Breastfeeding support for new mothers during the COVID-19 pandemic

By Dr. Ananya Mandal, MDJul 21 2020

As the COVID-19 pandemic grips the world, concerns about transmission of the highly infectious causative agent – severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - from mother to the baby are valid.

Several studies have dealt with the possibility of transmission of the infection from a COVID-19 positive to the newborn baby during birth or breastfeeding, and thus new mothers remain anxious. In a new study, researchers at the Australian Breastfeeding Association (ABA), South Melbourne Victoria, and School of Nursing and Midwifery Western Sydney University, Australia, have dealt with the concerns of these breastfeeding mothers who have sought advice at the ABA.

Their study titled, “Providing breastfeeding support during the COVID-19 pandemic: Concerns of mothers who contacted the Australian Breastfeeding Association,” was published prior to peer review on the open-access preprint server medRxiv*.

Study: Providing breastfeeding support during the COVID-19 pandemic: Concerns of mothers who contacted the Australian Breastfeeding Association. Image Credit: HTeam / Shutterstock

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

The COVID-19 pandemic

The World Health Organization (WHO) had declared the COVID-19 pandemic on 11 March this year. In Australia, the first case was detected on 25 January 2020. By the time the pandemic was declared, Australia had recorded around 2,000 cases.

To reduce transmission of this highly infectious virus, Australian public health officials brought in several measures such as the limiting of outdoor activity, prevention of gatherings, closures of schools, gyms, museums, restaurants and also put a stop to international travel.

The pandemic and antenatal and postnatal care

With these measures in place and the fear around the spread of the virus around the world, face to face during pregnancy (antenatal), after delivery (postnatal), and well-baby visits or (child health appointments) had to be put on hold, wrote the authors.

During this time, the Australian Breastfeeding Association (ABA) remained operational and provided support to the new mothers regarding breastfeeding.

The ABA has been providing “mother-to-mother support” for effective breastfeeding since 1964 – its inception.

Over 1,000 certified volunteers include breastfeeding counselors and community educators who help by managing online and face to face mother groups and support groups.

Breastfeeding during the pandemic

The WHO advised that mothers with COVID-19 should be provided with adequate support so that they may safely breastfeed their infants.

The authors of this study wrote that research shows that around 20 percent of the persons with COVID-19 succumb to severe illness, but this severity was relatively rare among children and babies.

The WHO says that breastfeeding may protect the newborn baby’s health and thus should be continued.

The organization published a set of guidelines on 13 March 2020 that stated infants born to women who are suspected or confirmed as having COVID-19 should be:

• “Placed skin-to-skin with their mothers immediately after birth.”
• “Initiate breastfeeding within an hour of birth.”
• “Be kept proximate to their mothers day and night.”
• “Exclusively breastfed.”

The WHO also advised that alongside these other precautions should be taken to prevent the spread of the novel coronavirus infection.

These include maintenance:

• respiratory hygiene
• hand hygiene
• cleaning of surfaces

Thus the ABA volunteers since the end of March started reporting that many mothers were anxious about passing on their infection to their babies and thus were not breastfeeding.

More and more number of these women were also asking for support about re-establishing lactation, they wrote.

This study was a survey to see the support provided to the mothers by the ABA volunteers regarding breastfeeding during the pandemic.

What was done in this survey?

This was an online survey that was performed between the 16^th and 18^th of March 2020. COVID-19 related concerns were recorded from 340 participants.

The participants were 336 new mothers, two fathers, one pregnant woman, and one grandmother. The reports were for 341 infants and young children.

The volunteers were asked to complete the survey regarding the type of assistance they had to provide to breastfeeding mothers during the pandemic. Nine open-ended questions were asked of the participants.

What was found?

Results showed that a total of 136 mothers or 64 percent sought some form of support regarding the protection of their newborn babies from diseases by a continuation of breastfeeding or asked for tips to increase breast milk supply and asked about ways to restart lactation.

The volunteers reported that many of the mothers were stressed and needed reassurance. Many reported feeling isolated. Breastfeeding safety was a concern among 34 mothers (10 percent).

Fear or unavailability prevented 129 or 61 percent of mothers from seeking face-to-face consultation with health care providers.

Common complaints and concerns among mothers seeking support from the ABA included “insufficient milk or weight gain, painful breasts, re-lactation, and reducing supplemental milk.”

Stress was felt as the most prevalent cause of falling milk supply among the mothers. Being unable to weigh and monitor the growth of their infants at well-baby visits also worried the mothers.

Conclusions

The researchers wrote that the role of the ABA volunteers in reassuring breastfeeding mothers during the pandemic is of paramount importance.

They call for policymakers at the Federal Department of Health to recognize this role in “national planning for infant and young child feeding in emergencies.” They call for these plans to be “urgently developed, funded, and implemented.”

The team wrote in conclusion, “ABA services continued to provide support and were able to rapidly deploy key information to mothers, ABA volunteers, and health professionals.

The role ABA can play in emergency response should be recognized and reflected in emergency planning.”

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.