Enablers and Challenges of Breastfeeding During the COVID-19 Pandemic

The COVID-19 pandemic greatly affected access to breastfeeding support. Limited research has evaluated the pandemic's impact on postpartum individuals' decisions to breastfeed during this time. This qualitative survey study described breastfeeding-related attitudes, decision-making, and experience of postpartum people early in the COVID-19 pandemic.

New mothers (< 6 months postpartum) were identified via electronic health records at 2 academic health care systems located in Northeastern and Midwestern United States and were invited via mailings and phone to complete a cross-sectional online survey assessing the impact of COVID-19 on mental and physical health and coping. Thematic analysis was conducted to organize responses into categories of impact (positive, negative, neutral), highlighting the major themes of the influence of COVID-19 on breastfeeding.

A total of 216 participants responded (66 Northeast, 150 Midwest), and the majority (64.6%) were age 31 to 45 years old. The predominance of positive themes associated with the pandemic that enabled participants' decisions to breastfeed were health benefits, convenience and ease, and changes in work routines, whereas the major challenges exacerbated by the pandemic were access to lactation support, mental health/stress, and COVID-19 restrictions. Breastfeeding decisions that were not explicitly affected by the pandemic included prior feeding intention and experience, as well as knowledge of importance and benefits.

Findings from this survey study enrich our understanding of the pandemic's impact on breastfeeding motivations and practices. As health care systems and policymakers seek to improve support for breastfeeding, feedback from postpartum mothers may suggest new ways to overcome barriers that arise in times of crisis.