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1.
Matern Child Nutr ; : e13450, 2022 Nov 09.
Article in English | MEDLINE | ID: covidwho-2108124

ABSTRACT

Associations between breastfeeding intention, duration and post-natal depression (PND) have been shown in pre-COVID-19 studies. However, studies during COVID-19 have not examined the associations between breastfeeding intention, breastfeeding practices, and PND in an international sample of post-natal women, taking into consideration COVID-19 related factors. This is the first study to address this gap as both PND and breastfeeding may be affected by COVID-19, and have important long-term effects on women's and infant's health. A cross-sectional internet-based survey was conducted with 3253 post-natal women from five countries: Brazil, South Korea, Taiwan, Thailand, and the United Kingdom from July to November 2021. The results showed that women who intended to breastfeed during pregnancy had lower odds of having PND than women who did not intend to. Women who had no breastfeeding intention but actually breastfed had greater odds (AOR 1.75) of having PND than women who intended to breastfeed and actually breastfed. While there was no statistical significance in expressed breast milk feeding in multivariable logistic regression models, women who had shorter duration of breastfeeding directly on breast than they planned had greater odds (AOR 1.58) of having PND than those who breastfed longer than they planned even after adjusting for covariates including COVID-19-related variables. These findings suggested the importance of working with women on their breastfeeding intention. Tailored support is required to ensure women's breastfeeding needs are met and at the same time care for maternal mental health during and beyond the pandemic.

2.
Public Health ; 2022.
Article in English | ScienceDirect | ID: covidwho-2105782

ABSTRACT

Objective To assess the impact of the addition of 12 maternity leave (ML) weeks (2011), a pay for performance (P4P) exclusive breastfeeding (EBF) promotion strategy (2015) and the COVID-19 pandemic in EBF inequalities in Chile. Study Design Interrupted time series analyses (ITSA). Methods Aggregated national EBF data by municipality and month were collected from 2009 to 2020. We assess the impact of the three events in EBF inequalities using two procedures: 1. ITSA stratified by municipal SES quintiles (Q1-Q5);2. calculating the EBF slope index of inequality (SII). Results The EBF prevalence was higher in lower SES municipalities before and after the three time-events. No impact in EBF inequalities were observed after the extended ML. The P4P strategy increased EBF at six months in all SES quintiles (effect size between 4% and 5%), but in a higher level in poorer municipalities (SII: -0.36% and -1.05%). During COVID-19, wealthier municipalities showed a slightly higher EBF at six-month prevalence (SII: 1.44%). Conclusion The null impact of the extended ML in EBF inequalities could be explained by a low access to ML among affiliated to the public health system (20%). The P4P strategy includes multiple interventions that seemed effective in increasing EBF across all SES quintiles, but further in lower quintiles. The restrictions in healthcare access in poorer municipalities could explain EBF inequalities during COVID-19.

3.
Bali Medical Journal ; 11(3):1354-1356, 2022.
Article in English | Web of Science | ID: covidwho-2100526

ABSTRACT

Introduction: Unachieved exclusive breastfeeding is still a problem in Indonesia. During pandemic covid-19 situation, the condition required to keep the distance from other people resulting the limited access between breastfeeding mothers and midwives. The role of the closest person that is husband is needed to constantly provide support. The objective of this research is to determine the relationship between husband's support during the covid-19 pandemic with exclusive breastfeeding.Methods: The type of research used is an analytic survey with a cross sectional method. The total population are 51 people and the sample of 45 people is taken using purposive sampling technique. Collecting data using questionnaire sheets given to respondents. Data analysis using Chi Square test (X2).Results: Based on analysis, we found that husband's support has a significant association with the quality of exclusive breastfeeding with p=0.000.Conclusion: The result of the research informed husbands who want to provide support in the form of effective communication between husband and wife during the breastfeeding process, able to help breastfeeding mothers to keep the spirit of breastfeeding, and will help provide breast milk as the best food for their babies. There is a significant relationship between husband's support in the success of exclusive breastfeeding during the covid-19 pandemic.

