1.7-3.6), and non-Hispanic Asian (aPR = 2.8; CI: 1.6-4.9) women reported more infant separation due to COVID-19. Not being allowed support persons was more common among AI/AN (aPR = 5.2; CI: 1.8-14.8) and non-Hispanic Black (aPR = 2.3; CI: 1.3-4.1) women. CONCLUSIONS COVID-19 related delivery hospitalization experiences were unequally distributed among racial and ethnic minorities.
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Affiliation(s)
- Regina M Simeone
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Mehreen Meghani
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Jessica R Meeker
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- U.S. Public Health Service, Rockville, MD, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lauren B Zapata
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- U.S. Public Health Service, Rockville, MD, USA
| | - Romeo R Galang
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Beatriz Salvesen Von Essen
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Ada Dieke
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sascha R Ellington
- Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Penny F, Brownell EA, Judge M, Marshall-Crim M, Cartagena D, McGrath JM. Use of a Supplemental Feeding Tube Device and Breastfeeding at 4 Weeks. MCN Am J Matern Child Nurs 2023; 48:334-340. [PMID: 37840203 DOI: 10.1097/nmc.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
BACKGROUND Mothers having difficulty breastfeeding their infants may use alternative supportive feeding methods. Although a supplemental feeding tube device is commonly used, efficacy for supporting sustained breastfeeding remains unknown. PURPOSE To describe supplemental feeding tube device use by breastfeeding mothers as an alternative feeding method through exploration of associations between supplemental feeding tube device use and continued breastfeeding at 4 weeks of infant's age. METHOD Forty mothers participated. They were interviewed during the birth hospitalization and at 4 weeks postpartum. Questions addressed use of supplemental feeding tube devices, breastfeeding issues, and continued breastfeeding relationships. We examined the relationship between LATCH scores at 2 to 3 days of life. RESULTS Breastfeeding mothers who chose to supplement with bottle-feeding instead of use of a supplemental feeding tube device were 30% less likely to continue breastfeeding at a medium/high/exclusive level. CONCLUSION Use of the supplemental feeding tube device may help avoid the potentially detrimental effect of bottle-feeding on continued breastfeeding.
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Zöllkau J, Heimann Y, Hagenbeck C, Pecks U, Abou-Dakn M, Schlösser R, Schohe A, Dressler-Steinbach I, Manz M, Banz-Jansen C, Reuschel E, Iannaccone A, Bohlmann MK, Kraft K, Fill Malfertheiner S, Wimberger P, Kolben T, Bartmann C, Longardt AC. Breastfeeding Behavior Within the Covid-19 Related Obstetric and Neonatal Outcome Study (CRONOS). J Hum Lact 2023; 39:625-635. [PMID: 37712573 DOI: 10.1177/08903344231190623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
BACKGROUND The SARS-CoV-2 pandemic and its influence on peripartum processes worldwide led to issues in breastfeeding support. RESEARCH AIM The aim of this study was to describe breastfeeding behavior and peripartum in-hospital management during the pandemic in Germany and Austria. METHODS This study was a descriptive study using a combination of secondary longitudinal data and a cross-sectional online survey. Registry data from the prospective multicenter COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS) cohort study (longitudinal, medical records of 1,815 parent-neonate pairs with confirmed SARS-CoV-2 infection during pregnancy) and a cross-sectional online survey of CRONOS hospitals' physicians (N = 67) were used for a descriptive comparison of feeding outcomes and postpartum management. RESULTS In 93.7% (n = 1700) of the cases in which information on the neonate's diet was provided, feeding was with the mother's own milk. Among neonates not receiving their mother's own milk, 24.3% (n = 26) reported SARS-CoV-2 infection as the reason. Peripartum maternal SARS-CoV-2 infection, severe maternal COVID-19 including the need for intensive care unit (ICU) treatment or invasive ventilation, preterm birth, mandatory delivery due to COVID-19, and neonatal ICU admission were associated with lower rates of breastfeeding. Rooming-in positively influenced breastfeeding without affecting neonatal SARS-CoV-2 frequency (4.2% vs. 5.6%). CRONOS hospitals reported that feeding an infant their mother's own milk continued to be supported during the pandemic. In cases of severe COVID-19, four of five hospitals encouraged breastfeeding. CONCLUSION Maintaining rooming-in and breastfeeding support services in the CRONOS hospitals during the pandemic resulted in high breastfeeding rates.
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Affiliation(s)
- Janine Zöllkau
- Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Yvonne Heimann
- Department of Obstetrics, Jena University Hospital, Jena, Germany
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ulrich Pecks
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Michael Abou-Dakn
- Department of Obstetrics and Gynecology, St. Joseph-Hospital, Berlin, Germany
| | - Rolf Schlösser
- Hospital for Children and Adolescents, University Hospital of Frankfurt, Frankfurt, Germany
| | - Anna Schohe
- Department of Obstetrics and Gynecology, St. Joseph-Hospital, Berlin, Germany
| | | | - Maike Manz
- Department of Obstetrics and Gynecology, Darmstadt City Hospital, Darmstadt, Germany
| | - Constanze Banz-Jansen
- Department of Gynecology and Obstetrics, Protestant Hospital of Bethel Foundation, Bielefeld, Germany
| | - Edith Reuschel
- University Department of Obstetrics and Gynecology, The Hospital St. Hedwig of The Order of St. John, University of Regensburg, Regensburg, Germany
| | | | - Michael K Bohlmann
- Department of Obstetrics and Gynecology, St. Elisabeth' Hospital, Loerrach, Germany
| | - Katrina Kraft
- Department of Obstetrics and Gynecology, Munich Municipal Hospital, Harlaching, Munich, Germany
| | - Sara Fill Malfertheiner
- University Department of Obstetrics and Gynecology, The Hospital St. Hedwig of The Order of St. John, University of Regensburg, Regensburg, Germany
| | - Pauline Wimberger
- Department of Gynecology and Obstetrics, TU Dresden, Dresden, Germany
| | - Thomas Kolben
- Department for Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Catharina Bartmann
- Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
| | - Ann - Carolin Longardt
- Clinic for Pediatrics and Adolescent Medicine I / Neonatology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
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Saus-Ortega C. Skin-to-skin contact in mothers with suspected, probable, or confirmed COVID-19. Birth 2023; 50:486-495. [PMID: 36774626 DOI: 10.1111/birt.12715] [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: 01/20/2021] [Accepted: 01/27/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND The World Health Organization recommends skin-to-skin contact (SSC) in newborns of mothers with COVID-19, applying infection prevention and control measures, and after a process of antenatal counseling on the possible risks and benefits. In this study, the reasons given for and against postnatal SSC in mothers with COVID-19 were reviewed. METHOD Between November and December 2020, we conducted a scoping review. Twenty-six relevant studies were identified. The results were extracted and presented narratively. RESULTS The reasons described for avoiding SSC have include contradictory recommendations, risk of virus transmission, impossibility of universal antepartum maternal screening for COVID-19, work overload, and ethical considerations. The reasons given for the maintenance of SSC include maternal and infant benefits of SSC, previous experiences in viral outbreaks, protection of newborns against infections, decreased contact with professionals, caregivers and surfaces, and preservation of natural processes. CONCLUSIONS The recommendation to allow SSC is based primarily on the acceptance that horizontal perinatal transmission is unlikely if correct hygiene precautions are taken and that the benefits of SSC outweigh the potential risks of neonatal COVID-19 infection. Knowing the reasons that have motivated the current recommendations on SSC is essential to be able to carry out an effective prenatal parental education that allows a shared decision to be made.
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Affiliation(s)
- Carlos Saus-Ortega
- Research Group in Art and Science in Care, Institute for Health Research La Fe (IISLAFE), University School of Nursing La Fe, València, Spain
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Grady J, Mulpeter E, Brimdyr K, Cadwell K. Rescinding evidence-based care and practices during the initial COVID-19 outbreak in the United States: a qualitative study of the experiences of lactation support providers. Front Public Health 2023; 11:1197256. [PMID: 37637806 PMCID: PMC10450022 DOI: 10.3389/fpubh.2023.1197256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
Background The COVID-19 pandemic disrupted healthcare systems and services including along the childbearing continuum. The aim of this study was to explore the experiences and perceptions of professional lactation support providers who cared for breastfeeding families during the early months of the pandemic (March 2020 - August 2020) in the United States. Design/methods We conducted a qualitative survey among active lactation support providers in the United States. Eligible participants spoke English, were Certified Lactation Counselors who maintained an active certification and who provided lactation care and services prior to and after the onset of the COVID-19 pandemic. Participants were recruited via email from the national database of Certified Lactation Counselors obtained from the national certification body. All ten Health and Human Service regions of the United States were included. Demographic data was collected on each respondent. Qualitative survey responses were analyzed thematically following the framework method. Findings Six-hundred and seventy-four (674) Certified Lactation Counselors responded to the survey from June to July of 2022. Their responses fell within the overarching theme of rescinding evidence-based care and practices that had been in place prior to the pandemic. Affected care practices included the insertion of limits on access to care and insinuating stigma and bias based on COVID-19 status. Irregular appointment schedules and staffing shortages also affected care. Participants reported that separation of the mother and their infant became the norm. Decisions made by management seemed to be grounded in fear and uncertainty, rather than on the evidence-based principles that had been in place prior to the pandemic. Conclusion A lack of coordination, consistency and support, along with fear of the unknown, troubled lactation support providers and impacted their ability to provide evidence-based care and to maintain access to care for all families. The findings of the survey and analysis underscore the importance of adequately preparing for future public health crises by determining how evidence-based care and practices can be preserved in emergent situations.
