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1.
Int Breastfeed J ; 17(1): 28, 2022 04 11.
Article in English | MEDLINE | ID: covidwho-1785163

ABSTRACT

BACKGROUND: Coronavirus Disease 2019 (COVID-19) has spread worldwide. The safety of breastfeeding of SARS-CoV-2-positive women has not yet reached a consensus among the scientific community, healthcare providers, experts in lactation care, health organizations and governments. This study was conducted to summarize the latest evidence about the safety of breastfeeding among suspected/confirmed infected mothers and to summarize the recommendations on breastfeeding during COVID-19 from different organizations. METHODS: A comprehensive literature review of publications about the safety of breastfeeding among SARS-CoV-2-infected mothers was conducted. Scientific databases were searched up to 26 May 2021. The evidence was summarized into five perspectives according to a framework proposed by van de Perre et al. with certain modifications. Moreover, websites of different health organizations were visited to gather the recommendations for breastfeeding. RESULTS: The current evidence demonstrated that the majority of infants breastfed by infected mothers were negative for SARS-CoV-2. Breast milk samples from suspected/infected mothers mainly demonstrated negative results in SARS-CoV-2 viral tests. There was insufficient evidence proving the infectivity of breast milk from infected mothers. Recent studies found other transmission modalities (e.g., milk containers, skin) associated with breastfeeding. Specific antibodies in the breast milk of infected mothers were also found, implying protective effects for their breastfed children. According to van de Perre's criteria, the breast milk of infected mothers was unlikely to transmit SARS-CoV-2. Owing to the low quality of the current evidence, studies with a more robust design are needed to strengthen the conclusion regarding the safety of breastfeeding. Further studies to follow up the health status of infants who were directly breastfed by their suspected/infected mothers, to collect breast milk samples at multiple time points for viral tests and to examine specific antibodies in breast milk samples are warranted. Current recommendations on breastfeeding during COVID-19 from different organizations are controversial, while direct breastfeeding with contact precautions is generally suggested as the first choice for infected mothers. CONCLUSIONS: This review determined the safety of breastfeeding and identified the focus for further research during the COVID-19 pandemic. Recommendations on breastfeeding are suggested to be updated in a timely manner according to the latest evidence.


Subject(s)
COVID-19 , Breast Feeding/methods , Child , Female , Humans , Infant , Infectious Disease Transmission, Vertical/prevention & control , Pandemics , SARS-CoV-2
4.
Am J Perinatol ; 38(11): 1209-1216, 2021 09.
Article in English | MEDLINE | ID: covidwho-1284751

ABSTRACT

OBJECTIVE: There are limited published data on the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus from mothers to newborns through breastfeeding or from breast milk. The World Health Organization released guidelines encouraging mothers with suspected or confirmed COVID-19 to breastfeed as the benefits of breastfeeding outweighs the possible risk of transmission. The objective of this study was to determine if SARS-CoV-2 was present in the breast milk of lactating mothers who had a positive SARS-CoV-2 nasopharyngeal swab test prior to delivery, and the clinical outcomes for their newborns. STUDY DESIGN: This was a single-center, observational, prospective cohort study. Maternal-newborn dyads that delivered at New York University Langone Hospital Brooklyn with confirmed maternal SARS-CoV-2 positive screen test at the time of admission were recruited for the study. Breast milk samples were collected during postpartum hospitalization and tested for the presence of SARS-CoV-2 genes N1 and N2 by two-step reverse transcription polymerase chain reaction. Additionally, the clinical characteristics of the maternal newborn dyad, results of nasopharyngeal SARS-CoV-2 testing, and neonatal follow-up data were collected. RESULTS: A total of 19 mothers were included in the study and their infants who were all fed breast milk. Breast milk samples from 18 mothers tested negative for SARS-CoV-2, and 1 was positive for SARS-CoV-2 RNA. The infant who ingested the breast milk that tested positive had a negative nasopharyngeal test for SARS-CoV-2, and had a benign clinical course. There was no evidence of significant clinical infection during the hospital stay or from outpatient neonatal follow-up data for all the infants included in this study. CONCLUSION: In a small cohort of SARS-CoV-2 positive lactating mothers giving birth at our institution, most of their breast milk samples (95%) contained no detectable virus, and there was no evidence of COVID-19 infection in their breast milk-fed neonates. KEY POINTS: · Breast milk may rarely contain detectable SARS-CoV-2 RNA and was not detected in asymptomatic mothers.. · Breast milk with detectable SARS-CoV-2 RNA from a symptomatic mother had no clinical significance for her infant.. · Breast feeding with appropriate infection control instructions appears to be safe in mother with COVID infection..