4.
Front Immunol ; 13: 1015002, 2022.
Article in English | MEDLINE | ID: covidwho-2089844

ABSTRACT

Infants exposed to caregivers infected with SARS-CoV-2 may have heightened infection risks relative to older children due to their more intensive care and feeding needs. However, there has been limited research on COVID-19 outcomes in exposed infants beyond the neonatal period. Between June 2020 - March 2021, we conducted interviews and collected capillary dried blood spots from 46 SARS-CoV-2 infected mothers and their infants (aged 1-36 months) for up to two months following maternal infection onset (COVID+ group, 87% breastfeeding). Comparative data were also collected from 26 breastfeeding mothers with no known SARS-CoV-2 infection or exposures (breastfeeding control group), and 11 mothers who tested SARS-CoV-2 negative after experiencing symptoms or close contact exposure (COVID- group, 73% breastfeeding). Dried blood spots were assayed for anti-SARS-CoV-2 S-RBD IgG and IgA positivity and anti-SARS-CoV-2 S1 + S2 IgG concentrations. Within the COVID+ group, the mean probability of seropositivity among infant samples was lower than that of corresponding maternal samples (0.54 and 0.87, respectively, for IgG; 0.33 and 0.85, respectively, for IgA), with likelihood of infant infection positively associated with the number of maternal symptoms and other household infections reported. COVID+ mothers reported a lower incidence of COVID-19 symptoms among their infants as compared to themselves and other household adults, and infants had similar PCR positivity rates as other household children. No samples returned by COVID- mothers or their infants tested antibody positive. Among the breastfeeding control group, 44% of mothers but none of their infants tested antibody positive in at least one sample. Results support previous research demonstrating minimal risks to infants following maternal COVID-19 infection, including for breastfeeding infants.


Subject(s)
COVID-19 , SARS-CoV-2 , Infant , Infant, Newborn , Adult , Female , Child , Humans , Adolescent , Antibodies, Viral , Immunoglobulin G , Immunoglobulin A
5.
Nurs Womens Health ; 2022 Oct 31.
Article in English | MEDLINE | ID: covidwho-2086602

ABSTRACT

OBJECTIVE: To explore the perspectives of lactation support providers delivering breastfeeding education via in-person and telehealth consultations and assess the impact of COVID-19 on the provision of breastfeeding education. DESIGN: Qualitative descriptive study using purposive sampling. SETTING: Massachusetts-based lactation support providers who provided in-person and/or telehealth consultations in various practice settings (e.g., inpatient; outpatient; private practice; and the Special Supplemental Nutrition Program for Women, Infants, and Children). PARTICIPANTS: Fourteen Massachusetts-based lactation support providers, ages 36 to 68 years. MEASUREMENTS: Participants completed an online demographic and employment characteristics survey and virtual key informant interviews, from which six main themes were defined. RESULTS: The six main themes included Common Questions Asked by Clients, Prenatal and Postpartum Consultation Topics, Facilitators for Telehealth Versus In-Person Consultations, Barriers for Telehealth Versus In-Person Consultations, Best Practices, and COVID-19 Adaptations. From participant interviews, common subthemes emerged. The primary adaptation due to COVID-19 was shifting to telehealth. Content in lactation consultations was similar via in-person and telehealth sessions. Typical content areas included breast pumping and mother's milk supply. A notable difference was the lack of physical examinations for women and newborns in telehealth sessions. Scheduling flexibility was a key facilitator of telehealth consultations, whereas the inability to provide hands-on assistance and chaotic home environments were common barriers. In-person facilitators included weighing newborns to assess feeding success and insurance billing coverage, whereas unsupportive family members were noted as a barrier. Diversity, equity, and inclusion-related barriers (e.g., language barriers, lack of reflective diversity, lack of stable Internet access) were observed in both settings. Best practices for in-person and telehealth consultations included meeting mothers where they are and focusing on mothers' goals. CONCLUSION: Practice adaptations adopted during the pandemic and best practice recommendations may be useful for lactation support providers and other health care professionals caring for breastfeeding dyads.

6.
Environment-Behaviour Proceedings Journal ; 7(21):153-164, 2022.
Article in English | Web of Science | ID: covidwho-2082450

ABSTRACT

Introduction: Child hunger commonly occurs in families with household food insecurity when mothers fail to continue breastfeeding due to stress and inability to produce sufficient breastmilk. This study aimed to investigate the association of breastfeeding knowledge, attitude, and practices (KAP) with food insecurity during the pandemic of COVID-19. Method: An online self-administered questionnaire related to the study was used to obtain data from 444 Malaysian Result: Findings showed that majority of the mothers have moderate to good knowledge, attitude and practices in breastfeeding. However, food insecurity and child hunger still occur. Conclusion: These findings may be helpful for healthcare professionals in developing effective strategies for continuation of breastfeeding during the pandemic.

