Lactation Initiation During COVID-19 at a Single Military Hospital

Area of Science:

• Public Health
• Maternal and Child Health
• Epidemiology

Background:

• Human milk offers significant short- and long-term health benefits for infants.
• Breastfeeding decisions are influenced by a complex interplay of personal, social, health, and economic factors.
• The COVID-19 pandemic presented unprecedented challenges to healthcare delivery and family life.

Purpose of the Study:

• To investigate whether breastfeeding initiation rates changed during the COVID-19 pandemic.
• To compare breastfeeding initiation in a military healthcare system before and during the pandemic.

Main Methods:

• A cross-sectional chart review of birthing records from a military medical center.
• Analysis of 1,463 maternal-infant dyads from March-August 2019 and 2020.
• Statistical analysis to determine associations between delivery year, maternal/infant characteristics, and feeding methods.

Main Results:

• No significant difference in overall breastfeeding initiation rates between 2019 and 2020.
• Black women showed a decreased likelihood of initiating breastfeeding compared to White women, a disparity that widened in 2020.
• Factors associated with lower breastfeeding initiation included Black race, cesarean birth, multiparity, and earlier gestational age (32-37 weeks).

Conclusions:

• Overall breastfeeding initiation rates were not significantly impacted by the COVID-19 pandemic in this military population.
• Significant disparities in breastfeeding initiation persisted and, in some cases, widened, particularly concerning race and birth method.
• Maternal race, birth method, parity, and gestational age remain critical factors influencing breastfeeding initiation in military healthcare settings.