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Affiliation(s)
- Julie Grady
- School of Nursing, Curry College, Milton, MA, United States
| | - Ellie Mulpeter
- Academy of Lactation Policy and Practice, South Dennis, MA, United States
| | - Kajsa Brimdyr
- Healthy Children Project, Inc., Harwich, MA, United States
| | - Karin Cadwell
- Healthy Children Project, Inc., Harwich, MA, United States
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Nakayama JY, Marks KJ, McGowan A, Li R, Hamner HC. Human milk expression in the first year postpartum among persons with low incomes. J Hum Nutr Diet 2023; 36:1261-1269. [PMID: 36624691 PMCID: PMC10329723 DOI: 10.1111/jhn.13136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
BACKGROUND Expressing milk (i.e., human milk) is common in the USA, but practices are unknown among families in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). This study of a WIC population explores the practice of and reasons for expressing milk in the first year postpartum. METHODS We analysed data from a longitudinal study to examine milk expression at 1, 3, 5, 7, 9, 11, and 13 months postpartum among breastfeeding persons enrolled in WIC with term singletons. We cross-sectionally analysed the weighted prevalence of milk expression at each survey month and report reasons for milk expression in the first 7 months. RESULTS Among the study participants who reported feeding human milk at Month 1, 70.4% expressed milk in the first 13 months postpartum. The prevalence of milk expression was 56.8% at Month 1 and decreased to 13.9% at Month 13 among those feeding any human milk that month. Reasons for expressing milk changed over time; in the first month, increasing milk supply, relieving engorgement, and having an emergency supply of milk were common. In later months, having a supply of milk available so that someone else could feed their infant was common. CONCLUSIONS Clinicians, health educators, WIC staff, and others working with WIC families can promote optimal expressed milk feeding and storage practices. Extra attention and support may be especially important in the first months postpartum when milk expression is common. Support for persons who are expressing milk can be tailored for reasons of milk expression.
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Affiliation(s)
- Jasmine Y. Nakayama
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristin J. Marks
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA
- US Public Health Service Commissioned Corps, Rockville, MD, USA
| | - Andrea McGowan
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Ruowei Li
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Heather C. Hamner
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ruiz MT, de Oliveira KF, Azevedo NF, Paschoini MC, Rodrigues WF, de Oliveira CJF, de Oliveira JF, Fonseca LMM, Wernet M. Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review. Rev Bras Enferm 2023; 76Suppl 1:e20220173. [PMID: 37531480 PMCID: PMC10389650 DOI: 10.1590/0034-7167-2022-0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 01/17/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19. METHODS a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation. RESULTS fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90-72.88), and artificial breastfeeding, 43.23% (CI = 30.99 - 55.88), without statistically significant differences. CONCLUSIONS despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Monika Wernet
- Universidade Federal de São Carlos. São Carlos, São Paulo, Brazil
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12
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Wesołowska A, Walczak B, Kalita-Kurzyńska K, Mołas A, Bzikowska-Jura A. Feeding Strategies in Newborns and Infants During the COVID-19 Pandemic-Polish Cross-Sectional Study. Int J Public Health 2023; 68:1605590. [PMID: 37457844 PMCID: PMC10338688 DOI: 10.3389/ijph.2023.1605590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Objective: We aimed to analyze factors affecting feeding strategies of newborns and infants during the COVID-19 pandemic in Poland. Methods: The cross-sectional study using a self-developed CAWI questionnaire was conducted between February and April 2021 among Polish mothers. The analysis included responses from 1,485 women who delivered during the COVID-19 pandemic restrictions. The inferential analysis uses Parson's chi-square test and the series of logistic models. The data were weighted to adjust age and educational level distribution. Results: When hospitalized, lack of skin-to-skin contact (OR = 0.094; p < 0.001, 95% CI [0.057 0.156]), not being informed about direct breastfeeding in the pandemic (OR = 0.195, p = 0.006, 95% CI [0.61 0.62]) and being suspected for COVID-19 (OR = 0.379, p < 0.001, 95% CI [0.223 0.642]) reduced the probability of breastfeeding. Feeding plans and feeding after leaving the hospital were impacted only by the educational level (OR = 2.463, p = 0.028, 95% CI [1.1 5.518]). Conclusion: While the mother's education level plays a key role in the nutrition plans and long-term feeding strategy, PUI status and hospital practices (lack of skin-to-skin and proper information) had a major negative impact on breastfeeding rates in the hospital.
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Affiliation(s)
- Aleksandra Wesołowska
- Department of Medical Biology, Laboratory of Human Milk and Lactation Research, Medical University of Warsaw, Warsaw, Poland
- Human Milk Bank Foundation, Warsaw, Poland
| | - Bartłomiej Walczak
- Institute of Applied Social Sciences, University of Warsaw, Warsaw, Poland
| | - Kinga Kalita-Kurzyńska
- Department of Medical Biology, Laboratory of Human Milk and Lactation Research, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Mołas
- Department of Medical Biology, Laboratory of Human Milk and Lactation Research, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Bzikowska-Jura
- Department of Medical Biology, Laboratory of Human Milk and Lactation Research, Medical University of Warsaw, Warsaw, Poland
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13
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Iobst SE, Breman RB, Walker M, Wysong G, Best N, Edmonds JK. Challenges, Job Satisfiers, and Self-Care among Perinatal Nurses in the United States during the COVID-19 Pandemic. MCN Am J Matern Child Nurs 2023; 48:118-126. [PMID: 36744889 DOI: 10.1097/nmc.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To explore the perceived challenges, job satisfiers, and self-care of perinatal nurses in the United States during the COVID-19 pandemic. STUDY DESIGN AND METHODS In May of 2021, a cross-sectional survey was distributed online to members of the Association of Women's Health, Obstetric, and Neonatal Nurses and the National Association of Neonatal Nurses. We calculated descriptive statistics on respondent characteristics and applied conventional content analysis to free-text comments. RESULTS Perinatal nurses ( N = 297) responded to three open-ended questions on their perceived challenges, job satisfiers, and self-care. Frequently reported challenges included changing guidelines and policies ( n = 101, 34%), personal protective equipment as a barrier ( n = 73, 24.6%), and visitor restrictions ( n = 64, 21.5%). Frequently reported job satisfiers were provision of high-quality care ( n = 137, 46.1%) and visitor restrictions ( n = 77, 25.9%). Respondents reported using mental ( n = 152, 51.2%) and physical ( n = 145, 48.8%) self-care strategies and 12.8% ( n = 38) reported using no self-care strategies. CLINICAL IMPLICATIONS The ability to provide high-quality care was reported as a leading job satisfier. Poor communication of consistent, evidence-based guidelines, lack of personal protective equipment, and inadequate unit staffing were leading challenges. Visitor restrictions were a challenge and a job satisfier, suggesting opportunities to better include visitors as support people. Most respondents reported engaging in one or more types of self-care outside of the hospital setting. Future research is needed to examine strategies for self-care among perinatal nurses when at work in the hospital setting.
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14
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Xiang K, Zhou YH. Breastmilk—Old but Not Obsolete: from the Safety of Breastfeeding During the Coronavirus Disease 2019 Pandemic to Broad Antiviral Drug Development. MATERNAL-FETAL MEDICINE 2023. [DOI: 10.1097/fm9.0000000000000188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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15
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Berger J, Burnham L, Nickel N, Knapp R, Gambari A, Beliveau P, Merewood A. Policies and Practices in a Cohort of Mississippi Birthing Hospitals During the COVID-19 Pandemic. Breastfeed Med 2023; 18:138-148. [PMID: 36800335 DOI: 10.1089/bfm.2022.0170] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Background and Objectives: Guidance around maternity care practices and infant feeding during the COVID-19 pandemic changed over time and was sometimes conflicting. Hospital maternity practices influence breastfeeding, an important preventive strategy against viral illness. Most birthing hospitals in Mississippi are enrolled in CHAMPS, a quality improvement initiative to support breastfeeding and continuously collect maternity care data. The aims of this study were to (1) assess changes to maternity care policies in response to COVID-19, and (2) compare hospital-level breastfeeding, skin-to-skin, and rooming-in rates, at cohort hospitals, before and during the pandemic, overall and stratified by race. Methods: Hospitals responded to a survey on maternity policies in May and September 2020 (Aim 1); hospitals submitted data on breastfeeding and maternity care practices before and during the pandemic (Aim 2). We tested for differences in survey responses using chi-squared statistics and performed an interrupted time series analysis on breastfeeding and maternity care practices data. Results: Twenty-six hospitals responded to the May and September 2020 surveys. Hospitals used different sources to create maternity care policies, and policies differed between institutions. Trends in rates of any and exclusive breastfeeding in the hospital cohort plateaued during the pandemic, in comparison to previous gains, and rates of skin-to-skin and hospital rooming-in decreased. No differences were evident between races. Conclusions: Policies (Aim 1) and practices in the quality improvement cohort hospitals were inconsistent during the COVID-19 pandemic, and changes measured to practices were detrimental (Aim 2). Ongoing monitoring is recommended.