7.
Int Breastfeed J ; 17(1): 73, 2022 10 17.
Article in English | MEDLINE | ID: covidwho-2079514

ABSTRACT

BACKGROUND: Exclusive breastfeeding (EBF) for six months is recommended as one of the most important ways to support child health and survival, particularly during the COVID-19 pandemic. However, breastfeeding women encountered several obstacles during the pandemic. The purpose of this study was to conduct a survey to document breastfeeding practices, EBF rates and associated factors with six month exclusive breastfeeding during the second wave of the coronavirus outbreak in Thailand. METHODS: A mixed-methods design that included a cross-sectional survey (n = 390) and semi-structured in-depth interviews (n = 15) was carried out between August and November 2021. Participants were women aged ≥ 15 years who had given birth within 6-12 months before data collection and delivered in three public hospitals in the top three provinces with the most severe COVID-19 outbreaks. RESULTS: The median duration of EBF was four months (interquartile range, IQR: 1-6 months) and 37.4% of women exclusively breastfed for six months. From binary logistic regression models, several personal factors were associated with exclusive breastfeeding for six months including being a housewife (AOR 2.848; 95% CI 1.512, 5.367), perceived sufficiency of family income (AOR 2.502; 95% CI 1.362, 4.594), working from home/business (AOR 2.071; 95% CI 1.074, 3.995), breastfeeding intention (AOR 1.162; 95% CI 1.116, 1.210), and maternal age (AOR 0.932; 95% CI 0.882, 0.986). From qualitative interviews, women who were able to exclusively breastfed during the outbreak explained five themes that were a protective shield; I have to save money, I could spend all my time with my baby and breastfeed, spousal support is valuable, and opportunity to avoid the obstructed beliefs about exclusive breastfeeding. CONCLUSIONS: Mothers with higher socioeconomic status and who were unemployed/worked from home and had support structures in place were able to successfully EBF during the COVID-19 outbreak. Healthcare providers can better support breastfeeding if they provide informational support and allow family members to participate in breastfeeding programs, especially spouses who provided key emotional and tangible support during pandemic.


Subject(s)
Breast Feeding , COVID-19 , COVID-19/epidemiology , Child , Cross-Sectional Studies , Female , Humans , Infant , Male , Mothers/psychology , Pandemics , Thailand/epidemiology
8.
Medical Forum Monthly ; 33(7):55-59, 2022.
Article in English | EMBASE | ID: covidwho-2073503

ABSTRACT

Objective: To assess the perception of women regarding breast feeding and lactation during Covid 19 pandemic. Study Design: Cross-sectional descriptive study. Place and Duration of Study: This study was conducted at the obstetrics and gynecology Department, neonatal follow-up clinics and vaccination center at Darul Sehat Hospital Karachi from September 2021 to November 2021. Material(s) and Method(s): A questionnaire was introduced to women after taking informed consent. Included females were either lactating currently or practicing since last six month and those with breast feeding problems were excluded from study. Questionnaire contain three portions of which first part inquired about demographic features, second part contained questions about perception and third part is about practices of breast feeding during Covid -19 pandemic. Data was analyzed using IBM-SPSS version 23.0. Means with standard deviation were given for quantitative variables and chi square test is used to assess association between perception of breast feeding and different study variables. Result(s): The study included 206 participants. Mean age was 28.8 years (SD +/-5.0). 66.2% suggested breastfeeding should continue even in covid prevalent communities, 33.8% claimed that covid virus can be transmitted via breastfeeding, 57.6% said wearing a mask should be mandatory while breastfeeding and 84.3% suggested washing hands prior to breastfeeding helps prevent transmission of virus from mother to baby. 66.2% thought breastfeeding protects the child against covid disease. Conclusion(s): Covid 19 pandemic has affected breastfeeding practices. Majority women suggested breastfeeding should continue even in communities where covid is pandemic, and that breastfeeding protects the child against covid disease. Copyright © 2022 Medical Forum Monthly. All rights reserved.