Subject(s)
Breast Feeding , COVID-19 , Infection Control/methods , Infectious Disease Transmission, Vertical/prevention & control , Milk, Human/virology , Pregnancy Complications, Infectious , SARS-CoV-2/isolation & purification , Adult , Asymptomatic Infections , Breast Feeding/adverse effects , Breast Feeding/methods , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Testing/methods , Female , Humans , Infant, Newborn , Male , New York City/epidemiology , Outcome Assessment, Health Care , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Prospective Studies
7.
Neonatal Netw ; 40(3): 140-145, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1259284

ABSTRACT

The impact of the COVID-19 pandemic upon the health care landscape has prompted many organizations to revise policies in response to ever-changing guidelines and recommendations regarding safe breastfeeding practices. The application of these professional guidelines into clinical practice is fraught with barriers, inconsistencies, and often-minimal evidential support. Key concerns for health care providers and patients include antenatal versus postnatal transmission, milk transmission, and separation care versus rooming-in, including the subsequent impacts upon breastfeeding and bonding. While SARS-CoV-2 is a novel virus, the volume of literature to support best practice for couplet care continues to be developed at a rapid pace. The benefits of breastfeeding are steeped in evidence and outweigh the potential risk of transmission of COVID-19 from mother to newborn. Health care organizations must continue to seek guidance for policy revision within the ever-growing body of evidence for best practice and evaluate current practices for feasibility during and after hospitalization.


Subject(s)
Breast Feeding/methods , Breast Feeding/psychology , COVID-19/psychology , Health Promotion/methods , Mothers/psychology , Neonatal Nursing/standards , Practice Guidelines as Topic , Adult , Female , Humans , Infant, Newborn , Pandemics , Pregnancy , SARS-CoV-2
8.
Breastfeed Med ; 16(1): 29-38, 2021 01.
Article in English | MEDLINE | ID: covidwho-1228415

ABSTRACT

In addition to providing life-giving nutrients and other substances to the breastfed infant, human milk can also represent a vehicle of pathogen transfer. As such, when an infectious disease outbreak, epidemic, or pandemic occurs-particularly when it is associated with a novel pathogen-the question will naturally arise as to whether the pathogen can be transmitted through breastfeeding. Until high-quality data are generated to answer this question, abandonment of breastfeeding due to uncertainty can result. The COVID-19 pandemic, which was in full swing at the time this document was written, is an excellent example of this scenario. During these times of uncertainty, it is critical for investigators conducting research to assess the possible transmission of pathogens through milk, whether by transfer through the mammary gland or contamination from respiratory droplets, skin, breast pumps, and milk containers, and/or close contact between mother and infant. To promote the most rigorous science, it is critical to outline optimal methods for milk collection, handling, storage, and analysis in these situations, and investigators should openly share their methods in published materials. Otherwise, the risks of inconsistent test results from preanalytical and analytical variation, false positives, and false negatives are unacceptably high and the ability to provide public health guidance poor. In this study, we provide "best practices" for collecting human milk samples for COVID-19 research with the intention that this will also be a useful guide for future pandemics.


Subject(s)
Benchmarking , Breast Feeding/methods , COVID-19/prevention & control , Infection Control/methods , Infectious Disease Transmission, Vertical/prevention & control , COVID-19/transmission , Female , Humans , Infant, Newborn , Intention , Milk, Human/virology , Mothers/psychology , SARS-CoV-2
9.
Ann Allergy Asthma Immunol ; 127(3): 312-317, 2021 09.
Article in English | MEDLINE | ID: covidwho-1220652