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Affiliation(s)
- Jacqueline Berger
- Department of Sociology and Anthropology, Georgia Southern University, Statesboro, Georgia, USA
| | - Laura Burnham
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
| | - Nathan Nickel
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Rebecca Knapp
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
| | - Aishat Gambari
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
| | - Paige Beliveau
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Anne Merewood
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
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16
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DeYoreo M, Kapinos K, Lawrence R, Alvarado G, Waymouth M, Demirci JR, Uscher-Pines L. Changes in Breastfeeding and Lactation Support Experiences During COVID. J Womens Health (Larchmt) 2023; 32:150-160. [PMID: 36576992 PMCID: PMC9940799 DOI: 10.1089/jwh.2022.0146] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: We surveyed parents who gave birth from 2019 to 2021 to examine changes in breastfeeding experiences and professional and lay breastfeeding support services due to the coronavirus disease 2019 (COVID-19) pandemic. We also examined racial and ethnic disparities in breastfeeding support. Materials and Methods: A cross-sectional opt-in survey of 1,617 parents was administered on Ovia's parenting app in January 2022. Respondents were 18-45 years of age and delivered in one of three birth cohorts: August-December 2019, March-May 2020, or June-August 2021. We fit linear and logistic regression models wherein the outcomes were six breastfeeding support and experience measures, adjusting for birth cohort and respondent demographics. Results: Parents who gave birth in the early pandemic versus those in the prepandemic had reduced odds of interacting with lactation consultants (odds ratio [OR]: 0.63; 95% confidence interval [CI]: 0.44-0.90), attending breastfeeding classes (OR: 0.71; 95% CI: 0.54-0.94), meeting breastfeeding goals (OR: 0.65; 95% CI: 0.46-0.92), and reporting it was easy to get breastfeeding help (estimate: -0.36; 95% CI: -0.55 to -0.17). Birth cohort was not associated with use of donor milk or receipt of in-hospital help. The later pandemic cohort differed from the prepandemic cohort for one outcome: they were less likely to meet their breastfeeding goals (OR: 0.67; 95% CI: 0.48-0.95). There were racial and ethnic disparities in the use of multiple types of breastfeeding support. Although one-third of respondents felt that the pandemic facilitated breastfeeding because of more time at home, 18% felt the pandemic posed additional challenges including disruptions to lactation support. Conclusions: Parents who gave birth in the later pandemic did not report significant disruptions to professional breastfeeding support, likely as a result of the growth of virtual services. However, disparities in receipt of support require policy attention and action.
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Affiliation(s)
| | - Kandice Kapinos
- RAND Corporation, Arlington, Virginia, USA
- Department of Population and Data Sciences, UTSW, Dallas, Texas, USA
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17
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Turner SE, Brockway M, Azad MB, Grant A, Tomfohr-Madsen L, Brown A. Breastfeeding in the pandemic: A qualitative analysis of breastfeeding experiences among mothers from Canada and the United Kingdom. Women Birth 2023:S1871-5192(23)00015-X. [PMID: 36669903 DOI: 10.1016/j.wombi.2023.01.002] [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: 05/16/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Previous research shows that the COVID-19 pandemic resulted in both barriers and facilitators to breastfeeding. However, little research has looked specifically at first-time mothers' experiences of breastfeeding during the pandemic or compared experiences of mothers living in different countries. AIM This research explores mothers' breastfeeding experiences to describe how the COVID-19 pandemic has affected breastfeeding journeys in Canada and the United Kingdom. METHODS Ten semi-structured online interviews were undertaken with first-time mothers who breastfed their baby at least once during the COVID-19 pandemic and are living in Canada or the United Kingdom. Interview transcripts were coded inductively using thematic analysis. FINDINGS One overarching theme (all on mother) and four sub-themes were identified: 1) accessing and advocating for health care, 2) social support, 3) becoming a mother in isolation, and 4) breastfeeding baby. Similar themes were constructed for both countries. DISCUSSION Mothers reported that diminished health care and social support created challenges in their breastfeeding journey. Many mothers reported receiving virtual breastfeeding support, which was largely experienced as unhelpful. Some mothers reported fewer distractions from visitors and more one-on-one time with their infant, which helped them to establish breastfeeding and a strong mother-infant bond. CONCLUSION In both Canada and the United Kingdom, new mothers need consistent, reliable health care and social support when breastfeeding. This study supports the need to protect breastfeeding support in the midst of a global emergency and beyond to ensure positive breastfeeding experiences for both mother and baby.
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Affiliation(s)
- Sarah E Turner
- Children's Hospital Research Institute of Manitoba, 715 McDermot Ave, Winnipeg, Manitoba R3E 3P4, Canada; Manitoba Interdisciplinary Lactation Center (MILC), 715 McDermot Ave, Winnipeg, Manitoba R3E 3P4, Canada; Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3, Canada.
| | - Meredith Brockway
- Faculty of Nursing, University of Calgary, 2259 2800, Professional Faculties, University Way NW, Calgary, Alberta T2N 4V8, Canada
| | - Meghan B Azad
- Children's Hospital Research Institute of Manitoba, 715 McDermot Ave, Winnipeg, Manitoba R3E 3P4, Canada; Manitoba Interdisciplinary Lactation Center (MILC), 715 McDermot Ave, Winnipeg, Manitoba R3E 3P4, Canada; Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, Manitoba R3E 0W3, Canada; Department of Pediatrics and Child Health, University of Manitoba, 840 Sherbrook St, Winnipeg, Manitoba R3A 1S1, Canada
| | - Aimee Grant
- Centre for Lactation, Infant Feeding and Translation (LIFT), Swansea University, University Singleton Park Campus, Haldane Building, Sketty, Swansea SA2 8PP, United Kingdom; School of Health and Social Care, Swansea University, University Singleton Park Campus, Haldane Building, Sketty, Swansea SA2 8PP, United Kingdom
| | - Lianne Tomfohr-Madsen
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, 2125 Main Mall, Vancouver, BC V6T 1Z4, Canada
| | - Amy Brown
- Centre for Lactation, Infant Feeding and Translation (LIFT), Swansea University, University Singleton Park Campus, Haldane Building, Sketty, Swansea SA2 8PP, United Kingdom; School of Health and Social Care, Swansea University, University Singleton Park Campus, Haldane Building, Sketty, Swansea SA2 8PP, United Kingdom
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18
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Impact of the Infant Formula Shortage on Breastfeeding Rates. J Pediatr Health Care 2022; 37:279-286. [PMID: 36528487 DOI: 10.1016/j.pedhc.2022.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/11/2022] [Indexed: 12/16/2022]
Abstract
INTRODUCTION This study aimed to determine the impact of the infant formula shortage on breastfeeding rates. METHOD The sample included infants attending newborn through 2-month visits at a rural pediatric practice. Preshortage data was compared with postshortage data from newborn (pre: n = 302; post: n = 302), 1-month (pre: n = 273, post: n = 259), and 2-month (pre: n = 255; post: n = 234) visits. RESULTS Data analysis using Pearson's χ2 and Mann-Whitney tests found a significant increase in breastfeeding rates postshortage compared with preshortage. Breastfeeding initiation increased by 10.6% compared with preshortage. DISCUSSION Many factors contributed to the significant increase in breastfeeding initiation during the formula shortage. Reports of illnesses associated with the ingestion of infant formula made breastfeeding more appealing. Furthermore, breast milk was readily available, whereas formula was not. Positive breastfeeding experiences during the formula shortage may lead to a sustained increase in breastfeeding.
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19
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Adesanya AM, Barrett S, Moffat M, Aquino MRJ, Nicholson W, Turner G, Cook E, Tyndall S, Rankin J. Impact of the COVID-19 pandemic on expectant and new parents' experience of pregnancy, childbirth, breast feeding, parental responsiveness and sensitivity, and bonding and attunement in high-income countries: a systematic review of the evidence. BMJ Open 2022; 12:e066963. [PMID: 36523240 PMCID: PMC9748518 DOI: 10.1136/bmjopen-2022-066963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To review the evidence on how pregnancy, birth experience, breast feeding, parental responsiveness and sensitivity, and bonding and attunement were impacted by COVID-19. METHODS We searched eight literature databases and websites of relevant UK-based organisations. The review focused on evidence during pregnancy and the early years (0-5 years). Studies of any study design published in English from 1 March 2020 to 15 March 2021 and conducted in high-income countries were included. Screening and data extraction were undertaken in duplicate. Evidence was synthesised using a narrative approach. Study quality of included studies was assessed using the Mixed Methods Appraisal Tool. RESULTS The search yielded 9776 publications, of which 26 met our inclusion criteria. Significant knowledge gaps on how COVID-19 affected pregnancy and breast feeding limited healthcare providers' ability to provide consistent evidence-based information and care at the start of the pandemic. There was an enduring sense of loss about loved ones being restricted from taking part in key moments. Parents were concerned about the limitations of virtual healthcare provision. Some parents reported more opportunities for responsive breast feeding and improved parent-infant bonding due to reduced social and work pressures. Women from minoritised ethnic groups were less likely to continue breast feeding and attributed this to a lack of face-to-face support. CONCLUSIONS The evidence suggests that new and expectant families have been both negatively and positively impacted by the COVID-19 pandemic and the resulting restrictions. The impacts on parents' opportunities to bond with their young children and to be attuned to their needs were felt unequally. It is important that emergency response policies consider the mother and the partner as a family unit when making changes to the delivery of maternal and child health and care services, so as to mitigate the impact on the family and existing health inequalities. PROSPERO REGISTRATION NUMBER CRD42021236769.