9.
Asian Journal of Medical Sciences ; 13(10):18-22, 2022.
Article in English | Academic Search Complete | ID: covidwho-2065386

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a very virulent and contagious coronavirus and has caused a pandemic of acute respiratory disease, named “Coronavirus disease 2019” (COVID-19) that emerged in the late 2019. In breast milk (BM), presence of SARS-CoV-2 virus and its antibodies have been examined. Aims and Objectives: The current observational study was conducted over a period of 1 year in the state of Mizoram to investigate the presence of SARS-CoV-2 virus and antibodies in pregnant mothers and their newborn along with breast milk. Materials and Methods: A total of 115 breast milk samples and 70 breast swabs (before or after breast washing) from 115 women who were recently diagnosed with COVID-19 were collected. Samples were analyzed for SARS-CoV-2 RNA using RT-PCR. Breast milk was also analyzed for SARS-CoV2, IgA, and IgG receptor binding domain (RBD), S2 subunit of the spike protein of SARS-CoV-2. Results: BM RTPCR was found to be positive 78 and 37 BM samples were found to be negative for RTPCR. Among the infants, 32 were exclusively on breastfeed and 83 were mixed feeding infants. Post-breastfeeding four infants were shown the signs and symptoms of COVID-19. IgA and IgG RBD and S2 subunit of the spike protein of SARS-CoV-2 antibodies were positive in 17, 16, and 12 BM samples which show that maternal antibodies to be developed in BM take time for production and the mothers infected almost 10 days ago, only showed presence of those antibodies. Conclusion: Our findings have shown increase admissions of COVID-19 infected antenatal mothers with positive outcome despite the requirement of intensive care. SARS-CoV-2 was detected in BM which was significantly high, but there was no transmission to the babies during the postnatal period. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

10.
Int J Womens Health ; 14: 1447-1457, 2022.
Article in English | MEDLINE | ID: covidwho-2065260

ABSTRACT

Objective: The aim of this systematic review was to explore the impact of the COVID-19 pandemic on breastfeeding support services and continuation rates. Methods: Electronic searches were undertaken in seven databases: Academic Search Complete, Springer Nature Journals, CINAHL Medline, Health Source: Nursing/Academic Edition, Masterfile premier, and SocINDEX. Publications following the COVID-19 pandemic between January 2020 and March 2022 were searched for using the following keywords: impact or effect or influence and breastfeeding support and breastfeeding continuation and COVID-19 or coronavirus. Fifteen studies were included for investigation and extracted to identify seven themes related to breastfeeding support during COVID-19. Results: Factors which impacted breastfeeding support during the COVID-19 pandemic included separation, lack of skin-to-skin contact, insufficient support, online breastfeeding support, the impact of the pandemic on breastfeeding rates and experiences, fears of the pandemic, and the need for additional support. The pandemic mostly influenced breastfeeding support negatively, with a small exception occurring where some mothers experienced lockdown as positive since it protected the mother-infant dyad from unwanted visitors. Virtual breastfeeding support was introduced in many contexts; however, practitioners and mothers reported that this could not replace the need for face-to-face support. Conclusion: Breastfeeding is a lifesaving intervention, especially in the face of a disruption such as a pandemic. This work highlights the need for clear, consistent, and evidence-based information about risks, and for key practices to be maintained including not separating mothers and infants, promoting skin-to-skin contact, and ensuring availability of high-quality breastfeeding support.

11.
J Nurs Manag ; 2022 Oct 07.
Article in English | MEDLINE | ID: covidwho-2063847

ABSTRACT

AIM: The aim was to evaluate the feasibility of protective measures for infants of low-income SARS-CoV-2 positive breastfeeding mothers. BACKGROUND: Breastfeeding mothers with SARS-CoV-2 positive should avoid exposing the infant through protective measures (PM), but it could be challenging in a low-income population. METHODS: A prospective, multicenter study was conducted between July and October 2020 (BRACOVID). The participants were recruited at birth and interviewed through a structured questionnaire at seven and 14 days in the home environment. The feasibility of PM during breastfeeding at home was defined by guidelines recommendations (mask using, handwashing, and distancing from newborn when not breastfeeding). Three groups according to the feasibility of guidelines: complete guidelines feasibility (CG): all PM; partial guidelines feasibility (PG): at least one PM feasible; no guidelines (NG): infeasibility to all of PM. Flu-like neonatal symptoms, mothers' breastfeeding practices. We evaluated the association between PM feasibility and socioeconomic factors. RESULTS: 117 infected mothers from 17 Brazilian hospitals were enrolled. 47 (40%) mothers followed all recommendations, 14 (11.9%) could not practice at least one recommendation, and 50 (42.7%) did not execute any of them. The breastfeeding rate was 98%. Factors associated with infeasibility were monthly family income < 92.7 dollars/person, high housing density (>1 inhabitant/room), teenage mothers, responsive feeding, and poor schooling. Regarding infants' flu-like symptoms, 5% presented symptoms at fourteen days (NG group). CONCLUSION: The guidelines were not applied to infants of SARs-CoV-positive mothers in 54.6% of the dyads since the recommendations were unviable in their environments. During pandemics, we should look for feasible and effective guidelines to protect neonates from low-income populations. IMPLICATIONS FOR NURSING MANAGEMENT: Poor socioeconomic conditions lead to the unfeasibility of protective measures for infants of low-income SARS-CoV-2 positive breastfeeding mothers during the isolation period in the pandemics. The orientations and the support provided to dyad should consider the socioeconomic factors to guide feasible measures in the home environment and promote adequate protections; only an individual approach will allow a safe environment for low-income infants.

