The impact of COVID-19 on breastfeeding rates: An international cross-sectional study

Ana Ganho-Ávila; Raquel Guiomar; Mónica Sobral; Francisca Pacheco; Rafael A. Caparros-Gonzalez; Carla Diaz-Louzao; Emma Motrico; Sara Domínguez-Salas; Ana Mesquita; Raquel Costa; Eleni Vousoura; Eleni Hadjigeorgiou; Rena Bina; Rachel Buhagiar; Vera Mateus; Yolanda Contreras-García; Claire A. Wilson; Erilda Ajaz; Camellia Hancheva; Pelin Dikmen-Yildiz; Alejandro de la Torre-Luque

doi:10.1016/j.midw.2023.103631

The impact of COVID-19 on breastfeeding rates: An international cross-sectional study

Ana Ganho-Ávila, Raquel Guiomar, Mónica Sobral, Francisca Pacheco, Rafael A. Caparros-Gonzalez, Carla Diaz-Louzao, Emma Motrico, Sara Domínguez-Salas, Ana Mesquita, Raquel Costa, Eleni Vousoura, Eleni Hadjigeorgiou, Rena Bina, Rachel Buhagiar, Vera Mateus, Yolanda Contreras-García, Claire A. Wilson, Erilda Ajaz, Camellia Hancheva, Pelin Dikmen-YildizAlejandro de la Torre-Luque

The Louis & Gabi Weisfeld School of Social Work

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background: Breastfeeding promotes children's health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic. Methods: This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries’ inequality levels) were studied by Generalized Linear Mixed-Effects Models. Results: A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child (β = -0.27), age of the child (β = -0.29), preterm birth (β = -0.52), admission to the neonatal/pediatric care (β = -0.44), lack of breastfeeding support (β = -0.18), current psychiatric treatment (β = -0.69) and inequality (β = -0.71) were negatively associated with breastfeeding (p <.001). Access to postnatal support groups was positively associated with breastfeeding (β = 0.59; p <.001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding (β = -0.16; p <.05) while access to maternity leave protected breastfeeding (β = 0.50; p <.001). Discussion: This study shows that mother's COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding.

Original language	English
Article number	103631
Journal	Midwifery
Volume	120
DOIs	https://doi.org/10.1016/j.midw.2023.103631
State	Published - May 2023

Bibliographical note

Publisher Copyright:
© 2023 Elsevier Ltd

Funding

This study is supported by the Portuguese Foundation for Science and Technology (FCT) Grants to MS (2021.07006.BD), RG (2020.05099.BD), and AGA (2020.02059.CEECIND). Carla Díaz-Louzao was supported by the Primary Care Prevention and Health Promotion Research Network redIAPP (Instituto de Salud Carlos III-ISCIII/RD16/0007/0006/Co-funded by FEDER), and by the project ED431C 2020/20 , co-financed by the “ Consellería de Cultura Educación e Ordenación Universitaria da Xunta de Galicia ”. Rena Bina was supported by the Bar-Ilan Dangoor Centre for Personalized Medicine. Vera Mateus received financial support from CAPES/PrInt grant nº. 88887.583508/2020-00. EPIUnit - UIDB/04750/2020, ITR - LA/P/0064/2020, and HEILab - UIDB/05380/2020 are supported by Portuguese fundings through FCT - Fundação para a Ciência e a Tecnologia, IP. Raquel Costa has a Postdoctoral grant supported by the European Social Fund (ESF) and FCT (SFRH/BPD/117597/2016; RC postdoctoral fellowship). Ana Mesquita was supported from the Portuguese Foundation for Science and Technology (FCT) and from EU through the European Social Fund and from the Human Potential Operational Program - IF/00750/2015. The Psychology Research Centre (PSI/01662), School of Psychology, University of Minho, is supported by FCT through the Portuguese State Budget (Ref.: UIDB/PSI/01662/2020). Claire A Wilson is funded by the UK's National Institute for Health and Care Research (NIHR) as an Academic Clinical Lecturer. The Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC) of the Faculty of Psychology and Educational Sciences of the University of Coimbra is supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Education and Science through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement [UID/PSI/01662/2013]. This paper is part of the COST Action Riseup-PPD CA18138 and was supported by COST under COST Action Riseup-PPD CA18138.

Funders	Funder number
CINEICC
COMPETE2020	UID/PSI/01662/2013
Center for Research in Neuropsychology and Cognitive and Behavioral Intervention
Instituto de Salud Carlos III-ISCIII/RD16/0007
PrInt	LA/P/0064/2020, 88887.583508/2020-00
Australian German Association	2020.02059
National Institute for Health and Care Research
European Commission	PSI/01662, IF/00750/2015, UIDB/PSI/01662/2020
European Cooperation in Science and Technology	CA18138
Fundação para a Ciência e a Tecnologia	2020.05099, 2021.07006
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Ministério da Educação e Ciência
European Social Fund	SFRH/BPD/117597/2016
Consellería de Cultura, Educación e Ordenación Universitaria, Xunta de Galicia
European Regional Development Fund	ED431C 2020/20

Keywords

Breastfeeding
COVID-19
Cross-countries
Perinatal health
SARS-CoV-2

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.midw.2023.103631

Cite this

Ganho-Ávila, A., Guiomar, R., Sobral, M., Pacheco, F., Caparros-Gonzalez, R. A., Diaz-Louzao, C., Motrico, E., Domínguez-Salas, S., Mesquita, A., Costa, R., Vousoura, E., Hadjigeorgiou, E., Bina, R., Buhagiar, R., Mateus, V., Contreras-García, Y., Wilson, C. A., Ajaz, E., Hancheva, C., ... de la Torre-Luque, A. (2023). The impact of COVID-19 on breastfeeding rates: An international cross-sectional study. Midwifery, 120, Article 103631. https://doi.org/10.1016/j.midw.2023.103631