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Affiliation(s)
- Adenike Motunrayo Adesanya
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Barrett
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Malcolm Moffat
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Maria Raisa Jessica Aquino
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Applied Research Collaboration North East and North Cumbria, Newcastle upon Tyne, UK
| | - Wendy Nicholson
- Office of Health Improvement and Disparities, UK Department of Health and Social Care, London, UK
| | - Gillian Turner
- Office of Health Improvement and Disparities, UK Department of Health and Social Care, London, UK
| | - Emma Cook
- Office of Health Improvement and Disparities, UK Department of Health and Social Care, London, UK
| | - Sarah Tyndall
- Office of Health Improvement and Disparities, UK Department of Health and Social Care, London, UK
| | - Judith Rankin
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Applied Research Collaboration North East and North Cumbria, Newcastle upon Tyne, UK
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20
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Palmquist AEL, Tomori C, Tumlinson K, Fox C, Chung S, Quinn EA. Pandemic policies and breastfeeding: A cross-sectional study during the onset of COVID-19 in the United States. FRONTIERS IN SOCIOLOGY 2022; 7:958108. [PMID: 36405376 PMCID: PMC9669788 DOI: 10.3389/fsoc.2022.958108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
The United States is one of the few countries, and the only high-income country, that does not federally mandate protection of postpartum employment through paid postpartum maternity and family leave policies. At the onset of the COVID-19 pandemic in the U.S., stay-at-home orders were implemented nationally, creating a natural experiment in which to document the effects of de facto paid leave on infant feeding practices in the first postpartum year. The purpose of this cross-sectional, mixed-methods study was to describe infant and young child feeding intentions, practices, decision-making, and experiences during the first wave of the COVID-19 pandemic in the U.S. Quantitative and qualitative data were collected March 27-May 31, 2020 via online survey among a convenience sample of respondents, ages 18 years and older, who were currently feeding a child 2 years of age or younger, yielding 1,437 eligible responses. Nearly all (97%) respondents indicated an intention to feed their infant exclusively with human milk in the first 6 months. A majority of respondents who were breastfeeding (66%) reported no change in breastfeeding frequency after the implementation of COVID-19 stay-at-home orders. However, thirty-one percent indicated that they breastfed more frequently due to stay-at-home orders and delayed plans to wean their infant or young child. Key themes drawn from the qualitative data were: emerging knowledge and perceptions of the relationship between COVID-19 and breastfeeding, perceptions of immune factors in human milk, and the social construction of COVID-19 and infant and young child feeding perceptions and knowledge. There were immediate positive effects of stay-at-home policies on human milk feeding practices, even during a time of considerable uncertainty about the safety of breastfeeding and the transmissibility of SARS-CoV-2 via human milk, constrained access to health care services and COVID-19 testing, and no effective COVID-19 vaccines. Federally mandated paid postpartum and family leave are essential to achieving more equitable lactation outcomes.
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Affiliation(s)
- Aunchalee E. L. Palmquist
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Cecília Tomori
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Katherine Tumlinson
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Carolyn Fox
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO, United States
| | - Stephanie Chung
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - E. A. Quinn
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO, United States
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21
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Bae SP, Lee WR, Hahn WH, Shin HJ, Ahn YM, Shin SM, Kim YJ, Kim EAR, Shin YJ, Yi DY, Lee SM, Lee J, Lee JA, Chung SH, Jung E, Choi EK, Heo JS. Survey of Korean pediatrician's perceptions of barriers to and improvements in breastfeeding. Clin Exp Pediatr 2022; 65:540-546. [PMID: 35914772 PMCID: PMC9650358 DOI: 10.3345/cep.2022.00311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/02/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although the benefits of breastfeeding are broadly acknowledged with the efforts of the government and several medical societies, the rate of exclusive breastfeeding through 6 months is lower in Korea than in developed countries. PURPOSE This study aimed to investigate pediatricians' perceptions of breastfeeding barriers and the current breastfeeding counseling environment and propose government policies to encourage breastfeeding in Korea. METHODS Fourteen survey questions were developed during meetings of Korean Society of Breastfeeding Medicine experts. The Korean Pediatric Society emailed a structured questionnaire to domestic pediatricians registered as official members of the Korean Pediatric Society on May 4, 2021, and June 3, 2021. This study examined the survey responses received from 168 pediatricians. RESULTS The 168 respondents included 62 professors, 53 paid doctors, and 53 private physicians. Breastfeeding was recommended by 146 Korean pediatricians (86.9%). However, only 99 responders (59%) currently provide breastfeeding counseling in hospitals. Most respondents stated providing less than 15 minutes of breastfeeding counseling time in the clinic. Moreover, 89.88% of the respondents responded that they would participate in breastfeeding counseling education if an appropriate breastfeeding counseling program was newly established. CONCLUSION This study showed that, although Korean pediatricians had a positive attitude toward breastfeeding, limited counseling was provided for parents. Along with policy support to improve the medical environment through the establishment of an appropriate breastfeeding counseling program, high-quality counseling and an increased breastfeeding rate are expected.
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Affiliation(s)
- Seong Phil Bae
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Woo Ryoung Lee
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Won-Ho Hahn
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hye-Jung Shin
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Young Min Ahn
- Department of Pediatrics, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea
| | - Son Moon Shin
- Department of Pediatrics, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Yong Joo Kim
- Department of Pediatrics, Hanyang Univerisity Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Ellen Ai-Rhan Kim
- Department of Pediatrics, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | | | - Dae Yong Yi
- Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Juyoung Lee
- Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University College of Medicine, Bucheon, Korea
| | - Jin A Lee
- Department of Pediatrics, Seoul National University-Seoul Metropolitan Government Borame Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Hoon Chung
- Department of Pediatrics, Gangdong Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Euiseok Jung
- Department of Pediatrics, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Eui Kyung Choi
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Ju Sun Heo
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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22
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Bernstein K, Gonrong P, Shallat S, Seidel B, Leider J. Creating a Culture of Breastfeeding Support and Continuity of Care in Central Illinois. Health Promot Pract 2022; 23:108S-117S. [DOI: 10.1177/15248399221111180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Central Illinois breastfeeding rates fall short of the recommendation to breastfeed exclusively through 6 months, and Black, low-income, and rural families disproportionately experience low rates. A continuity of care framework, which emphasizes interdisciplinary coordination from the prenatal period through weaning, can support breastfeeding. This case study describes an innovative practice model informed by the Collective Impact Model (CIM) designed to promote breastfeeding continuity of care and community support in Central Illinois. Development and maintenance of the Central Illinois Breastfeeding Professional Network (CIBPN), a network of diverse public health practitioners, leveraged CIM principles. The CIBPN began with influential Breastfeeding Champions, identified through the Illinois State Physical Activity and Nutrition program. Champions convened Central Illinois breastfeeding allies and led the CIBPN to coalesce around a common agenda and engage in mutually reinforcing activities. Linked breastfeeding data for families giving birth at a Central Illinois hospital and receiving postnatal care at a health center were analyzed as a snapshot of CIBPN initiatives. The CIBPN engaged at least 135 practitioners and more than 27 organizations. At least 33 people received advanced breastfeeding training, and many professional development opportunities were offered. Numerous breastfeeding support improvements were made at and between CIBPN sites. Breastfeeding rates at the birthing hospital and health center were stable, including during the COVID-19 pandemic. This article contributes to the practice-based evidence for breastfeeding support by strengthening continuity of care through a successful application of the CIM by public health practitioners.