12.
Telemed J E Health ; 28(10): 1449-1457, 2022 10.
Article in English | MEDLINE | ID: covidwho-2062839

ABSTRACT

Introduction: Breastfeeding is an unquestionable right of mothers and their children; however, it is not a one-woman job. For breastfeeding to succeed, women must have access to appropriate support and guidance. The COVID-19 pandemic and subsequent restriction measures and lockdown to reduce community spread of the disease have negatively impacted breastfeeding support from health services and thus, in mothers' breastfeeding experiences. Objective: The present study aims at evaluating the impact of the COVID-19 pandemic on breastfeeding consultations in LactApp (a mobile application [app] for m-Health focused on breastfeeding support, www.lactapp.com) during the COVID-19 pandemic. Materials and Methods: We conducted an observational, descriptive, and retrospective study with LactApp data recorded between July 2018 and March 2021, including 9,151,456 queries classified in 48 topics among 137,327 active users. We used the Interrupted time series model to evaluate the increase of the number of queries consulted and active users due to the COVID-19 pandemic. Wilcoxon test was used to study the increase of certain topics due to the COVID-19 pandemic. Results: LactApp active users increased by 12,092 users (p < 0.001) during the COVID-19 outbreak and confinement and queries consulted in LactApp also significantly increased by 10,899 queries per month after the pandemic outbreak. The breastfeeding topics that significantly increased are those related to growth spurts, breastfeeding stages, breastfeeding technique, breast pain and mastitis, problems with infants not gaining weight correctly, hypogalactia, increased milk demand, and relactation. These findings are important to understand the potential of online tools when face-to-face professional support is unavailable. Conclusions: Critical issues in breastfeeding establishment were highly consulted and significantly increased in the app during the pandemic. We believe that LactApp was a useful tool for breastfeeding support when women could not obtain appropriate support elsewhere. LactApp might be considered a powerful tool to identify critical issues of breastfeeding and trends in an automatized manner.


Subject(s)
COVID-19 , Telemedicine , Breast Feeding , COVID-19/epidemiology , Child , Communicable Disease Control , Female , Humans , Infant , Mothers , Pandemics , Referral and Consultation , Retrospective Studies
13.
Revista de Obstetricia y Ginecologia de Venezuela ; 82(3):362-372, 2022.
Article in Spanish | Scopus | ID: covidwho-2057202

ABSTRACT

Objective: To describe, through the scientific studies available in the national and international literature, the benefits of breastfeeding in the COVID-19 pandemic. Methods: This is a literary integrative review research, constructed from materials published between 2019 and 2020. For the selection of texts, an Internet survey was carried out using the databases of the Virtual Health Library. The keywords investigated were: Breastfeeding;COVID-19;Nurse;Pandemic and Obstetrics. Results: We included 18 articles that were considered relevant to the proposed topic. Two thematic categories were used: 1. Results of breastfeeding in pregnant and postpartum women with suspicion and confirmation of COVID-19;2. Actions for breastfeeding in times of COVID-19 pandemic. Conclusion: Breastfeeding should be encouraged even in women with COVID-19, provided hand hygiene and the use of a surgical mask are performed. Further studies with greater methodological rigor should be developed to overcome controversies on the matter. © 2022 Sociedad de Obstetricia y Ginecologia de Venezuela. All rights reserved.