ABSTRACT

OBJECTIVE: To present an update of birth cohort study designs and their contributions to allergic risk. DATA SOURCES: The PubMed database was used to search for relevant articles. STUDY SELECTIONS: Peer-reviewed prospective and retrospective studies involving the assessment of allergy using human birth cohorts between 2014 and 2021 were evaluated. RESULTS: Parental history of allergic diseases, especially in cases involving both parents, is associated with increased risk of allergy. Exposure to prenatal and postnatal smoking and limited diet diversity were associated with increased allergic burden. The impact of early-life infections and antibiotics on disease development may be associated with the onset of asthma, though this remains debated. Cohort studies also revealed that the mode of delivery and breastfeeding duration affect the odds ratio of asthma and eczema development. Household exposures, including pets, house dust mites, and scented aeroallergens may confer protective effects, whereas high air pollution exposure and low socioeconomic status may be risk enhancing. Exposure to antibiotics during early life may be associated with increased asthma risk, whereas viral infections may lead to disease protection, though the impact of the coronavirus disease 2019 pandemic on allergic risk is yet to be understood. CONCLUSION: Although evaluating the risk of allergic disease development is complex, clinicians can apply these insights on the multifactorial nature of atopy to better understand and potentially mitigate disease development.


Subject(s)
Asthma/immunology , Breast Feeding/methods , Diet/methods , Eczema/immunology , Hypersensitivity/immunology , Inheritance Patterns/immunology , Allergens/administration & dosage , Animals , Anti-Bacterial Agents/adverse effects , Asthma/etiology , Asthma/genetics , Asthma/prevention & control , Cohort Studies , Eczema/etiology , Eczema/genetics , Eczema/prevention & control , Environmental Exposure/adverse effects , Environmental Pollutants/adverse effects , Female , Humans , Hypersensitivity/etiology , Hypersensitivity/genetics , Hypersensitivity/prevention & control , Pets/immunology , Pregnancy , Pyroglyphidae/chemistry , Pyroglyphidae/immunology , Risk Factors , Virus Diseases/immunology , Virus Diseases/virology
10.
Am J Perinatol ; 38(6): 622-631, 2021 05.
Article in English | MEDLINE | ID: covidwho-1135708

ABSTRACT

OBJECTIVE: There is a paucity of evidence to guide the clinical care of late preterm and term neonates born to women with perinatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The objective of this case series is to describe early neonatal outcomes and inpatient management in U.S. hospitals. STUDY DESIGN: We solicited cases of mother-infant dyads affected by novel coronavirus disease 2019 (COVID-19) from the Better Outcomes through Research for Newborns (BORN) Network members. Using a structured case template, participating sites contributed deidentified, retrospective birth hospitalization data for neonates ≥35 weeks of gestation at birth with mothers who tested positive for SARS-CoV-2 before delivery. We describe demographic and clinical characteristics, clinical management, and neonatal outcomes. RESULTS: Sixteen U.S. hospitals contributed 70 cases. Birth hospitalizations were uncomplicated for 66 (94%) neonates in which 4 (6%) required admission to a neonatal intensive care unit. None required evaluation or treatment for infection, and all who were tested for SARS-CoV-2 were negative (n = 57). Half of the dyads were colocated (n = 34) and 40% directly breastfed (n = 28). Outpatient follow-up data were available for 13 neonates, all of whom remained asymptomatic. CONCLUSION: In this multisite case series of 70 neonates born to women with SARS-CoV-2 infection, clinical outcomes were overall good, and there were no documented neonatal SARS-CoV-2 infections. Clinical management was largely inconsistent with contemporaneous U.S. COVID-19 guidelines for nursery care, suggesting concerns about the acceptability and feasibility of those recommendations. Longitudinal studies are urgently needed to assess the benefits and harms of current practices to inform evidence-based clinical care and aid shared decision-making. KEY POINTS: · Birth hospitalizations were uncomplicated for late preterm and term infants with maternal COVID-19.. · Nursery management of dyads affected by COVID-19 varied between hospitals.. · Adherence to contemporaneous U.S. clinical guidelines for nursery care was low.. · Breastfeeding rates were lower for dyads roomed separately than those who were colocated..


