ABSTRACT
Introduction: Every postpartum mother is recommended to breastfeed her baby because breast milk is the main need of newborns. The COVID-19 pandemic has had an impact on life in various aspects, including on the breastfeeding mothers, especially if they suffer from COVID-19 infection. Aim: The study aims to provide comprehensive evidence regarding potential virus transmission and antibody transfer through breastmilk and the experiences of mothers related to breastfeeding during the COVID-19 pandemic. Methods: A systematic review was conducted following the PRISMA guidelines. The search strategy involved the use of keywords related to COVID-19 and breastfeeding in PubMed and Science Direct databases. Articles were selected according to inclusion and exclusion criteria. Results: Breastfeeding has been recommended to be continued during the pandemic due to the benefits associated with it and the absence of sufficient evidence for transmission of COVID-19 infection through breast milk. During the lockdown period, there was a change in breastfeeding patterns, although most mothers believed that breastfeeding should be continued. Anxiety and lack of support affected breastfeeding practices. Breastfeeding mothers reported a dilemmatic situation. They felt protected because of the lockdown policy but also struggled to get support from their social environment. The impact varied in terms of stopping breastfeeding practice altogether, breastfeeding irregularly, and even giving formula milk. Conclusion: Adherence to health protocols can reduce the risk of transmission of COVID-19 infection through breastfeeding from mother to baby. Support from the family and the environment is needed to ensure the continuity of breastfeeding practice. © 2022 Kurniawati et al.
ABSTRACT
Background: Breast cancer (BC) survivors must continue their treatments during the pandemic, include the psychotherapy, although limited due to the COVID-19 pandemic. Previous studies suggested inconclusive promising results of internet-based cognitive behavioural (iCBT) for breast cancer survivors. This study aims to compare the efficacies between iCBT and usual care (UC) for improving psychosocial aspects, sexual functioning, and treatment-induced menopausal symptoms (TIMS) among breast cancer survivors. Methods: We did comprehensive literature searching in several online databases to include all relevant studies from January 2000 until January 2021 then followed PRISMA guideline. We included all randomized controlled trials (RCTs) that compared the efficacies between iCBT and UC in BC survivors then accessed the changes of psychosocial aspects, sexual functioning, and TIMS. We used the Cochrane Risk-of-bias (RoB 2) tool for accessing bias risks. We performed analysis to provide standard mean difference (SMD) with 95% confidence interval (CI) using random-effect heterogeneity test. Results: We included 5 RCTs met our inclusion criteria. The iCBT shows non-inferiority compared with the UC group for improving seven psychosocial aspects in BC survivors. The iCBT improves sexual pleasure (SMD=0.26, 95% CI 0.04–0.48, p=0.02, I2=0%) and discomfort during sex (SMD=−0.40, 95% CI -0.79 to -0.01, p=0.04, I2=54%) significantly, but not statistically significant in improving intercourse frequency (SMD=0.15, 95% CI -0.49 to 0.80, p=0.65, I2=88%). The iCBT also shows significant improvements of sleep quality (SMD=−0.86, 95% CI -1.28 to -0.44, p<0.0001, I2=83%), hot flush frequency (SMD=−0.5, 95% CI -0.70 to -0.29, p<0.00001, I2=0%), night sweet frequency (SMD=−0.75, 95% CI -1.24 to -0.26, p=0.003, I2=81%), and the overall levels of TIMS (SMD=0.53, 95% CI 0.31–0.75, p<0.00001, I2=0%). Conclusions: The iCBT showed potential benefits for improving psychosocial aspects, sexual functioning, and TIMS among BC survivors compared with the UC. However, further studies are needed to establish the efficacies. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.