14.
Womens Health (Lond) ; 18: 17455057221125088, 2022.
Article in English | MEDLINE | ID: covidwho-2053775

ABSTRACT

BACKGROUND: Peer support, also described as woman-to-woman support, has been well established as an effective intervention for overcoming barriers to breastfeeding duration. To access support and receive information, mothers are likely to access social media platforms, especially given the challenges to healthcare access presented by the COVID-19 pandemic. Previous research has established that virtual communities can promote peer-to-peer support similar to that seen in communities of practice. RESEARCH AIM: The aims of this study were to describe levels of perceived informational social support among mothers in an online virtual community and to determine which features of the virtual community were perceived most favorably by breastfeeding mothers. METHODS: The study design was a cross-sectional survey of members of an existing social media community of breastfeeding mothers with use of the Online Social Support Scale-Informational subscale, Breastfeeding Self-Efficacy Short Form, and additional open-ended questions during the early phases of the COVID-19 pandemic. Participants were recruited within a single, lactation-focused virtual community that was moderated by lactation support professionals. RESULTS: In regard to online social support specific to information seeking, the reported social support was moderate to high (M = 35.53, range = 17-48). Most items had a score average of approximately 3, indicating that participants perceived informational support "Pretty often" from their group interactions. Participants in this study had an average Breastfeeding Self-Efficacy-Short Form score of 57.91, indicating a moderately high level of breastfeeding self-efficacy. Content analysis of open-ended items regarding favorable characteristics of the virtual community indicated participants appreciated the immediacy of feedback and the presence of lactation support professionals within the community. CONCLUSION: Mothers in the lactation professional-led virtual community perceived moderately high support in health information seeking and experienced moderately high breastfeeding self-efficacy. Additional work is needed to determine the impact of participation in virtual communities on breastfeeding outcomes.


Subject(s)
Breast Feeding , COVID-19 , Cross-Sectional Studies , Female , Humans , Lactation , Mothers , Pandemics , Social Support
15.
J Hum Lact ; : 8903344221126644, 2022 Oct 05.
Article in English | MEDLINE | ID: covidwho-2053643

ABSTRACT

BACKGROUND: The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life and that breastfeeding should continue for 2 years and beyond. Most women initiate breastfeeding, but many do not continue for the recommended duration. While midwife-led continuity of antenatal care is linked to improved mother and infant outcomes, the influence on breastfeeding duration has not been previously reviewed. RESEARCH AIM: To critically analyze the literature that compared midwife-led continuity of antenatal care with other models of care where researchers have measured breastfeeding duration beyond postpartum hospital discharge. METHODS: A systematic literature review with critical analysis was used to answer the research aim. We systematically searched and screened five databases for quantitative studies where researchers had reported breastfeeding duration beyond postpartum hospital discharge after midwife-led continuity of antenatal care, compared with another model of antenatal care. Methodological quality was assessed using tools from the Cochrane Collaboration (RoB2 and ROBINS-I). In total, nine studies met the inclusion criteria. RESULTS: Clear conclusions about the association between midwife-led continuity of antenatal care and breastfeeding duration were not found. The risk of bias within non-randomized studies ranged from serious to critical, and a judgement of "some concerns" of risk of bias in the one randomized study. CONCLUSION: To date, the question of whether midwife-led continuity of antenatal care improves breastfeeding duration has not been established. There has been a lack of consistency in definitions of breastfeeding and descriptions of models of care, which has weakened the evidence-based of literature reviewed.Our review protocol was registered with PROSPERO; although due to COVID-19, this registration was not checked for eligibility by the PROSPERO team (CRD42020151276). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151276.

16.
J Hum Lact ; : 8903344221125129, 2022 Oct 03.
Article in English | MEDLINE | ID: covidwho-2053642

ABSTRACT

BACKGROUND: There are different approaches to breastfeeding interventions, but the global 6-month exclusive breastfeeding rates remain suboptimal. The COVID-19 pandemic has brought extra difficulties in promoting breastfeeding. RESEARCH AIM: To test the feasibility and effectiveness of a theory-based, real-time online educational and support program for breastfeeding related outcomes. METHODS: An assessor-blinded, prospective pilot randomized controlled trial with parallel-group, repeated-measures design was used. The sample was low-risk primiparous mothers (N = 40) who delivered in the local public hospitals. Study outcomes consisted of exclusive breastfeeding rate, breastfeeding self-efficacy, and other breastfeeding outcomes measured by a self-reported questionnaire, including the Breastfeeding Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Comparisons between the differences in the intervention and control groups were carried out. RESULTS: Thirteen participants in the intervention group successfully completed the program. They had a higher exclusive breastfeeding rate, breastfeeding self-efficacy, breastfeeding initiation rate, and longer exclusive breastfeeding duration than the control group. Additionally, the intervention group had a lower partial breastfeeding rate, and a higher maternal postnatal depression score and infant's morbidity at postnatal 2 months. However, all the results were not statistically significant (p > .050). Overall, the intervention was highly valued by all participants who appreciated the regular postnatal follow-ups. CONCLUSIONS: Despite showing the satisfactory feasibility of the program, no significant improvements were found in all study outcomes. Considering the participants' comments, we suggest refining and further testing the intervention with a larger sample size over a longer-term follow-up to confirm its effectiveness.This study has been registered at ClinicalTrials.gov (NCT04741425).