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title = "The impact of COVID-19 on breastfeeding rates: An international cross-sectional study",

abstract = "Background: Breastfeeding promotes children's health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic. Methods: This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries{\textquoteright} inequality levels) were studied by Generalized Linear Mixed-Effects Models. Results: A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child (β = -0.27), age of the child (β = -0.29), preterm birth (β = -0.52), admission to the neonatal/pediatric care (β = -0.44), lack of breastfeeding support (β = -0.18), current psychiatric treatment (β = -0.69) and inequality (β = -0.71) were negatively associated with breastfeeding (p <.001). Access to postnatal support groups was positively associated with breastfeeding (β = 0.59; p <.001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding (β = -0.16; p <.05) while access to maternity leave protected breastfeeding (β = 0.50; p <.001). Discussion: This study shows that mother's COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding.",

keywords = "Breastfeeding, COVID-19, Cross-countries, Perinatal health, SARS-CoV-2",

author = "Ana Ganho-{\'A}vila and Raquel Guiomar and M{\'o}nica Sobral and Francisca Pacheco and Caparros-Gonzalez, {Rafael A.} and Carla Diaz-Louzao and Emma Motrico and Sara Dom{\'i}nguez-Salas and Ana Mesquita and Raquel Costa and Eleni Vousoura and Eleni Hadjigeorgiou and Rena Bina and Rachel Buhagiar and Vera Mateus and Yolanda Contreras-Garc{\'i}a and Wilson, {Claire A.} and Erilda Ajaz and Camellia Hancheva and Pelin Dikmen-Yildiz and {de la Torre-Luque}, Alejandro",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Ltd",

year = "2023",

month = may,

doi = "10.1016/j.midw.2023.103631",

language = "אנגלית",

volume = "120",

journal = "Midwifery",

issn = "0266-6138",

publisher = "Churchill Livingstone",

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Ganho-Ávila, A, Guiomar, R, Sobral, M, Pacheco, F, Caparros-Gonzalez, RA, Diaz-Louzao, C, Motrico, E, Domínguez-Salas, S, Mesquita, A, Costa, R, Vousoura, E, Hadjigeorgiou, E, Bina, R, Buhagiar, R, Mateus, V, Contreras-García, Y, Wilson, CA, Ajaz, E, Hancheva, C, Dikmen-Yildiz, P & de la Torre-Luque, A 2023, 'The impact of COVID-19 on breastfeeding rates: An international cross-sectional study', Midwifery, vol. 120, 103631. https://doi.org/10.1016/j.midw.2023.103631

TY - JOUR

T1 - The impact of COVID-19 on breastfeeding rates

T2 - An international cross-sectional study

AU - Ganho-Ávila, Ana

AU - Guiomar, Raquel

AU - Sobral, Mónica

AU - Pacheco, Francisca

AU - Caparros-Gonzalez, Rafael A.

AU - Diaz-Louzao, Carla

AU - Motrico, Emma

AU - Domínguez-Salas, Sara

AU - Mesquita, Ana

AU - Costa, Raquel

AU - Vousoura, Eleni

AU - Hadjigeorgiou, Eleni

AU - Bina, Rena

AU - Buhagiar, Rachel

AU - Mateus, Vera

AU - Contreras-García, Yolanda

AU - Wilson, Claire A.

AU - Ajaz, Erilda

AU - Hancheva, Camellia

AU - Dikmen-Yildiz, Pelin

AU - de la Torre-Luque, Alejandro

PY - 2023/5

Y1 - 2023/5

N2 - Background: Breastfeeding promotes children's health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic. Methods: This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries’ inequality levels) were studied by Generalized Linear Mixed-Effects Models. Results: A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child (β = -0.27), age of the child (β = -0.29), preterm birth (β = -0.52), admission to the neonatal/pediatric care (β = -0.44), lack of breastfeeding support (β = -0.18), current psychiatric treatment (β = -0.69) and inequality (β = -0.71) were negatively associated with breastfeeding (p <.001). Access to postnatal support groups was positively associated with breastfeeding (β = 0.59; p <.001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding (β = -0.16; p <.05) while access to maternity leave protected breastfeeding (β = 0.50; p <.001). Discussion: This study shows that mother's COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding.

AB - Background: Breastfeeding promotes children's health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic. Methods: This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries’ inequality levels) were studied by Generalized Linear Mixed-Effects Models. Results: A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child (β = -0.27), age of the child (β = -0.29), preterm birth (β = -0.52), admission to the neonatal/pediatric care (β = -0.44), lack of breastfeeding support (β = -0.18), current psychiatric treatment (β = -0.69) and inequality (β = -0.71) were negatively associated with breastfeeding (p <.001). Access to postnatal support groups was positively associated with breastfeeding (β = 0.59; p <.001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding (β = -0.16; p <.05) while access to maternity leave protected breastfeeding (β = 0.50; p <.001). Discussion: This study shows that mother's COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding.

KW - Breastfeeding

KW - COVID-19

KW - Cross-countries

KW - Perinatal health

KW - SARS-CoV-2

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The impact of COVID-19 on breastfeeding rates: An international cross-sectional study

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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