Melissa C Bartick1,2, Verónica Valdés3,4, Angela Giusti5, Elise M Chapin6, Nikhil B Bhana7, Maria-Teresa Hernández-Aguilar8,9, Elysângela Dittz Duarte10, Lucia Jenkins11, John Gaughan12, Lori Feldman-Winter13. 1. Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts, USA. 2. Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. 3. Department of Family Medicine, School of Medicine, Catholic University, Santiago, Chile. 4. Lactation Committee, Chilean Pediatric Society, Santiago, Chile. 5. National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità (National Institute of Health), Rome, Italy. 6. Baby-Friendly Initiatives, Italian National Committee for UNICEF, Rome, Italy. 7. Cooper Medical School, Rowan University, Camden, New Jersey, USA. 8. Unidad de Lactancia, Dr. Peset University Hospital, Valencia, Spain. 9. Baby-Friendly Initiative (IHAN), Spain. 10. Department of Maternal and Child Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Brazil. 11. BabyCafe USA, Melrose, Massachusetts, USA. 12. Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA. 13. Department of Pediatrics, Children's Regional Hospital, Cooper University Health Care-Cooper Medical School of Rowan University, Camden, New Jersey, USA.
Abstract
Background: Maternity care practices such as skin-to-skin care, rooming-in, and direct breastfeeding are recommended, but it is unclear if these practices increase the risk of clinically significant COVID-19 in newborns, and if disruption of these practices adversely affects breastfeeding. Methods: We performed a retrospective cohort study of 357 mothers and their infants <12 months who had confirmed or suspected COVID-19. Subjects came from an anonymous worldwide online survey between May 4 and September 30, 2020, who were recruited through social media, support groups, and health care providers. Using multivariable logistic regression, Fisher's exact test, and summary statistics, we assessed the association of skin-to-skin care, feeding, and rooming-in with SARS-CoV-2 outcomes, breastfeeding outcomes, and maternal distress. Results: Responses came from 31 countries. Among SARS-CoV-2+ mothers whose infection was ≤3 days of birth, 7.4% of their infants tested positive. We found a nonsignificant decrease in risk of hospitalization among neonates who roomed-in, directly breastfed, or experienced uninterrupted skin-to-skin care (p > 0.2 for each). Infants who did not directly breastfeed, experience skin-to-skin care, or who did not room-in within arms' reach, were significantly less likely to be exclusively breastfed in the first 3 months, adjusting for maternal symptoms (p ≤ 0.02 for each). Nearly 60% of mothers who experienced separation reported feeling "very distressed," and 29% who tried to breastfeed were unable. Presence of maternal symptoms predicted infant transmission or symptoms (adjusted odds ratio = 4.50, 95% confidence interval = 1.52-13.26, p = 0.006). Conclusion: Disruption of evidence-based quality standards of maternity care is associated with harm and may be unnecessary.
Background: Maternity care practices such as skin-to-skin care, rooming-in, and direct breastfeeding are recommended, but it is unclear if these practices increase the risk of clinically significant COVID-19 in newborns, and if disruption of these practices adversely affects breastfeeding. Methods: We performed a retrospective cohort study of 357 mothers and their infants <12 months who had confirmed or suspected COVID-19. Subjects came from an anonymous worldwide online survey between May 4 and September 30, 2020, who were recruited through social media, support groups, and health care providers. Using multivariable logistic regression, Fisher's exact test, and summary statistics, we assessed the association of skin-to-skin care, feeding, and rooming-in with SARS-CoV-2 outcomes, breastfeeding outcomes, and maternal distress. Results: Responses came from 31 countries. Among SARS-CoV-2+ mothers whose infection was ≤3 days of birth, 7.4% of their infants tested positive. We found a nonsignificant decrease in risk of hospitalization among neonates who roomed-in, directly breastfed, or experienced uninterrupted skin-to-skin care (p > 0.2 for each). Infants who did not directly breastfeed, experience skin-to-skin care, or who did not room-in within arms' reach, were significantly less likely to be exclusively breastfed in the first 3 months, adjusting for maternal symptoms (p ≤ 0.02 for each). Nearly 60% of mothers who experienced separation reported feeling "very distressed," and 29% who tried to breastfeed were unable. Presence of maternal symptoms predicted infant transmission or symptoms (adjusted odds ratio = 4.50, 95% confidence interval = 1.52-13.26, p = 0.006). Conclusion: Disruption of evidence-based quality standards of maternity care is associated with harm and may be unnecessary.
Authors: Sofia Colaceci; Gloria Anderson; Veronica Ricciuto; Denise Montinaro; Giorgia Alazraki; Desirée Mena-Tudela Journal: Int J Environ Res Public Health Date: 2022-06-18 Impact factor: 4.614
Authors: Aleksandra Wesołowska; Magdalena Orczyk-Pawiłowicz; Agnieszka Bzikowska-Jura; Małgorzata Gawrońska; Bartłomiej Walczak Journal: Int J Environ Res Public Health Date: 2022-03-11 Impact factor: 3.390