Association of Severe Acute Respiratory Syndrome Coronavirus 2 Infection With Early Breastfeeding

Henry H Bernstein; Eric J Slora; Tara Mathias-Prabhu; Hee Su Park; Cathie Spino

doi:10.1016/j.acap.2022.10.005

Association of Severe Acute Respiratory Syndrome Coronavirus 2 Infection With Early Breastfeeding

Acad Pediatr. 2023 Mar;23(2):343-350. doi: 10.1016/j.acap.2022.10.005. Epub 2022 Oct 12.

Authors

Henry H Bernstein¹, Eric J Slora², Tara Mathias-Prabhu², Hee Su Park², Cathie Spino³

Affiliations

¹ Cohen Children's Medical Center (HH Bernstein, EJ Slora, T Mathias-Prabhu, and HS Park), New Hyde Park, NY; Zucker School of Medicine at Hofstra/Northwell (HH Bernstein), Hempstead, NY. Electronic address: hbernstein@northwell.edu.
² Cohen Children's Medical Center (HH Bernstein, EJ Slora, T Mathias-Prabhu, and HS Park), New Hyde Park, NY.
³ University of Michigan (C Spino), Ann Arbor, Mich.

Abstract

Objective: The association of maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) status before delivery with breastfeeding is unknown. This study compares breastfeeding initiation, exclusivity, and duration between SARS-CoV-2-positive (+) and SARS-CoV-2-negative (-) mothers during the first 2 months of their newborns' lives.

Methods: A single center, retrospective cohort study of pediatric contacts during the first 2 months in a diverse mother-infant population (n = 285) compared breastfeeding outcomes by maternal SARS-CoV-2 status during a pandemic surge. Infants of SARS-CoV-2 positive mothers were also tested before discharge. Comparison of maternal demographics (age, race, ethnicity), maternal/infant characteristics (parity, insurance, delivery mode, infant sex, hospital length of stay), and pediatric contacts by maternal SARS-CoV-2 status included Fisher's exact and Wilcoxon tests and Poisson regression for count outcomes. Logistic regression compared breastfeeding outcomes between the 2 groups, adjusting for potential confounders and effect modifiers.

Results: Maternal demographics and maternal/infant characteristics were similar. While 19% of mothers tested positive for SARS-CoV-2 (n = 54), their infants were all negative. SARS-CoV-2 positive mothers had fewer in-person, but more virtual pediatric contacts. After controlling for the above variables, SARS-CoV-2 positive mothers had lower odds of breastfeeding initiation within 1 to 7 days of life (78% vs 88%; adjusted odds ratio [aOR] = 0.40, 95% confidence interval [CI]: 0.17, 0.96) and of any breastfeeding during month 2 (54% vs 76%; aOR = 0.37, 95% CI: 0.16, 0.86) compared with SARS-CoV-2 negative mothers.

Conclusions: Maternal SARS-CoV-2 positivity at delivery was independently associated with less initiation and shorter duration of any breastfeeding during month 2. SARS-CoV-2 positive women would likely benefit from additional breastfeeding support during pandemic surges.

Keywords: breastfeeding duration; breastfeeding exclusivity; coronavirus disease 2019; pandemic; severe acute respiratory syndrome coronavirus 2.

MeSH terms

Breast Feeding
COVID-19*
Child
Female
Humans
Infant
Infant, Newborn
Mothers
Pregnancy
Pregnancy Complications, Infectious*
Retrospective Studies
SARS-CoV-2