17.
J Pediatr (Rio J) ; 98(5): 496-503, 2022.
Article in English | MEDLINE | ID: covidwho-2049564

ABSTRACT

OBJECTIVE: Evaluate the association between breastfeeding, exclusive breastfeeding at six months and the introduction of complementary feeding during the pre-pandemic and the COVID-19 pandemic periods. METHODS: Cohort study conducted with puerperal women and their newborns in the immediate postpartum period at a reference maternity hospital in Southern Brazil between 2018-2020. The COVID-19 pandemic period and the need to work outside the home during restricted circulation were the factors of exposure. The outcome evaluated was the weaning in the first six months (breastfeeding and exclusive breastfeeding) and the introduction of complementary feeding before the sixth month of life. RESULTS: 547 puerperal women and their newborns were included. During the COVID-19 pandemic, there was a higher risk to weaning of exclusive breastfeeding up until six months (RR 1.16; 95%CI 1.03-1.31) and introducing complementary feeding early (RR 1.40; 95%CI 1.01-1.96). The need to work outside the home during the COVID-19 pandemic increased the risk of not breastfeeding exclusively at the sixth month (RR 1.27; 95%CI 1.08-1.49). CONCLUSIONS: The difficulties of the pandemic did reflect negatively on breastfeeding and complementary feeding practices. The pandemic was a risk factor for the early weaning of exclusive breastfeeding and the introduction of complementary feeding. However, not having to work outside the home during the pandemic period was a protective factor for exclusive breastfeeding at six months.


Subject(s)
Breast Feeding , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Cohort Studies , Female , Humans , Infant , Infant Nutritional Physiological Phenomena , Infant, Newborn , Pandemics , Pregnancy
18.
Drug Safety ; 45(10):1231, 2022.
Article in English | ProQuest Central | ID: covidwho-2047124

ABSTRACT

Introduction: Initially, vaccination against Covid-19 was not recommended during pregnancy due to the lack of data. With the benefit of hindsight, it has become recommended. This decision followed the reassuring results from pregnant women who voluntarily or inadvertently received Covid-19 vaccines, especially with mRNA vaccines [1]. In Tunisia, from May 2021, pregnant women have been prioritized in the national vaccination program with the recommendation of the messenger RNA platform. Objective: To follow-up Covid-19 vaccinated pregnant and/or breastfeeding women in Tunisia. Methods: We have started a pilot study (from September 2021 to April 2022) for monitoring pregnant and/or breastfeeding women. Data collection was carried out via telephone calls. We excluded women who were unreachable after two phone calls. The data collected concerned the course as well as the outcome of the pregnancy and the health status of newborns. In addition, women were asked about the possible occurrence of adverse effects following immunization. Results: Our study included 1253 women. Seventeen percent of them were previously infected with Covid-19. The vaccination schedule was complete (two doses) in 83% of cases. Pfizer-BioNTech vaccine (PBV) was used in 73% of cases (11% of cases in the first trimester, 42% in the second trimester and 19% in the third trimester) and Moderna vaccine in 26%. Coronavac vaccine was used in 1% of cases. Vaccination was performed during pregnancy in 74 % of cases and breastfeeding in 11% of cases. Fifteen percent of women received the first dose during pregnancy and the second dose after childbirth. Reported adverse events following vaccination were: pain at the injection site in 47%, fever in 23%, soreness in 15%, asthenia in 6%, headache in 5%, hot flashes in 3% and chills in 1% of cases. Pregnancy and breastfeeding outcomes were favourable in 1246 women (99.4% of cases). Forty-seven percent of women delivered at term without incident and newborns were apparently in good health. One case of spontaneous miscarriage was reported in a woman with a history of spontaneous abortion and Covid-19 infection two weeks after receiving the first dose of PBV. Six cases of neonatal jaundice were also reported with PBV with good evolution with phototherapy. Conclusion: Our study confirms the data in the literature concerning the safety of Covid-19 vaccines on pregnant and/or breastfeeding women.

