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Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization

Duong Vu Hoang1, Jennifer Cashin2, Karleen Gribble3

  • 1Alive & Thrvie Southeast Asia, FHI 360, Hanoi, Vietnam.

BMJ Nutrition, Prevention & Health
|February 1, 2021
PubMed

Insights

International COVID-19 guidance for new mothers and infants showed significant inconsistencies, often undermining breastfeeding and maternal proximity. Policies must prioritize infant health by supporting breastfeeding and skin-to-skin contact during infectious disease outbreaks.

Area of Science:

  • Public Health
  • Infectious Disease Management
  • Maternal and Child Health

Background:

  • Clinical management guidance for mothers with COVID-19 and their infants is essential.
  • Balancing SARS-CoV-2 transmission risk with benefits of maternal proximity and breastfeeding is critical.
  • Reviewing international COVID-19 guidance for maternal/newborn care assesses alignment with WHO recommendations on breastfeeding support.

Purpose of the Study:

  • To review international COVID-19 guidance for maternal and newborn care.
  • To assess alignment with World Health Organization (WHO) recommendations.
  • To determine the extent to which policies supported or undermined breastfeeding.

Main Methods:

  • Assessed guidance documents from 33 countries for care of infants with mothers suspected/confirmed COVID-19.
  • Evaluated alignment with WHO recommendations on skin-to-skin contact, breastfeeding initiation/continuation, rooming-in, and psychological support.
  • Included assessment of provision of expressed/donor milk and breastmilk substitutes.

Main Results:

  • Found considerable inconsistency in international recommendations.
  • Identified common recommendations against breastfeeding-supportive practices, even in high infant mortality countries.
  • Observed that no reviewed guidance fully aligned with all WHO recommendations, indicating undervaluation of maternal proximity and breastfeeding.

Conclusions:

  • Guidance for infectious disease outbreaks must prioritize skin-to-skin contact, breastfeeding, and rooming-in for maternal/infant well-being.
  • Future guidance development should consider the reliability and breastfeeding value of existing recommendations.
  • Recommendations against maternal proximity/breastfeeding require compelling evidence of necessity and lower harm than maintaining dyad integrity.
Abstract

Keywords:
malnutritionmental health

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