Exclusive Breastfeeding in the Bronx-Successes and Shortcomings

Area of Science:

• Public Health
• Epidemiology
• Maternal and Child Health

Background:

• Exclusive breastfeeding (EBF) rates in urban settings like the Bronx have historically been suboptimal.
• The COVID-19 pandemic introduced significant disruptions to the postpartum period, affecting the mother-infant dyad.
• The pandemic's long-term impact on EBF rates, particularly in high-risk populations, remained unclear.

Purpose of the Study:

• To investigate the effect of the COVID-19 pandemic on EBF rates during birth hospitalization.
• To analyze EBF trends in a high-risk urban patient population before and during the pandemic.

Main Methods:

• A retrospective chart review was conducted on newborns admitted between 2019 and 2021 at an urban medical center.
• Patients were categorized into prepandemic and pandemic cohorts.
• Data collected included demographics, maternal comorbidities, length of stay, feeding method, and newborn characteristics, with EBF defined as exclusive mother's milk intake during hospitalization.

Main Results:

• The study included 630 prepandemic and 643 pandemic newborns; cohorts had similar baseline maternal characteristics.
• While the pandemic cohort had more high-risk newborns (29.4% vs 23.3%) and less access to lactation consultants (24.0% vs 53.2%), EBF rates did not differ significantly.
• Overall EBF rates were 9.5% prepandemic and 11.4% pandemic (p=0.29); rates for non-high-risk newborns were 12.2% and 15.0% (p=0.22), respectively.

Conclusions:

• EBF rates in the Bronx did not change during the COVID-19 pandemic, despite an increase in high-risk newborns.
• Factors such as lactation consultation access, maternal race, ethnicity, and language may influence EBF outcomes and warrant further investigation.
• Understanding healthcare disparities is crucial for addressing barriers to EBF in vulnerable urban populations.