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Affiliation(s)
| | | | - Shelly Shallat
- OSF Healthcare Children’s Hospital of Illinois, Peoria, IL, USA
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Beth Seidel
- UnityPoint Health—Methodist, Peoria, IL, USA
| | - Julien Leider
- Institute for Health Research and Policy, University of Chicago, Chicago, IL, USA
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23
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Lewis EL, Smoots AN, Woodworth KR, Olsen EO, Roth NM, Yazdy M, Shephard H, Sizemore L, Wingate H, Dzimira P, Reynolds B, Lush M, Fuchs EL, Ojo K, Siebman S, Hall AJ, Azziz-Baumgartner E, Perrine C, Hsia J, Ellington S, Tong VT, Gilboa SM. Breast Milk Feeding of Infants at Birth Among People With Confirmed SARS-CoV-2 Infection in Pregnancy: SET-NET, 5 States, March 29, 2020-December 31, 2020. Am J Public Health 2022; 112:S787-S796. [PMID: 36288521 PMCID: PMC9612185 DOI: 10.2105/ajph.2022.307023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/04/2022]
Abstract
Objectives. To describe prevalence of breast milk feeding among people with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy and examine associations between breast milk feeding, timing of maternal infection before delivery, and rooming-in status during delivery hospitalization. Methods. We performed a retrospective cohort study using data from Massachusetts, Minnesota, Nebraska, Pennsylvania, and Tennessee of whether people with confirmed SARS-CoV-2 infection during pregnancy in 2020 initiated breast milk feeding at birth. Results. Among 11 114 (weighted number) people with SARS-CoV-2 infection in pregnancy, 86.5% (95% confidence interval [CI] = 82.4%, 87.6%) initiated breast milk feeding during birth hospitalization. People with infection within 14 days before delivery had significantly lower prevalence of breast milk feeding (adjusted prevalence ratio [APR] = 0.88; 95% CI = 0.83, 0.94) than did those with infection at least 14 days before delivery. When stratified by rooming-in status, the association between timing of infection and breast milk feeding remained only among infants who did not room in with their mother (APR = 0.77; 95% CI = 0.68, 0.88). Conclusions. Pregnant and postpartum people with SARS-CoV-2 infection should have access to lactation support and be advised about the importance of breast milk feeding and how to safely feed their infants in the same room. (Am J Public Health. 2022;112(S8):S787-S796. https://doi.org/10.2105/AJPH.2022.307023).
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Affiliation(s)
- Elizabeth L Lewis
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Ashley N Smoots
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Kate R Woodworth
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Emily O'Malley Olsen
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Nicole M Roth
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Mahsa Yazdy
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Hanna Shephard
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Lindsey Sizemore
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Heather Wingate
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Paula Dzimira
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Bethany Reynolds
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Mamie Lush
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Erika L Fuchs
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Kristen Ojo
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Sam Siebman
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Aron J Hall
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Eduardo Azziz-Baumgartner
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Cria Perrine
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Jason Hsia
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Sascha Ellington
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Van T Tong
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
| | - Suzanne M Gilboa
- Elizabeth L. Lewis, Ashley N. Smoots, Kate R. Woodworth, Emily O'Malley Olsen, Nicole M. Roth, Aron J. Hall, Eduardo Azziz-Baumgartner, Cria Perrine, Jason Hsia, Sascha Ellington, Van T. Tong, and Suzanne M. Gilboa are with the Centers for Disease Control and Prevention (CDC) COVID-19 Response, Atlanta, GA. Mahsa Yazdy and Hanna Shephard are with the Massachusetts Department of Public Health, Boston. Lindsey Sizemore and Heather Wingate are with the Tennessee Department of Health, Nashville. Paula Dzimira and Bethany Reynolds are with the Pennsylvania Department of Health, Pittsburgh. Mamie Lush is with the Division of Public Health, Nebraska Department of Health and Human Services, Lincoln. Erika L. Fuchs is with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Kristen Ojo and Sam Siebman are with the Minnesota Department of Health, St. Paul
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24
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Guo J, Tan M, Zhu J, Tian Y, Liu H, Luo F, Wang J, Huang Y, Zhang Y, Yang Y, Wang G. Proteomic Analysis of Human Milk Reveals Nutritional and Immune Benefits in the Colostrum from Mothers with COVID-19. Nutrients 2022; 14:nu14122513. [PMID: 35745243 PMCID: PMC9227629 DOI: 10.3390/nu14122513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 02/05/2023] Open
Abstract
Despite the well-known benefits of breastfeeding and the World Health Organization’s breastfeeding recommendations for COVID-19 infected mothers, whether these mothers should be encouraged to breastfeed is under debate due to concern about the risk of virus transmission and lack of evidence of breastmilk’s protective effects against the virus. Here, we provide a molecular basis for the breastfeeding recommendation through mass spectrometry (MS)-based proteomics and glycosylation analysis of immune-related proteins in both colostrum and mature breastmilk collected from COVID-19 patients and healthy donors. The total protein amounts in the COVID-19 colostrum group were significantly higher than in the control group. While casein proteins in COVID-19 colostrum exhibited significantly lower abundances, immune-related proteins, especially whey proteins with antiviral properties against SARS-CoV-2, were upregulated. These proteins were detected with unique site-specific glycan structures and improved glycosylation diversity that are beneficial for recognizing epitopes and blocking viral entry. Such adaptive differences in milk from COVID-19 mothers tended to fade in mature milk from the same mothers one month postpartum. These results suggest that feeding infants colostrum from COVID-19 mothers confers both nutritional and immune benefits, and provide molecular-level insights that aid breastmilk feeding decisions in cases of active infection.
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Affiliation(s)
- Juanjuan Guo
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
| | - Minjie Tan
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
| | - Jing Zhu
- Institute of Biotechnology and Health, Beijing Academy of Science and Technology, Beijing 100089, China
- Correspondence: (J.Z.); (G.W.)
| | - Ye Tian
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
| | - Huanyu Liu
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
| | - Fan Luo
- State Key Laboratory of Virology, Institute of Medical Virology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China;
| | - Jianbin Wang
- School of Life Sciences, Tsinghua-Peking Center for Life Sciences, Tsinghua University, Beijing 100084, China;
| | - Yanyi Huang
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
- Biomedical Pioneering Innovation Center, Peking University, Beijing 100871, China
| | - Yuanzhen Zhang
- Department of Gynaecology and Obstetrics, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan 430071, China; (J.G.); (H.L.); (Y.Z.)
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China
| | - Yuexin Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China;
| | - Guanbo Wang
- Institute for Cell Analysis, Shenzhen Bay Laboratory, Shenzhen 518132, China; (M.T.); (Y.T.); (Y.H.)
- Biomedical Pioneering Innovation Center, Peking University, Beijing 100871, China
- Correspondence: (J.Z.); (G.W.)
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25
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Souza SRRK, Pereira AP, Prandini NR, Resende ACAP, de Freitas EAM, Trigueiro TH, Wall ML. Breastfeeding in times of COVID-19: a scoping review. Rev Esc Enferm USP 2022; 56:e20210556. [PMID: 35723901 PMCID: PMC10081646 DOI: 10.1590/1980-220x-reeusp-2021-0556en] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/18/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to identify how the COVID-19 pandemic has influenced postpartum women in breastfeeding. METHOD a scoping review, with a search in seven databases. Studies available in full, in English, Portuguese or Spanish, published from December/2019-April/2021 were included. The analysis was carried out by categorizing common themes. RESULTS 25 studies were included, grouped into five categories, presenting the influence of the pandemic: in the routine of breastfeeding care, evidencing preventive measures against COVID-19; in breastfeeding rates, highlighting changes in dietary practices; in the support network for breastfeeding, indicating a lack of service care; in the postpartum women's emotions, with predominance of concern and stress; in the use of technology to support breastfeeding, with teleservice facilitating care. CONCLUSION the COVID-19 pandemic has influenced new forms of care, in the offer and duration of breastfeeding, in emotional health and in the support network fragility. It is expected to contribute so that health professionals provide care with greater assertiveness in the face of this new situation.
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Affiliation(s)
| | - Ana Paula Pereira
- Universidade Federal do Paraná, Faculdade de Enfermagem, Curitiba, PR, Brazil
| | - Naiane Ribeiro Prandini
- Universidade Federal do Paraná, Programa de Pós-Graduação em Enfermagem, Curitiba, PR, Brazil
| | | | | | | | - Marilene Loewen Wall
- Universidade Federal do Paraná, Departamento de Enfermagem, Curitiba, PR, Brazil
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26
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Hoyo V, Shah RC, Dave G, Volkov BB. Integrating special and underserved populations in translational research: Environmental scan of adaptive capacity and preparedness of Clinical and Translational Science Award (CTSA) program hubs. J Clin Transl Sci 2022; 6:e89. [PMID: 35989859 PMCID: PMC9379934 DOI: 10.1017/cts.2022.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic has exacerbated health disparities and rendered them acutely more visible. Special and underrepresented populations need to be fully integrated into the translational research process from the very beginning and all the way through. This article presents findings and rapid analysis mini-case studies from the Environmental Scan (E-Scan) of adaptive capacity and preparedness of Clinical and Translational Science Award hubs, specific to the goal of integrating special and vulnerable populations in different institutional research settings. In our discussion of the findings and case studies, we flexibly apply local adaptive capacity framework concepts and characteristics, and, whenever possible, we present ideas on how to enhance capacity in those areas, based on the challenges and practices identified through the E-Scan. Although the past year has recorded incredible achievements in vaccine development, clinical trials, diagnostics, and overall biomedical research, these successes continue to be hampered by our inability to turn them into achievements equally available and accessible to all populations.
