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Factors associated with exclusive breastfeeding at discharge during the COVID-19 pandemic in 17 WHO European Region countries

Chertok, Ilana Azulay ; Artzi-Medvedik, Rada ; Arendt, Maryse ; Sacks, Emma ; Otelea, Marina Ruxandra ; Rodrigues, Carina ; Costa, Raquel ; Linden, Karolina ; Zaigham, Mehreen LU orcid and Elden, Helen , et al. (2022) In International Breastfeeding Journal 17. p.1-14
Abstract

BACKGROUND: Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates at discharge over time and to identify factors associated with exclusive breastfeeding during the pandemic.

METHODS: A cross-sectional survey was conducted among mothers who gave birth in a maternity care facility in the World Health Organization (WHO) European Region countries during the COVID-19 pandemic. The socio-ecological model was employed to examine intrapersonal, interpersonal,... (More)

BACKGROUND: Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates at discharge over time and to identify factors associated with exclusive breastfeeding during the pandemic.

METHODS: A cross-sectional survey was conducted among mothers who gave birth in a maternity care facility in the World Health Organization (WHO) European Region countries during the COVID-19 pandemic. The socio-ecological model was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with maternal report of exclusive breastfeeding at the time of discharge.

RESULTS: There were 26,709 participating mothers from 17 European Region countries who were included in the analysis. Among the mothers, 72.4% (n = 19,350) exclusively breastfed and 27.6% (n = 7,359) did not exclusively breastfeed at discharge. There was an overall decline in exclusive breastfeeding rates over time (p = 0.015) with a significantly lower rate following the publication of the WHO breastfeeding guidelines on 23 June 2020 (AOR 0.88; 95% CI 0.82, 0.94). Factors significantly associated with exclusive breastfeeding outcomes in the logistic regression analysis included maternal age, parity, education, health insurance, mode of birth, inadequate breastfeeding support, lack of early breastfeeding initiation, lack of full rooming-in, birth attendant, perceived healthcare professionalism and attention, facility room cleanliness, timing of birth, and location of birth.

CONCLUSIONS: Results from the study indicate the decline in exclusive breastfeeding rates in the WHO European Region during the COVID-19 pandemic. Using the socio-ecological model to identify factors associated with breastfeeding outcomes facilitates an integrated and holistic approach to address breastfeeding needs among women across the region. These findings demonstrate the need to augment breastfeeding support and to protect exclusive breastfeeding among mother-infant dyads, in an effort to reverse the declining exclusive breastfeeding rates. The study highlights the need to educate mothers and their families about the importance of exclusive breastfeeding, reduce maternal-infant separation, increase professional breastfeeding support, and follow evidence-based practice guidelines to promote breastfeeding in a comprehensive and multi-level manner.

TRIAL REGISTRATION NUMBER: Clinical Trials NCT04847336.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
Pregnancy, Infant, Female, Humans, Breast Feeding, Patient Discharge, COVID-19/epidemiology, Pandemics, Cross-Sectional Studies, Maternal Health Services, SARS-CoV-2, World Health Organization, Mothers
in
International Breastfeeding Journal
volume
17
article number
83
pages
1 - 14
publisher
BioMed Central (BMC)
external identifiers
  • pmid:36461061
  • scopus:85143304288
ISSN
1746-4358
DOI
10.1186/s13006-022-00517-1
language
English
LU publication?
yes
additional info
© 2022. The Author(s).
id
84e4f6fa-817b-434d-b061-c6467b573a07
date added to LUP
2022-12-10 14:43:41
date last changed
2024-04-16 18:13:30
@article{84e4f6fa-817b-434d-b061-c6467b573a07,
  abstract     = {{<p>BACKGROUND: Exclusive breastfeeding is the optimal infant nutrition, providing infants immunoprotection against many diseases including SARS-CoV-2 infection. Restrictions during the COVID-19 pandemic may have negatively affected breastfeeding practices in maternity care facilities. The aims of the study were to examine exclusive breastfeeding rates at discharge over time and to identify factors associated with exclusive breastfeeding during the pandemic.</p><p>METHODS: A cross-sectional survey was conducted among mothers who gave birth in a maternity care facility in the World Health Organization (WHO) European Region countries during the COVID-19 pandemic. The socio-ecological model was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with maternal report of exclusive breastfeeding at the time of discharge.</p><p>RESULTS: There were 26,709 participating mothers from 17 European Region countries who were included in the analysis. Among the mothers, 72.4% (n = 19,350) exclusively breastfed and 27.6% (n = 7,359) did not exclusively breastfeed at discharge. There was an overall decline in exclusive breastfeeding rates over time (p = 0.015) with a significantly lower rate following the publication of the WHO breastfeeding guidelines on 23 June 2020 (AOR 0.88; 95% CI 0.82, 0.94). Factors significantly associated with exclusive breastfeeding outcomes in the logistic regression analysis included maternal age, parity, education, health insurance, mode of birth, inadequate breastfeeding support, lack of early breastfeeding initiation, lack of full rooming-in, birth attendant, perceived healthcare professionalism and attention, facility room cleanliness, timing of birth, and location of birth.</p><p>CONCLUSIONS: Results from the study indicate the decline in exclusive breastfeeding rates in the WHO European Region during the COVID-19 pandemic. Using the socio-ecological model to identify factors associated with breastfeeding outcomes facilitates an integrated and holistic approach to address breastfeeding needs among women across the region. These findings demonstrate the need to augment breastfeeding support and to protect exclusive breastfeeding among mother-infant dyads, in an effort to reverse the declining exclusive breastfeeding rates. The study highlights the need to educate mothers and their families about the importance of exclusive breastfeeding, reduce maternal-infant separation, increase professional breastfeeding support, and follow evidence-based practice guidelines to promote breastfeeding in a comprehensive and multi-level manner.</p><p>TRIAL REGISTRATION NUMBER: Clinical Trials NCT04847336.</p>}},
  author       = {{Chertok, Ilana Azulay and Artzi-Medvedik, Rada and Arendt, Maryse and Sacks, Emma and Otelea, Marina Ruxandra and Rodrigues, Carina and Costa, Raquel and Linden, Karolina and Zaigham, Mehreen and Elden, Helen and Drandic, Daniela and Grylka-Baeschlin, Susanne and Miani, Céline and Valente, Emanuelle Pessa and Covi, Benedetta and Lazzerini, Marzia and Mariani, Ilaria}},
  issn         = {{1746-4358}},
  keywords     = {{Pregnancy; Infant; Female; Humans; Breast Feeding; Patient Discharge; COVID-19/epidemiology; Pandemics; Cross-Sectional Studies; Maternal Health Services; SARS-CoV-2; World Health Organization; Mothers}},
  language     = {{eng}},
  month        = {{12}},
  pages        = {{1--14}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{International Breastfeeding Journal}},
  title        = {{Factors associated with exclusive breastfeeding at discharge during the COVID-19 pandemic in 17 WHO European Region countries}},
  url          = {{http://dx.doi.org/10.1186/s13006-022-00517-1}},
  doi          = {{10.1186/s13006-022-00517-1}},
  volume       = {{17}},
  year         = {{2022}},
}