Subject(s)
Breast Feeding , COVID-19 , Hospitalization/statistics & numerical data , Pregnancy Complications, Infectious , Premature Birth/epidemiology , Term Birth , Adult , Breast Feeding/methods , Breast Feeding/statistics & numerical data , COVID-19/epidemiology , COVID-19/therapy , Female , Gestational Age , Guideline Adherence , Health Services Needs and Demand , Humans , Infant, Newborn , Infant, Premature , Intensive Care Units, Neonatal/statistics & numerical data , Male , Practice Guidelines as Topic , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/virology , Pregnancy Outcome/epidemiology , United States/epidemiology
11.
BJOG ; 128(5): 908-915, 2021 04.
Article in English | MEDLINE | ID: covidwho-1119188

ABSTRACT

OBJECTIVE: To demonstrate that delayed cord clamping (DCC) is safe in mothers with confirmed SARS-CoV-2 infection. DESIGN, SETTING AND PARTICIPANTS: Prospective observational study involving epidemiological information from 403 pregnant women with SARS-CoV-2 between 1 March and 31 May 2020. Data were collected from 70 centres that participate in the Spanish Registry of COVID-19. METHODS: Patients' information was collected from their medical chart. MAIN OUTCOMES AND MEASURES: The rate of perinatal transmission of SARS-CoV-2 and development of the infection in neonates within 14 days postpartum. RESULTS: The early cord clamping (ECC) group consisted of 231 infants (57.3%) and the DCC group consisted of 172 infants (42.7%). Five positive newborns (1.7% of total tests performed) were identified with the nasopharyngeal PCR tests performed in the first 12 hours postpartum, two from the ECC group (1.7%) and three from the DCC group (3.6%). No significant differences between groups were found regarding neonatal tests for SARS-CoV-2. No confirmed cases of vertical transmission were detected. The percentage of mothers who made skin-to-skin contact within the first 24 hours after delivery was significantly higher in the DCC group (84.3% versus 45.9%). Breastfeeding in the immediate postpartum period was also significantly higher in the DCC group (77.3% versus 50.2%). CONCLUSIONS: The results of our study show no differences in perinatal outcomes when performing ECC or DCC, and skin-to-skin contact, or breastfeeding. TWEETABLE ABSTRACT: This study demonstrates that delayed cord clamping is safe in mothers with confirmed SARS-CoV-2 infection.


Subject(s)
COVID-19 , Constriction , Delivery, Obstetric , Infectious Disease Transmission, Vertical , Pregnancy Complications, Infectious , SARS-CoV-2/isolation & purification , Umbilical Cord/surgery , Adult , Breast Feeding/methods , Breast Feeding/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Delivery, Obstetric/methods , Delivery, Obstetric/statistics & numerical data , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Kangaroo-Mother Care Method/methods , Kangaroo-Mother Care Method/statistics & numerical data , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Pregnancy Outcome/epidemiology , Spain/epidemiology , Time-to-Treatment
13.
Acta Obstet Gynecol Scand ; 100(7): 1219-1229, 2021 07.
Article in English | MEDLINE | ID: covidwho-1039800

ABSTRACT

INTRODUCTION: Evidence on perinatal mental health during the coronavirus disease 2019 (COVID-19) pandemic and its potential determinants is limited. Therefore, this multinational study aimed to assess the mental health status of pregnant and breastfeeding women during the pandemic, and to explore potential associations between depressive symptoms, anxiety, and stress and women's sociodemographic, health, and reproductive characteristics. MATERIAL AND METHODS: A cross-sectional, web-based study was performed in Ireland, Norway, Switzerland, the Netherlands, and the UK between 16 June and 14 July 2020. Pregnant and breastfeeding women up to 3 months postpartum who were older than 18 years of age were eligible. The online, anonymous survey was promoted through social media and hospital websites. The Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder seven-item scale (GAD-7), and the Perceived Stress Scale (PSS) were used to assess mental health status. Regression model analysis was used to identify factors associated with poor mental health status. RESULTS: In total, 9041 women participated (including 3907 pregnant and 5134 breastfeeding women). The prevalence of major depressive symptoms (EDS ≥ 13) was 15% in the pregnancy cohort and and 13% the breastfeeding cohort. Moderate to severe generalized anxiety symptoms (GAD ≥ 10) were found among 11% and 10% of the pregnant and breastfeeding women. The mean (±SD) PSS scores for pregnant and breastfeeding women were 14.1 ± 6.6 and 13.7 ± 6.6, respectively. Risk factors associated with poor mental health included having a chronic mental illness, a chronic somatic illness in the postpartum period, smoking, having an unplanned pregnancy, professional status, and living in the UK or Ireland. CONCLUSIONS: This multinational study found high levels of depressive symptoms and generalized anxiety among pregnant and breastfeeding women during the COVID-19 outbreak. The study findings underline the importance of monitoring perinatal mental health during pandemics and other societal crises to safeguard maternal and infant mental health.