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Affiliation(s)
- Verónica Hoyo
- Northwestern University Clinical and Translational Sciences Institute (NUCATS), Northwestern University, Chicago, IL, USA
- Clinical and Translational Research Institute, University of California, San Diego, La Jolla, CA, USA
| | - Raj C. Shah
- Institute for Translational Medicine, The University of Chicago, Rush University Medical Center, Chicago, IL, USA
- Department of Family Medicine, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Center for Community Health Equity, Rush University, DePaul University, Chicago, IL, USA
| | - Gaurav Dave
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
- North Carolina Translational and Clinical Sciences Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Boris B. Volkov
- University of Minnesota Clinical and Translational Science Institute, Minneapolis, MN, USA
- Institute for Health Informatics and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
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Impact of Coronavirus Disease-2019 on Hospital Care for Neonatal Opioid Withdrawal Syndrome. J Pediatr 2022; 245:47-55. [PMID: 35131283 PMCID: PMC8816795 DOI: 10.1016/j.jpeds.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/24/2022] [Accepted: 02/01/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare prenatal exposures, hospital care processes, and hospitalization outcomes for opioid-exposed newborns before and during the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN In this multicenter retrospective analysis, data were collected from 19 Massachusetts hospitals, including 5 academic and 14 community hospitals. The pre-COVID-19 cohort was defined as births occurring during March 1, 2019-February 28, 2020, and the COVID-19 cohort was defined as births occurring during March 1, 2020-December 31, 2020. Opioid-exposed newborns born at ≥35 weeks of gestation were included. Differences in prenatal substance exposures, hospital care processes, and neonatal opioid withdrawal syndrome (NOWS) outcomes, including pharmacologic treatment for NOWS (PharmTx), length of stay (LOS), and as-needed (prn) treatment failure rates, were evaluated. RESULTS There were 663 opioid-exposed newborns in the pre-COVID-19 group and 476 in the COVID-19 group. No between-group differences were seen in prenatal substance exposures or the need for PharmTx. Compared with the pre-COVID-19 group, in the COVID-19 group there was less rooming-in after maternal discharge (53.8% vs 63.0%; P = .001) and less care in the pediatric unit setting (23.5% vs 25.3%; P = .001), longer LOS (adjusted risk ratio, 1.04; 95% CI, 1.01-1.08), and a higher rate of breast milk receipt at discharge (aOR, 2.03; 95% CI, 1.22-3.39). Within the subset of academic centers, more infants failed prn treatment in the COVID-19 group (53.8% vs 26.5%, P = .02; aOR, 3.77; 95% CI, 0.98-14.5). CONCLUSIONS Among the hospitals in our collaborative, hospital processes for NOWS, including care setting, rooming-in, and LOS were negatively impacted in the COVID-19 group, particularly in academic medical centers.
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Warner SA, Arevalo JL. Literature Review of Mothers Diagnosed With COVID-19 and the Impact on Breastfeeding Their Newborns. Nurs Womens Health 2022; 26:234-241. [PMID: 35551888 PMCID: PMC9611848 DOI: 10.1016/j.nwh.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/04/2022] [Accepted: 03/29/2022] [Indexed: 01/09/2023]
Abstract
In early 2020, newborns were separated from their mothers who were diagnosed with COVID-19 infection. The purpose of this literature review is to examine the current evidence to determine if the transmission of COVID-19 infection to the neonate increases if newborns are directly breastfed by mothers who are positive for COVID-19 infection. There were 28 studies conducted in seven countries, with 10 of those studies conducted in the United States. In total, 5,123 neonates were born to mothers diagnosed with COVID-19, with 3,872 neonates determined to have been breastfed or provided mixed feeding including breast milk. Overall, 2.35% (91/3,872) of the newborns tested positive, and all recovered from COVID-19 infection. As frontline health care providers, nurses are instrumental in offering support and education on the risks and benefits of breastfeeding for individuals diagnosed with COVID-19.
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Abrams SA, Duggan CP. Infant and child formula shortages: now is the time to prevent recurrences. Am J Clin Nutr 2022; 116:289-292. [PMID: 35580593 PMCID: PMC9348970 DOI: 10.1093/ajcn/nqac149] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
An acute shortage of infant formulas in the United States occurred in early 2022, exacerbating a longer-standing, less severe shortage that has occurred over the last several years. The shortage has been particularly problematic for specialized formulas such as those needed for infants and children with food allergies, intestinal failure, kidney disease, and metabolic disorders. Although undoubtedly the magnitude of the current shortage will abate over time, it has affected many children and caused tremendous distress for thousands of families. We propose a series of interventions to be undertaken as soon as feasible to help ensure that the conditions that led to this problem do not recur and families regain confidence in the safety and supply reliability of formulas for infants and young children regardless of their medical needs.
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Affiliation(s)
| | - Christopher P Duggan
- Center for Nutrition, Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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30
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Turner S, McGann B, Brockway M’M. A review of the disruption of breastfeeding supports in response to the COVID-19 pandemic in five Western countries and applications for clinical practice. Int Breastfeed J 2022; 17:38. [PMID: 35570307 PMCID: PMC9107585 DOI: 10.1186/s13006-022-00478-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 04/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic has significantly altered how breastfeeding support is provided, resulting in mixed breastfeeding outcomes and experiences for mothers. The World Health Organization has consistently supported breastfeeding from the beginning of the pandemic. However, recommendations from obstetrical and gynaecological societies within individual countries have varied in their alignment with this guidance, resulting in inconsistent recommendations. It is unknown how breastfeeding guidelines, maternal breastfeeding experiences, and breastfeeding initiation and duration compared across five Western countries. The current study is comprised of two parts, each with a different objective. Part One objective: to review pandemic-related changes in professional society guidelines on breastfeeding support in Australia, New Zealand, Canada, the United Kingdom, and the United States; and Part Two objective: to conduct a narrative review to summarize the evidence of how the pandemic has changed breastfeeding initiation, duration, and mothers’ breastfeeding experiences during the pandemic in these five countries and provide recommendations for clinical lactation support. Methods We searched for indicators that are impactful on breastfeeding outcomes: skin-to-skin contact, rooming in, direct breastfeeding and breast washing, in the five countries mentioned above and compared these to the recommendations from the World Health Organization. Next, we conducted a narrative review of the literature from these five countries to explore how the pandemic altered breastfeeding outcomes and used this information to provide suggestions for clinical practice moving forward. Results Recommendations on the four practices above differed by country and were not always in alignment with the World Health Organization recommendations. Mother-infant separation after birth in the United States was associated with a lower prevalence of breastfeeding initiation and duration. While some mothers reported positive breastfeeding experiences during the pandemic, many mothers indicated negative experiences related to decreased social and professional support. Conclusions The pandemic can inform practice recommendations and can be viewed as an opportunity to permanently modify existing methods to support breastfeeding families. The use of virtual care increased during the pandemic and should continue with specific considerations for prioritizing in-person care. This will help to provide more timely and accessible support for breastfeeding mothers.
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31
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Tully KP, Smith JL, Pearsall MS, Sullivan C, Seashore C, Stuebe AM. Postnatal Unit Experiences Associated With Exclusive Breastfeeding During the Inpatient Stay: A Cross-Sectional Online Survey. J Hum Lact 2022; 38:287-297. [PMID: 34841934 PMCID: PMC9805698 DOI: 10.1177/08903344211057876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Efforts to provide accessible and effective infant feeding support are advancing to set up new families to meeting their goals. However, data continue to be limited for understanding how inpatient postpartum support and experiences contribute to exclusive breastfeeding during hospitalization. RESEARCH AIMS To explore postnatal unit experiences including skin-to-skin contact, overnight support, rooming-in, responsive clinicians, and understandable communication that correlate with early infant feeding outcomes among a sample of mothers who intended to breastfeed. METHODS This was a prospective cross-sectional survey study. Through secure online survey, participants submitted (N = 2,401) responses from November 2016 to May 2017 about their experiences with maternity healthcare and offered thoughts on the postnatal unit environment. Descriptive statistics were used to examine distributions of maternal characteristics, postpartum experience, and birthing facility characteristics. RESULTS Exclusive breastfeeding was positively correlated with the following postnatal unit experiences: mother did not ask that her infant be taken out of the postnatal unit room; infant staying in postnatal unit room except for treatment(s); mother got help from clinical staff when needed after pressing the call button; and nurse, midwife, and/or doctor always explained information to mother in ways that they understood. CONCLUSION Postnatal unit experiences associated with exclusive breastfeeding during postpartum hospitalization were rooming in; parents who did not ask for their infant to be taken out of the unit room; whether mothers received timely help from clinical staff; and information was explained in a way they could understand.
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Affiliation(s)
- Kristin P Tully
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacquana L Smith
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Carl Seashore
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alison M Stuebe
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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32
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Schuh TL, Mithal LB, Naureckas S, Miller ES, Garfield CF, Shah MD. Outcomes from birth to 6 months of publicly insured infants born to mothers with severe acute respiratory syndrome coronavirus 2 infection in the United States. J Perinat Med 2022; 50:334-342. [PMID: 34882359 PMCID: PMC8997689 DOI: 10.1515/jpm-2021-0251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/29/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We evaluated inpatient management, transition to home, breastfeeding, growth, and clinical outcomes of infants born to mothers diagnosed with SARS-CoV-2 infection in pregnancy and followed in a Federally Qualified Health Center (FQHC), that serves a diverse and low-income patient population, from birth through 6 months of life. METHODS Infants born between 4/3/20 and 7/26/20 at Prentice Women's Hospital with mothers who received prenatal care at Erie Family Health Center (Erie), the second largest FQHC in Illinois, and had confirmed SARS-CoV-2 during pregnancy were included. Data were abstracted from delivery hospital admission and outpatient follow-up appointments between 4/8/20 and 2/4/21. RESULTS Thirty-three infants met inclusion criteria. Average gestational age was 38.9 weeks (IQR 37.6-40.4), 3 (10%) were premature and 5 (15%) required NICU admission. Nearly all (97%) mothers expressed intent to breastfeed. Outpatient follow-up rates were similar to historical cohorts and 82% (23/28) of infants were vaccination compliant. Growth parameters showed normal distributions at all time points. At 6 months, any and exclusive breast milk feeding rates were lower compared to historic cohorts (18 vs. 36%, p<0.05, 0 vs. 21%, p<0.01). Three infants (10%) received development-related referrals, one carried an underlying genetic diagnosis. Outpatient visits were predominantly face-to-face with telemedicine use comprising only 6% of visits (11/182). CONCLUSIONS Longitudinal follow-up of 33 publicly insured infants born to mothers with SARS-CoV-2 infection in pregnancy followed in an FQHC showed high rates of follow-up and vaccination compliance, normal growth patterns and reassuring clinical status, and lower than expected rates of breastfeeding.
