Breastfeeding Practices for COVID-19-Infected Mothers: A Systematic Review and Meta-Analysis

Abstract

(1) Background: The ongoing COVID-19 pandemic has led to an increasing number of women giving birth while also grappling with SARS-CoV-2. The objective of this review is to examine the possibility of transmission of the virus from mother to infant through breastfeeding, skin-to-skin contact, and rooming-in and to explore methods for managing COVID-19-positive mother-infant dyads. (2) Methods: A comprehensive search strategy was employed that covered pertinent studies from the Cochrane Library, PubMed Central, and Scopus databases. The Matrix Method and PRISMA guidelines were utilized by the researchers, with the search being updated until 20 December 2021, one year after the initial vaccine delivery. The inclusion criteria for the study involved articles published in English, those employing broad search terms, and those comprising full-text reviews. Additionally, the researchers required that the articles be published from December 2019 onwards. To further analyze the data, a meta-analysis was performed to estimate the rate of infant infection from mothers who engaged in breastfeeding, skin-to-skin contact, and rooming-in practices. (3) Results: Eighteen studies were analyzed in this review, with an infected infant rate of 2.8%. The maternal practices used in these studies ranged from direct separation of the infant to direct skin-to-skin contact, rooming-in, and exclusive breastfeeding. One study investigated the factors associated with positive test results in newborns and found that only the maternal social vulnerability index >90 was a significant predictor. The type of delivery, rooming-in, and the mother's symptom status were not associated with positive neonatal outcomes. (4) Conclusions: According to current data, the incidence of perinatal infection with SARS-CoV-2 is relatively low. It is advised that mothers adhere to several supportive care measures, including engaging in breastfeeding, skin-to-skin contact, and rooming-in. These measures ought to be complemented by diligent hand hygiene, the wearing of masks, and the cleansing of breasts solely when necessary.

Keywords: COVID-19; SARS-CoV-2; breastfeeding; coronavirus; maternal practices; rooming-in; skin-to-skin contact.

Figure 1

PRISMA 2020 flow diagram for new systematic reviews, which included searches of databases, registers, and other sources.

Figure 2

Proportion metanalysis of the overall estimate of SARS-CoV-2 infection among infants born to infected mothers.

Figure 3

Proportion of the estimate of SARS-CoV-2 infection among infants born to infected mothers in subgroups analyses from studies with and without rooming-in.

Figure 4

Proportion of the estimate of SARS-CoV-2 infection among infants born to infected mothers in subgroups analyses from studies with and without skin-to-skin.

Figure 5

Proportion of the estimate of SARS-CoV-2 infection among infants born to infected mothers in subgroups analyses from studies with and without exclusive breastfeeding.