19.
Drug Safety ; 45(10):1175, 2022.
Article in English | ProQuest Central | ID: covidwho-2046530

ABSTRACT

Introduction: Rare or serious Adverse Events (AEs) in the reproductive sphere have been reported following the administration of the COVID-19 vaccine, especially mRNA vaccines. Although several fertility Societies have announced that COVID-19 mRNA vaccines are unlikely to affect fertility, pregnancy, or breastfeeding, there is no denying that the current evidence is very limited [1]. Objective: Aim of this study was a post-marketing assessment of the safety profile of COVID-19 vaccines, through the analysis of the Individual Case Safety Reports (ICSRs) collected in EudraVigilance in 2021 year, by focusing on reproductive disorders. Methods: We analyzed all ICSRs that contained at least one COVID-19 vaccine as suspected and at least one AE belonging to the Standardized MedDRA Query (SMQ) level 1 "Fertility disorders" or "Pregnancy and neonatal conditions". We performed a descriptive analysis and all AEs have been coded as Preferred Term (PT) according to MedDRA. Finally, we used the Reporting Odds Ratio (ROR) with a 95% of Confidence Interval (95% CI) to investigate disproportional reporting of AEs belonging to the SMQs of interest among the vaccines included in the analysis. Results: During the study period, 27,089 ICSR were collected and the total number of AEs was found to be 31,337;of these, 62.8% were referred to Comirnaty®, 20.8% to Spikevax®, 12.7% to Vaxzevria®, and 3.7% to Janssen®. For each of the four COVID-19 vaccines, 96.4% were related to female patients, aged between 18-64 years (88.1%), 71.5% were not serious, 46.0% were not resolved yet and 82.3% were reported by non-healthcare professionals. Regardless of the type of vaccine, the most reported PTs were amenorrhea, irregular menstruation, and delayed menstruation. The ROR showed that the probability to report an AE belonging to the SMQ "Fertility disorders" is greater for Comirnaty® (ROR: 4.20, 95% CI 4.08-4.32) while no statistically significant difference was observed to the SMQ "Pregnancy and neonatal conditions". Conclusion: In this study, no potential signs of reproductive system safety were found regarding fertility, pregnancy or breastfeeding. Most of the reported events were related to changes in the menstrual cycle, although these disorders are temporary and normally common in the female population. At the time, the EMA's PRAC concluded that the evidence did not support a causal link between these vaccines and menstrual disorders, however, it decided to further studies collecting data from real life contexts are strongly needed to assess their safety profile in relation to reproductive function.

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Malaysian Journal of Public Health Medicine ; 22(2):16-26, 2022.
Article in English | Scopus | ID: covidwho-2045690

ABSTRACT

Breastfeeding during the COVID-19 pandemic is challenging. Strong intention and good knowledge on the risk and benefit of breastfeeding are important for a woman to breastfeed her child during this period. This study aims to develop and validate a Malay language questionnaire in order to measure Malaysian women's knowledge and intention about breastfeeding during the pandemic. The items were developed based on an extensive review of literature as well as breastfeeding guidelines and suggestions from experts, followed by an assessment of content and face validity that involved nine and 30 reviewers respectively. A pilot study was conducted on 90 respondents and the reliability assessment was performed using Rasch analysis. Exploratory factor analysis (EFA) was used to determine the number of latent factors within the intention dimension. Among 29 knowledge items and 36 intention items, 19 knowledge items remained with a person separation (person reliability) as well as item separation (item reliability) of 1.73(0.75) and 3.97(0.94). The final intention domain had 17 items with a person separation (person reliability) as well as item separation (item reliability) of 1.54(0.70) and 3.87(0.94). Three latent factors were identified within the intention questionnaire. The final 17 items explained 53.7% of the variance with an overall Kaiser-Meyer-Olkin measure of sampling adequacy of 0.70, χ2 = 623.40 (136), p<0.001. Using the framework of the theory of planned behaviour, the drafted questionnaire is reliable and valid based on the Rasch measurement model to measure the knowledge and intention about breastfeeding during an infection outbreak. © 2022, Malaysian Journal of Public Health Medicine. All Rights Reserved.

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