The role of doulas in providing breastfeeding support during the COVID-19 pandemic.

BACKGROUND: Doulas have been instrumental in providing breastfeeding support to nursing mothers before and during the COVID-19 pandemic, as they can significantly impact a mother's ability to initiate and maintain breastfeeding. However, the COVID-19 pandemic, subsequent lockdowns, and social isolation created challenges for nursing mothers to access doulas' services, usually provided in person. In this study, we examined the role of doulas in providing breastfeeding support during the COVID-19 pandemic, exploring adaptation to COVID-19 guidelines and the challenges doulas face in providing breastfeeding support during the pandemic. METHODS: A systematic review was conducted following the PRISMA guidelines. Thirteen scientific databases and twenty peer-reviewed journals were searched for journal articles published in English between January 2020 and March 2022 using key search terms (e.g., Doula, Breastfeeding, COVID-19). Studies evaluating the role of doulas in providing breastfeeding support during COVID-19, and the impact of COVID-19 Guidelines on doula services, were included. Two reviewers independently performed the risk of bias assessment and data extraction. Summative content analysis was used to analyze the data. RESULTS: The majority of studies were conducted in developed nations. This systematic review includes eight articles, four qualitative, one survey, two mixed-methods studies, and one prospective research study. Seven of the eight studies were conducted in the United States, and the eighth was conducted in multiple countries. These studies have three main themes: (1) virtual breastfeeding support provided by doulas during the pandemic; (2) remote social support provided by doulas to breastfeeding mothers during the pandemic; and (3) barriers to doula service delivery due to COVID-19 restrictions, primarily the exclusion of doulas as essential workers. The eight studies showed that doulas found innovative ways to serve the needs of birthing and nursing mothers during the difficulties brought on by the pandemic. CONCLUSION: Doulas provided breastfeeding support during the COVID-19 pandemic by utilizing innovative service delivery methods while navigating changes in COVID-19 guidance. However, system-level integration of doulas' work and the acknowledgment of doulas as essential healthcare providers are needed to enhance doula service delivery capacity, especially during a pandemic, to help improve maternal health outcomes.

Healing Baltimore: Creating Support for VALUE (Vaccine Access & Acceptance, Lives in Unity, Education & Engagement) Baltimore Ambassadors as They Serve During the COVID-19 Pandemic.

VALUE (Vaccine Acceptance & Access Lives in Unity, Engagement & Education) Baltimore began in February 2021 with the vision of helping underserved communities in Baltimore City value COVID-19 vaccination and have access to the vaccine. VALUE dispatched ambassadors to provide COVID-19 education and risk-mitigation strategies in their communities. Once the project was implemented, we noticed that our ambassadors were often overwhelmed by misinformation in the community and our priority populations faced deeper issues relating to the social determinants of health (SDOH) and social needs such as food, transportation, job loss, and housing.To help our ambassadors cope with and address these issues, we created Healing Baltimore in April 2021. Healing Baltimore aims to support our VALUE ambassadors as they contribute toward improving the wellbeing of Baltimore now and after COVID. Healing Baltimore has four elements: (1) Weekly Self-Care Tips, (2) Weekly Positive Facts about Baltimore, (3) SDOH Referral to Baltimore City Health Department Services, and (4) Webinars to teach us about the VALUE communities while offering the opportunity to discuss historical trauma. We share our lessons learned from Healing Baltimore, which include (1) increasing ambassador input, (2) engagement, (3) co-creation, (4) collaboration, and (5) community appreciation.

Effect of COVID-19 Pandemic Response and Parental Adverse Childhood Experiences on Child Health and Well-Being.

Family responses to crises such as COVID-19 are driven by parents' experiences. Parental history of adverse childhood experiences (ACEs) might play an important role in predicting resilience, coping capacity, and parenting practices during the COVID-19 pandemic response. The purpose of this review is to examine the impact of COVID-19 pandemic disruption on child health and well-being as influenced by the previous history of ACEs in the parents. Scopus, Google Scholar, PubMed, and PsychInfo were searched for peer-reviewed articles using the keywords "COVID-19", "Parents or Maternal Adverse Childhood Experiences", and "child health" or "child well-being". Data were extracted using a literature review matrix template. Title, abstract, and full article-level reviews were conducted by two reviewers. The association between COVID-19 disruption, negative parenting, and child behavioral and emotional problems was stronger for parents with younger children with a history of high ACE scores. Parents with high ACE scores were more likely to cope poorly with childcare duties and engage in child neglect, verbal abuse, and reduced feeding frequency, specifically during the COVID-19 pandemic. The review findings support the framework of inadequate resilience and coping skills of adults with a history of ACEs during periods of stress and unpredictability such as the COVID-19 pandemic. The negative effects of these parental stressors on a child's health and well-being are modifiable and could be mitigated by targeted interventions. Trauma-informed care should be adopted to contribute to optimum child health.