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Affiliation(s)
| | - Leena B. Mithal
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA,Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Sara Naureckas
- Erie Family Health Centers, Chicago, IL, USA,Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Emily S. Miller
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Craig F. Garfield
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA,Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Malika D. Shah
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA,Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
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33
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Wesołowska A, Orczyk-Pawiłowicz M, Bzikowska-Jura A, Gawrońska M, Walczak B. Protecting Breastfeeding during the COVID-19 Pandemic: A Scoping Review of Perinatal Care Recommendations in the Context of Maternal and Child Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3347. [PMID: 35329035 PMCID: PMC8949921 DOI: 10.3390/ijerph19063347] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/05/2022] [Accepted: 03/08/2022] [Indexed: 12/14/2022]
Abstract
The objective of this scoping review is to determine to what extent the recommendations on perinatal care protect breastfeeding during the COVID-19 pandemic. The review follows the PRISMA ScR Extension guidelines. The research was conducted in Scopus, Medline via Pubmed, and Web of Science databases from 1 March 2020 to 31 May 2021, using 392 combinations of keywords. We searched for reviews and original papers published in English providing recommendations on delivery mode, companion during labor, the possibility of skin-to-skin contact (SSC), breastfeeding, and visitors policy. After screening, 86 out of 8416 publications qualified for data extraction. The majority of them indicated that COVID-19 infection is not a sufficient reason for a cesarean section; however, on a national level, cesarean births in severely ill patients were overrepresented. A significant number of recommendations deprived mothers of the necessary support during their labor and stay in the maternity ward. A shared decision-making model was hardly visible. Only the earliest COVID-19 recommendations suspended direct breastfeeding; in later publications, decisions were related to the mother's health, but other options of natural feeding were rarely discussed.
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Affiliation(s)
- Aleksandra Wesołowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Department of Medical Biology, Medical University of Warsaw, Litewska 14/16, 00-575 Warsaw, Poland; (A.W.); (A.B.-J.)
- Human Milk Bank Foundation, Podkowy Str. 128 J, 04-937 Warsaw, Poland;
| | - Magdalena Orczyk-Pawiłowicz
- Department of Biochemistry and Immunochemistry, Division of Chemistry and Immunochemistry, Wroclaw Medical University, M. Skłodowskiej-Curie 48/50, 50-369 Wrocław, Poland;
| | - Agnieszka Bzikowska-Jura
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Department of Medical Biology, Medical University of Warsaw, Litewska 14/16, 00-575 Warsaw, Poland; (A.W.); (A.B.-J.)
| | - Małgorzata Gawrońska
- Human Milk Bank Foundation, Podkowy Str. 128 J, 04-937 Warsaw, Poland;
- Faculty of Sociology, University of Warsaw, Karowa 18, 00-927 Warsaw, Poland
| | - Bartłomiej Walczak
- Institute of Applied Social Sciences, University of Warsaw, Nowy Świat 69, 00-927 Warsaw, Poland
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Panda SK, Mishra A, Pathak M. Clinical Outcome of Neonates Born to SARS-CoV-2 Positive Mothers in India: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e22958. [PMID: 35411267 PMCID: PMC8989249 DOI: 10.7759/cureus.22958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 11/05/2022] Open
Abstract
During the SARS-CoV-2 pandemic, India accounted for 10-50% of cases reported across the world. Perinatal care from a developing country during this period has its own importance. This study was conducted to evaluate the health outcome of neonates born to SARS-CoV-2 positive mothers in India from the published literature by a systematic review and meta-analysis. Articles reporting neonates born from SARS-CoV-2 confirmed mothers in India, published in PubMed, Scopus®, and Embase® databases, were analyzed. After registration with the International Prospective Register of Systematic Reviews (PROSPERO), the study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary outcomes were the mode of delivery, perinatal asphyxia, preterm birth, breastfeeding, neonatal mortality, SARS-CoV-2 infectivity among neonates of SARS-CoV-2 mothers. The pooled rate was expressed with a 95% confidence interval. Heterogeneity and study level effect size were assessed using I² statistics and DerSimonian and Laird random effect method of meta-analysis. Data analysis was made by Stata 15.1 (StataCorp LLC, College Station, Texas, USA). Total 3,551 neonates born from 3,542 SARS-CoV-2 positive mothers were included from 14 studies (four prospective and 10 retrospective studies). The pooled rates of premature birth, Caesarean delivery, breastfeeding, and neonatal mortality were 18.89%, 55.89%, 67.79%, respectively, with 12.64/1000 live births. SARS-CoV-2 positivity rate was 5.28%; 11.76% were symptomatic, and five (1.7%) died from 281 SARS-CoV-2 positive neonates. There was an increase in the number of Caesarean delivery, premature birth, and lower mortality among neonates born to SARS-CoV-2 positive mothers compared to the Indian neonatal database. Around five percent of neonates delivered to SARS-CoV-2 positive mothers were infected, and the majority of them had good clinical outcomes.
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Affiliation(s)
- Santosh K Panda
- Department of Pediatrics, Kalinga Institute of Medical Sciences, Bhubaneshwar, IND
| | - Alpana Mishra
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
| | - Mona Pathak
- Department of Research and Development, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
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van Goudoever JB, Spatz DL, Hoban R, Dumitriu D, Gyamfi-Bannerman C, Berns M, McKechnie L, Davanzo R. Updating Clinical Practices to Promote and Protect Human Milk and Breastfeeding in a COVID-19 Era. Front Pediatr 2022; 10:867540. [PMID: 35558372 PMCID: PMC9086708 DOI: 10.3389/fped.2022.867540] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/30/2022] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic has impacted breastfeeding and lactation globally, with clinical practices implemented early in the pandemic being mostly anti-breastfeeding, e.g., separation of mothers from their infants, and not evidence based. As the pandemic has progressed, evidence has emerged reconfirming the value of human milk and the importance of protecting and supporting breastfeeding, especially the initiation of lactation. However, it is clear that COVID-19 has changed the clinical care paradigm around breastfeeding and lactation support and, as such, it is imperative that practices adapt and evolve to maintain the emphasis on lactation support. We participated in a round table conference aiming to rescue and develop protocols and practices that support breastfeeding during the COVID-19 pandemic. One key area to target will be to maximize the use of the antenatal period. The early identification of lactation risk factors together with the development of person-centered methods to deliver breastfeeding information and education to parents-to-be will be critical. In addition, the establishment of a hospital culture that values breastfeeding and prioritizes the use of human milk will be integral for the motivation of health care professionals. That culture will also support active management of the initiation of lactation and the development of a 'back-up plan' toolkit to support the mother experiencing lactation difficulties. Post-discharge support will also be crucial with the development of both in-person and virtual lactation support programs, in particular for the immediate post-discharge period to benefit mothers who experience an early discharge process. These measures will allow for a new, adapted framework of practice that acknowledges the current COVID-19 paradigm and maintains the emphasis on the need to protect and support breastfeeding and the use of human milk.
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Affiliation(s)
| | - Diane L Spatz
- University of Pennsylvania School of Nursing & Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Rebecca Hoban
- The Hospital for Sick Children (SickKids), University of Toronto, Toronto, ON, Canada
| | - Dani Dumitriu
- Columbia University Irving Medical Center, New York, NY, United States
| | | | - Monika Berns
- Charité - Universitätsmedizin, Klink für Neonatologie, Berlin, Germany
| | - Liz McKechnie
- Leeds Centre for Newborn Care, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Riccardo Davanzo
- Institute for Maternal and Child Health Institute, IRCCS "Burlo Garofolo", Trieste, Italy
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Souza SRRK, Pereira AP, Prandini NR, Resende ACAP, de Freitas EAM, Trigueiro TH, Wall ML. Aleitamento materno em tempos de COVID-19: uma scoping review. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0556pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: identificar como a pandemia de COVID-19 tem influenciado as puérperas no aleitamento materno. Método: scoping review, com busca em sete bases de dados. Incluíram-se estudos disponíveis na íntegra, em inglês, português ou espanhol, publicados de dezembro/2019-abril/2021. A análise deu-se por categorização de temas comuns. Resultados: incluíram-se 25 estudos, agrupados em cinco categorias, apresentando a influência da pandemia: na rotina de cuidados ao aleitamento materno, evidenciando medidas preventivas contra COVID-19; nas taxas do aleitamento materno, destacando mudanças nas práticas alimentares; na rede de apoio para o aleitamento materno, apontando falta de assistência de serviços; nas emoções das puérpera, predominando preocupação e estresse; no uso da tecnologia para apoio ao aleitamento materno, com teleatendimento facilitando a assistência. Conclusão: a pandemia de COVID-19 influenciou novas formas de assistência, na oferta e no tempo de amamentação, na saúde emocional e na fragilidade da rede de apoio. Espera-se contribuir para que profissionais da saúde proporcionem assistência com maior assertividade diante dessa nova situação.
