COVID-19 and Its Effect on Breastfeeding

By Alison Heyerdahl

COVID-19 has challenged almost every aspect of our lives, and for new parents, the pandemic has meant trying to navigate unprecedented circumstances, with mixed messages about the safety of their newborns and a lack of postnatal support.  Lockdown measures and social distancing protocols implemented to prevent the spread of COVID-19 have greatly impacted breastfeeding behavior.  Under normal circumstances, breastfeeding is enriched when mothers and babies have time to bond, professional and peer-to-peer support are available, and a mother feels well. Therefore, it is understandable why the COVID-19 pandemic has negatively affected breastfeeding practices.  

What causes breastfeeding success?

It is well-known that mothers can best breastfeed when they receive high-quality support.   Skin-to-skin contact immediately after birth, mother and baby staying together, and professional support to initiate breastfeeding are the biggest predictors of breastfeeding success.  

Why has COVID-19 reduced levels of breastfeeding?

Although during COVID-19 it has been found that women’s willingness and desire to breastfeed has not decreased, the healthcare system is under severe pressure. Staff, such as lactation specialists, are less available. Mothers lack the support they need to build up an adequate milk supply.  

Mothers are being discharged earlier from maternity wards, hospital guests are restricted from visiting, there has been a decrease in access to lactation support services, and an increase in the use of milk substitutes (such as formula) for newborn babies.  The earlier discharge also means that mothers are more likely to experience breastfeeding issues at home, and without professional support or that of their peers, are likely to give it up much earlier than is desirable.  

During the early stages of COVID-19, fears about transmitting the virus to their babies through breastmilk, utero, or direct contact were significant concerns.  Furthermore, there was very little data on how COVID-19 affected babies and children.  For fear of infection, it was recommended that women should give birth without their partners or doula present, that mothers should be separated from their newborns, and should not breastfeed.   It has been found that COVID-19 seldom passes from mother to baby, and if babies get infected with the virus, they are rarely symptomatic.  

In addition to the impact of COVID-19 on breastfeeding support, it has been found that mothers are experiencing higher-than-usual levels of stress, resulting in significant anxiety and depression, further impacting breastfeeding behavior.  

What are the consequences of not breastfeeding?

The benefits of breastfeeding have been well-documented. With the decline in breastfeeding practices during COVID-19, there has been an increase in infant disorders, such as diarrhea and ear infection (otitis media).  It is also much more expensive to buy formula for babies rather than breastfeed, adding to the economic burden new parents may be experiencing. 

How to encourage mothers to breastfeed during COVID-19:

• Encourage skin-to-skin contact after birth and keep mother and baby together to ensure bonding.

• Ensure breastfeeding occurs within the first hour after birth.

• Ensure that mothers with milk supply issues and other risk factors are identified early and get the support they need.

• Emphasize the importance and health benefits of breastfeeding, encouraging mothers to continue breastfeeding at home. 

• Encourage mothers to seek peer-to-peer support or virtual professional support and education to ensure breastfeeding continues.

• Provide mothers with breast pumps, if necessary.  

 In conclusion, COVID-19 has severely disrupted normal life, creating particularly stressful circumstances for new parents and causing an unjustifiable decline in breastfeeding practices.  This results from three interrelated factors: fear of infection, uncertainty, confusion around COVID-19, and the economic constraints placed upon hospitals or clinics. It has been found that the risk of mothers passing COVID-19 to their newborns is relatively low, and so breastfeeding should be continued with support for as long as possible to ensure maximum benefit to their infants.