Encouraging and Reinforcing Safe Breastfeeding Practices during the COVID-19 Pandemic

Abstract

Aim: Promote safe breastfeeding during the pandemic. Methods: All participants were encouraged to request safe breastfeeding education from their prenatal provider. Pregnant mothers received appropriate breastfeeding and COVID-19 safe breastfeeding education in line with the CDC’s COVID-19 breastfeeding guidelines. Data were obtained from 39 mothers attending Nashville General Hospital pediatric well-baby clinics (Group I: from December 2019 to June 2020) and 97 pregnant women attending prenatal clinics (Group II: from July 2020 to August 2021). Results: The participants’ ages ranged from 15 to 45 years, with a mean of 27.5 ± 6.2. The women in both groups were similar in age, education, employment, and breastfeeding experience. They were equally unlikely to use face masks at home even while receiving guests or holding their babies. Although 121 (89.0%) women claimed face mask use while shopping, the rate for never doing so was 7 (18.0%) vs. 8 (8.3%) (p < 0.006) for Groups I and II, respectively. Safe practices included limited outing (66 (48.5%)), sanitized hands (62 (45.6%)), restricted visitors (44 (32.4%)), and limited baby outing (27 (19.9%)), and 8 (8.3%) in Group II received COVID-19 vaccinations. About half described fair and accurate COVID-19 safe breastfeeding knowledge, but 22 (30.1%) of them claimed they received no information. Breastfeeding contraindication awareness for Groups I and II were as follows: cocaine = 53.8% vs. 37.1%, p < 0.06; HIV = 35.9% vs. 12.4%, p < 0.002; breast cancer = 17.9% vs. 16.5%; and COVID-19 with symptoms = 28.2% vs. 5.2%, p < 0.001. The information source was similar, with family, friends, and media accounting for 77 (56.6%) of women while doctors, nurses, and the CLC was the source for 21 (15.4%) women. Exclusive breastfeeding one month postpartum for Groups I and II was 41.9% and 12.8% (p < 0.006), respectively. Conclusion: The mothers were not more knowledgeable regarding breastfeeding safely one year into the COVID-19 pandemic. Conflicting lay information can create healthy behavior ambivalence, which can be prevented by health professionals confidently advising mothers to wear face masks when breastfeeding, restricting visitors and outings, and accepting COVID-19 vaccination. This pandemic remains an open opportunity to promote and encourage breastfeeding to every mother as the default newborn feeding method.

Breastfeeding during the COVID-19 pandemic

“…Breast milk is indispensable because it is sufficient to nourish and meet the energy needs of children entirely during the first six months of life, with its sufficiency gradually reducing thereafter to not less than half in the next six months (i.e., up to one year), and to a third up to two years of age. Thus, it is the best source of nutrition for infants ( 108 , 109 , 110 , 111 , 5 , 84 ) and should therefore be continued until the child is at least 2 years old ( 58 , 108 , 109 , 110 , 111 ). Breastfeeding also protects the neonates, infants and children against morbidity and mortality ( 86 ).…”

“…Breastfeeding also protects the neonates, infants and children against morbidity and mortality ( 86 ). Breast milk also improves survival as it confers passive immunity to the infant as it is rich in immunoglobulins which are very effective against bacterial and viral infections as well as some cancers ( 23 , 19 , 84 , 67 . Breast milk also plays a critical role in the development of a healthy and balanced microbiome ( 44 , 45 ).…”

“…The critical role that breastfeeding plays is beyond providing nutrition but also conferring passive immunity to the infant, therefore, breastfed infants are less prone to infectious diseases like diarrhoea and when they do suffer from these diseases they have better prognosis ( 87 , 75 , 64 ). Therefore, mothers and their families should be provided with appropriate information regarding safe breastfeeding during the pandemic ( 84 ). The mothers should also be taught the “Ten Steps to Successful Breastfeeding” as part of the Baby-Friendly Hospital Initiative (BFHI) which is supported being important societies like the CDC ( 84 ).…”

“…Therefore, mothers and their families should be provided with appropriate information regarding safe breastfeeding during the pandemic ( 84 ). The mothers should also be taught the “Ten Steps to Successful Breastfeeding” as part of the Baby-Friendly Hospital Initiative (BFHI) which is supported being important societies like the CDC ( 84 ). Initiation of breastfeeding should still happen within the 1st hour of birth even during the pandemic ( 67 ).…”

“…When a mother has COVID-19 she should breastfeed while adhering to COVID-19 guidelines. She can also express her own breast milk and safely feed it to the infant herself ( 84 ). But in the event that a mother is unable to breastfeed because of being very ill, she should be supported by a healthy caregiver by for example, feeding the infant with milk that has been expressed from the mother's breast.…”