Subject(s)
Anxiety , Breast Feeding , COVID-19 , Depression , Mental Health/statistics & numerical data , Perinatal Care , Stress, Psychological , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/etiology , Breast Feeding/methods , Breast Feeding/psychology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Depression/diagnosis , Depression/epidemiology , Depression/etiology , Female , Humans , Ireland/epidemiology , Perinatal Care/methods , Perinatal Care/statistics & numerical data , Peripartum Period/psychology , Pregnancy , Pregnancy Outcome/epidemiology , Pregnancy Outcome/psychology , Psychiatric Status Rating Scales , Risk Factors , SARS-CoV-2 , Socioeconomic Factors , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology , United Kingdom/epidemiology
16.
Breastfeed Med ; 15(8): 488-491, 2020 08.
Article in English | MEDLINE | ID: covidwho-628894

ABSTRACT

Background: Limited data are available on the perinatal and postnatal transmission of novel coronavirus disease 2019 (COVID-19). The Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) recommended breastfeeding with necessary precautions to mothers with COVID-19. Case Presentation: A 20-year-old pregnant woman with no symptoms of COVID-19 presented to the hospital for delivery at 39 weeks of gestation. She was tested for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by reverse transcriptase polymerase chain reaction (RT-PCR) because her father had been diagnosed with COVID-19. A nasopharyngeal swab RT-PCR test was positive for SARS-CoV-2. Therefore, the baby and the mother were cared for separately after delivery. Breast milk obtained after first lactation was tested by real-time RT-PCR and was positive for SARS-CoV-2. Conclusions: In this article, we aimed to report the presence of SARS-CoV-2 in breast milk. Although further studies are needed, this situation may have an impact on breastfeeding recommendations.


Subject(s)
Betacoronavirus/isolation & purification , Breast Feeding , Coronavirus Infections , Infectious Disease Transmission, Vertical/prevention & control , Milk, Human/virology , Pandemics , Pneumonia, Viral , Pregnancy Complications, Infectious , Adult , Asymptomatic Diseases/therapy , Breast Feeding/adverse effects , Breast Feeding/methods , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Coronavirus Infections/prevention & control , Delivery, Obstetric , Female , Gestational Age , Humans , Infant, Newborn , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Pneumonia, Viral/prevention & control , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/physiopathology , SARS-CoV-2
18.
Am J Perinatol ; 37(13): 1377-1384, 2020 11.
Article in English | MEDLINE | ID: covidwho-752407

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in changes to perinatal and neonatal care, concentrating on minimizing risks of transmission to the newborn and health care staff while ensuring medical care is not compromised for both mother and infant. Current recommendations on infant care and feeding when mother has COVID-19 ranges from mother-infant separation and avoidance of human milk feeding, to initiation of early skin-to-skin contact and direct breastfeeding. Health care providers fearing risks of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) maternal-infant transmission may veer toward restricted breastfeeding practices. We reviewed guidelines and published literature and propose three options for infant feeding depending on various scenarios. Option A involves direct breastfeeding with the infant being cared for by the mother or caregiver. In option B, the infant is cared for by another caregiver and receives mother's expressed milk. In the third option, the infant is not breastfed directly and does not receive mother's expressed milk. We recommend joint decision making by parents and the health care team. This decision is also flexible as situation changes. We also provide a framework for counseling mothers on these options using a visual aid and a corresponding structured training program for health care providers. Future research questions are also proposed. We conclude that evidence and knowledge about COVID-19 and breastfeeding are still evolving. Our options can provide a quick and flexible reference guide that can be adapted to local needs. KEY POINTS: · SARS-CoV-2 is unlikely transmitted via human milk.. · A shared decision making on infant feeding is the preferred approach.. · Mothers can safely breastfeed with appropriate infection control measures..


