Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 May 15;17(1):38.
doi: 10.1186/s13006-022-00478-5.

A review of the disruption of breastfeeding supports in response to the COVID-19 pandemic in five Western countries and applications for clinical practice

Sarah Turner  1   2   3 , Bridget McGann  1   4 , Meredith 'Merilee' Brockway  5   6   7
Affiliations
Review

A review of the disruption of breastfeeding supports in response to the COVID-19 pandemic in five Western countries and applications for clinical practice

Sarah Turner et al. Int Breastfeed J. .

Abstract

Background: The COVID-19 pandemic has significantly altered how breastfeeding support is provided, resulting in mixed breastfeeding outcomes and experiences for mothers. The World Health Organization has consistently supported breastfeeding from the beginning of the pandemic. However, recommendations from obstetrical and gynaecological societies within individual countries have varied in their alignment with this guidance, resulting in inconsistent recommendations. It is unknown how breastfeeding guidelines, maternal breastfeeding experiences, and breastfeeding initiation and duration compared across five Western countries. The current study is comprised of two parts, each with a different objective. Part One objective: to review pandemic-related changes in professional society guidelines on breastfeeding support in Australia, New Zealand, Canada, the United Kingdom, and the United States; and Part Two objective: to conduct a narrative review to summarize the evidence of how the pandemic has changed breastfeeding initiation, duration, and mothers' breastfeeding experiences during the pandemic in these five countries and provide recommendations for clinical lactation support.

Methods: We searched for indicators that are impactful on breastfeeding outcomes: skin-to-skin contact, rooming in, direct breastfeeding and breast washing, in the five countries mentioned above and compared these to the recommendations from the World Health Organization. Next, we conducted a narrative review of the literature from these five countries to explore how the pandemic altered breastfeeding outcomes and used this information to provide suggestions for clinical practice moving forward.

Results: Recommendations on the four practices above differed by country and were not always in alignment with the World Health Organization recommendations. Mother-infant separation after birth in the United States was associated with a lower prevalence of breastfeeding initiation and duration. While some mothers reported positive breastfeeding experiences during the pandemic, many mothers indicated negative experiences related to decreased social and professional support.

Conclusions: The pandemic can inform practice recommendations and can be viewed as an opportunity to permanently modify existing methods to support breastfeeding families. The use of virtual care increased during the pandemic and should continue with specific considerations for prioritizing in-person care. This will help to provide more timely and accessible support for breastfeeding mothers.

Keywords: Breastfeeding; COVID-19 pandemic; Maternal experiences; Professional support; Virtual support.

PubMed Disclaimer

Conflict of interest statement

S.T. holds a non-paid volunteer position with the International Society for Research in Human Milk and Lactation (ISRHML). She has accepted a speaker honorarium from the Ohio Lactation Consultant Association and the Kansas Breastfeeding Coalition. Sarah currently funded by the Canadian Institute of Health Research as a Vanier Scholar.

B.M. has nothing to disclose.

M.B is a Molly Towell Research Fellow and is currently funded by the Garfield Weston Foundation and MITACS Canada. She has accepted a speaker honorarium from the Ohio Lactation Consultant Association. She has contributed with remuneration to online courses on breast milk and the infant microbiome produced by Microbiome Courses.

Figures

Fig. 1
Fig. 1
Analysis of Breastfeeding guidelines in Australia/New Zealand, Canada, the United Kingdom, and the United States in cases of confirmed or suspected maternal COVID-19 in 2020
Fig. 2
Fig. 2
SWOT analysis (strengths, weaknesses, opportunities, and threats) of virtual breastfeeding care emerging from the pandemic
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization . Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) is suspected: Interim guidance (March 2020) 2020.
    1. World Health Organization . Clinical management of COVID-19: Interim guidance (May 2020) 2020.
    1. World Health Organization . Breastfeeding and COVID-19: scientific brief (June 2020) 2020.
    1. Bartick MC, Gaughan J, Feldman-Winter L. Maternal and infant outcomes associated with maternity practices related to COVID-19: the COVID mothers study. Breastfeed Med. 2021;16:1–11. doi: 10.1089/bfm.2020.29171.ams. - DOI - PubMed
    1. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of hospital practices supportive of breastfeeding in the context of COVID-19-United States, July 15- august 20, 2020. Morb Mortal Wkly Rep. 2020;69:1767–1770. doi: 10.15585/mmwr.mm6947a3. - DOI - PMC - PubMed