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Schmitt N, Mattern E, Cignacco E, Seliger G, König-Bachmann M, Striebich S, Ayerle GM. Effects of the Covid-19 pandemic on maternity staff in 2020 - a scoping review. BMC Health Serv Res 2021; 21:1364. [PMID: 34961510 PMCID: PMC8710925 DOI: 10.1186/s12913-021-07377-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
In the spring of 2020, the SARS-CoV-2 virus caused the Covid-19 pandemic, bringing with it drastic changes and challenges for health systems and medical staff. Among the affected were obstetricians and midwives, whose close physical contact with pregnant women, women who recently gave birth, and their children was indispensable. In the obstetric setting, births cannot be postponed, and maternity staff had to adapt to assure obstetric safety while balancing evidence-based standards with the new challenges posed by the pandemic. This scoping review gives a comprehensive overview of the effecs the Covid-19 pandemic had on maternity staff. We followed the evidence-based approach described by Arksey & O'Malley: we searched several databases for English and German articles published between January 2020 and January 2021 that discussed or touched upon the effects the pandemic had on maternity staff in OECD countries and China. We found that structural challenges caused by the crisis and its subjective effects on maternity staff fell into two main topic areas. Structural challenges (the first main topic) were divided into five subtopics: staff shortages and restructuring; personal protective equipment and tests; switching to virtual communication; handling women with a positive SARS-CoV-2 infection; and excluding accompanying persons. The pandemic also strongly affected the staff's mental health (the second main topic.) Attempting to meet challenges posed by the pandemic while afraid of contamination, suffering overwork and exhaustion, and struggling to resolve ethical-moral dilemmas had severe negative subjective effects. Several studies indicated increased depression, anxiety, stress levels, and risk of post-traumatic stress symptoms, although the crisis also generated strong occupational solidarity. Care for pregnant, birthing, and breast-feeding women cannot be interrupted, even during a pandemic crisis that requires social distancing. Maternity staff sometimes had to abandon normal standards of obstetric care and were confronted with enormous challenges and structural adjustments that did not leave them unscathed: their mental health suffered considerably. Researchers should study maternity staff's experiences during the pandemic to prepare recommendations that will protect staff during future epidemics.
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Affiliation(s)
- Nadine Schmitt
- Institute of Health and Nursing Science, Center for Health Sciences, Medical Faculty of Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle, Saale, Germany.
| | - Elke Mattern
- Department of Applied Health Sciences, University of Applied Sciences Bochum, Bochum, Germany
| | - Eva Cignacco
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Gregor Seliger
- Department of Obstetrics and Prenatal Medicine, Center of Fetal Surgery, University Hospital Halle (Saale) and Center for Reproductive Medicine and Andrology, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
| | | | - Sabine Striebich
- Institute of Health and Nursing Science, Center for Health Sciences, Medical Faculty of Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle, Saale, Germany
| | - Gertrud M Ayerle
- Institute of Health and Nursing Science, Center for Health Sciences, Medical Faculty of Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle, Saale, Germany
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Peltzer NK, Olson K, Williams S, Hansen-Smith H, Elia J, McGurk MD. Exploring Challenges and Opportunities for Breastfeeding in Hawai'i During the COVID-19 Pandemic. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2021; 80:25-29. [PMID: 34704065 PMCID: PMC8538114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Increasing exclusive breastfeeding rates is an established public health strategy to reduce chronic disease and protect infants from illness. The role of breastfeeding in addressing health disparities takes on new significance as the COVID-19 pandemic has disproportionately impacted some communities in Hawai'i, and those with chronic conditions face increased risk of hospitalization and death. However, there are myriad policy, systemic, and environmental barriers that make it difficult for parents to breastfeed, some of which have been exacerbated by the COVID-19 pandemic. This editorial discusses the importance of breastfeeding in reducing chronic disease, reviews the status of breastfeeding in Hawai'i, explores the challenges parents face in breastfeeding their infants, especially in the time of COVID-19, and presents opportunities for improved access to lactation care to reduce health disparities.
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Lou F, Qin H, He S, Li M, An X, Song L, Tong Y, Fan H. The Benefits of Breastfeeding Still Outweigh the Risks of COVID-19 Transmission. Front Med (Lausanne) 2021; 8:703950. [PMID: 34568367 PMCID: PMC8455845 DOI: 10.3389/fmed.2021.703950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/06/2021] [Indexed: 01/04/2023] Open
Affiliation(s)
- Fuxing Lou
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Hongbo Qin
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Shiting He
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Maochen Li
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Xiaoping An
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Lihua Song
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Yigang Tong
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Huahao Fan
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
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Kashima S, Walker B, Stephens A. Providing emotional and psychological support to nursing mothers through Chevron’s response to the COVID-19 pandemic. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2021. [DOI: 10.1080/15555240.2021.1964982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sara Kashima
- Chevron Employee Assistance and WorkLife Services, Chevron Corporation, San Ramon, California, USA
| | - Brian Walker
- Chevron Employee Assistance and WorkLife Services, Chevron Corporation, San Ramon, California, USA
| | - Angie Stephens
- Chevron Employee Assistance and WorkLife Services, Chevron Corporation, San Ramon, California, USA
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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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Abstract
As nurses, we must continue to promote and protect the use of human milk and breastfeeding during and after the COVID-19 pandemic. We should continue access to online and virtual breastfeeding help but expand opportunities for in-person technical breastfeeding assistance in pediatric offices and in the community. Our breastfeeding expert, Dr. Spatz, offers suggestions for promoting breastfeeding during the pandemic and beyond.
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Affiliation(s)
- Diane L Spatz
- Dr. Diane L. Spatz is a Professor of Perinatal Nursing & the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania. She holds a joint appointment with the Children's Hospital of Philadelphia (CHOP) where she is a nurse scientist for the lactation program & founder of CHOP's Mothers' Milk Bank. Dr. Spatz can be reached via email at
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Zöllkau J, Heimann Y, Kertscher C, Weber D, Schleußner E. Umfrage in Kliniken – Stillmanagement in der SARS-CoV-2-Pandemie: hohe Compliance zu den Empfehlungen der Fachgesellschaften in deutschen Frauenkliniken. Geburtshilfe Frauenheilkd 2021. [DOI: 10.1055/a-1401-4993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
| | | | | | - Dana Weber
- Landesgeschäftsstelle für Qualitätssicherung Thüringen
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Cimolai N. A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19. SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:1272-1294. [PMID: 33754135 PMCID: PMC7968576 DOI: 10.1007/s42399-021-00836-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 02/07/2023]
Abstract
The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.
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Affiliation(s)
- Nevio Cimolai
- Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Children’s and Women’s Health Centre of British Columbia, 4480 Oak Street, Vancouver, B.C. V6H3V4 Canada
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Gutschow K, Davis-Floyd R. The Impacts of COVID-19 on US Maternity Care Practices: A Followup Study. FRONTIERS IN SOCIOLOGY 2021; 6:655401. [PMID: 34150906 PMCID: PMC8212572 DOI: 10.3389/fsoc.2021.655401] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/05/2021] [Indexed: 05/06/2023]
Abstract
This article extends the findings of a rapid response article researched in April 2020 to illustrate how providers' practices and attitudes toward COVID-19 had shifted in response to better evidence, increased experience, and improved guidance on how SARS-CoV-2 and COVID-19 impacted maternity care in the United States. This article is based on a review of current labor and delivery guidelines in relation to SARS-CoV-2 and COVID-19, and on an email survey of 28 community-based and hospital-based maternity care providers in the United State, who discuss their experiences and clients' needs in response to a rapidly shifting landscape of maternity care during the COVID-19 pandemic. One-third of our respondents are obstetricians, while the other two-thirds include midwives, doulas, and labor and delivery nurses. We present these providers' frustrations and coping mechanisms in shifting their practices in relation to COVID-19. The primary lessons learned relate to improved testing and accessing PPE for providers and clients; the need for better integration between community- and hospital-based providers; and changes in restrictive protocols concerning labor support persons, rooming-in with newborns, immediate skin-to-skin contact, and breastfeeding. We conclude by suggesting that the COVID-19 pandemic offers a transformational moment to shift maternity care in the United States toward a more integrated and sustainable model that might improve provider and maternal experiences as well as maternal and newborn outcomes.
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Affiliation(s)
- Kim Gutschow
- Departments of Anthropology and Religion, Williams College, Willliamstown, MA, United States
- *Correspondence: Kim Gutschow,
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