Subject(s)
Breast Feeding/methods , Coronavirus Infections , Infection Control/methods , Infectious Disease Transmission, Vertical/prevention & control , Milk, Human/virology , Pandemics , Pneumonia, Viral , Pregnancy Complications, Infectious , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Counseling/methods , Decision Making , Female , Humans , Infant, Newborn , Maternal Behavior , Mothers/psychology , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/prevention & control , Risk Adjustment/methods , SARS-CoV-2
19.
J Hum Lact ; 36(4): 723-738, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-740327

ABSTRACT

BACKGROUND: Gestational diabetes mellitus is associated with adverse maternal and fetal outcomes and increases subsequent risk of Type 2 diabetes. Researchers have shown that breastfeeding may reduce diabetes risk in women with recent gestational diabetes. RESEARCH AIM: To assess association between infant feeding and postpartum glucose tolerance in mothers with recent gestational diabetes within 1 year postpartum. METHODS: A literature search was performed up to December 31, 2019, retrieving articles related to infant feeding, gestational diabetes, and postpartum glucose regulation in four major databases (PubMed, Cochrane, CINAHL, and Embase). Methodological quality was assessed using tools from the United States National Institutes of Health and the National Heart, Lung, and Blood Institute. RESULTS: The search yielded 15 cohort studies meeting the selection criteria. Of the 15 studies, 13 (86.7%) examined the influence of breastfeeding on postpartum glycemic status, and eight (53.4%) compared the mean blood glucose values between breastfeeding and non-breastfeeding participants. Of the 13 studies that compared postpartum glycemic status, nine (60%) of the research teams found that breastfeeding lowered rates of impaired glucose tolerance, and four (26.7%) showed no significant change. In eight of the studies reporting mean blood glucose values, six (75%) reported significantly lower fasting plasma glucose in breastfeeding participants, with reductions ranging from 3.7 to 7.4 mg/dL (0.2-0.4 mmol/L). CONCLUSION: Breastfeeding has been associated with improved postpartum glucose regulation in mothers with gestational diabetes. In pregnant women with gestational diabetes, breastfeeding may reduce the risk of Type 2 diabetes, and women with gestational diabetes should be strongly encouraged and supported to breastfeed.


Subject(s)
Breast Feeding/adverse effects , Diabetes, Gestational/physiopathology , Glycemic Control/standards , Postpartum Period/metabolism , Adult , Blood Glucose/analysis , Breast Feeding/methods , Breast Feeding/trends , Correlation of Data , Diabetes, Gestational/epidemiology , Female , Glycemic Control/methods , Humans , Postpartum Period/physiology , Pregnancy
20.
Int Breastfeed J ; 15(1): 69, 2020 08 08.
Article in English | MEDLINE | ID: covidwho-706665

ABSTRACT

BACKGROUND: The first reports of the Chinese experience in the management of newborns of mothers with SARS-CoV 2 infection did not recommend mother-baby contact or breastfeeding. At present, the most important International Societies, such as WHO and UNICEF, promote breastfeeding and mother-baby contact as long as adequate measures to control COVID-19 infection are followed. In cases where maternal general health conditions impede direct breastfeeding or in cases of separation between mother and baby, health organizations encourage and support expressing milk and safely providing it to the infants. METHODS: A series of 22 case studies of newborns to mothers with COVID-19 infection from March 14th to April 14th, 2020 was conducted. Mothers and newborns were followed for a median period of 1.8 consecutive months. RESULTS: Out of 22 mothers, 20 (90.9%) chose to breastfeed their babies during hospital admission. Timely initiation and skin to skin contact at delivery room was performed in 54.5 and 59.1%, respectively. Eighty two percent of newborns to mothers with COVID-19 were fed with breast milk after 1 month, decreasing to 77% at 1.8 months. Six of 22 (37.5%) mothers with COVID-19 required transitory complementary feeding until exclusive breastfeeding was achieved. During follow-up period, there were no major complications, and no neonates were infected during breastfeeding. CONCLUSIONS: Our experience shows that breastfeeding in newborns of mothers with COVID-19 is safe with the adequate infection control measures to avoid mother-baby contagion. Supplementing feeding with pasteurized donor human milk or infant formula may be effective, until exclusive breastfeeding is achieved.


Subject(s)
Betacoronavirus , Breast Feeding/methods , Coronavirus Infections/complications , Milk, Human , Pneumonia, Viral/complications , COVID-19 , Coronavirus Infections/prevention & control , Female , Humans , Infant , Infant Nutritional Physiological Phenomena , Mothers/psychology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2
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