CDC Report Shows 1 in 5 Hospitals Cut Breastfeeding Support During Pandemic

Mom wearing a mask nursing a baby

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Key Takeaways

  • COVID-19 safety protocols have led to reduced hospital stays after childbirth.
  • 1 in 5 hospitals reduced lactation support in wake of the pandemic.
  • Medical experts urge that in most cases, it is safe for mothers to breastfeed, maintain skin-to-skin touch, and room with their newborns.

Nothing has been the same since the coronavirus pandemic began, and that includes childbirth. A momentous occasion in any parent’s life has been adjusted to help prevent the spread of COVID. The CDC reports that, during the summer of 2020, about 73% of hospitals discharged parents and babies in under 48 hours post-delivery, while 18% decreased lactation support.

For this study, researchers surveyed 1,344 hospitals and found that of parents suspected of having COVID, 14% were discouraged from having skin-to-skin contact with their babies while 6.5% were altogether prohibited from it.

Many hospitals, about 40%, discouraged the baby sharing a room with their parent, and 5% prohibited it. Almost 13% did not offer breastfeeding support, but did encourage parents to express milk. These practices (skin-to-skin contact, room-sharing, and breastfeeding support) are necessary for a baby's health and for early bonding with their parent.

These implementations were hospitals’ ways of interpreting various guidelines in an attempt to prevent an outbreak. In some cases, however, hospital policies were in opposition to actual recommendations from the World Health Organization (WHO) and other experts.

“Women with suspected or confirmed COVID-19 who are separated from their newborns and whose newborns are not feeding directly at the breast might need timely, professional breastfeeding support," study authors reported. They also recommend that babies discharged in under 48 hours be seen in a timely fashion by the child's pediatrician.

What Are the Recommended Guidelines? 

The World Health Organization recommends that mothers with COVID still get skin-to-skin contact, room-sharing, and have the ability to breastfeed while wearing a mask, unless they don’t feel well enough to take care of their baby. The American Academy of Family Physicians and the American College of Obstetricians and Gynecologists promotes collaborative planning between hospital staff and parents to determine best practices.

Tracey Leimkuhler, BSN, RNC

If moms choose to breastfeed, they can. If they choose to bottle-feed, we inform them of the benefits of breastfeeding, but we don't pressure them. If they strongly want to bottle that’s okay, but 90% try to breastfeed and continue with that.

— Tracey Leimkuhler, BSN, RNC

The discrepancies arise with the CDC and American Academy of Pediatrics suggesting early on that parents be separated from babies if they are COVID-positive. Because there was so much about the virus that we did not know in the early months of the pandemic, extra precautions were taken for the safety of parents and babies.

Both organizations later updated their guidance as new information became available. According to the AAP, “No published report has identified an infant who has died during the initial birth hospitalization as a direct result of SARS-CoV-2 infection." They continue by saying that the risk is “no greater” than if mom is separated from her baby.

The WHO, meanwhile, "recommends that mothers with suspected or confirmed COVID-19 should be encouraged to initiate or continue to breastfeed. Mothers should be counseled that the benefits of breastfeeding substantially outweigh the potential risks for transmission.” They also state that there is no evidence of COVID being transmitted to babies through breast milk.

In addition to being an all-natural and cost-effective method of feeding your baby, breast milk conveys a number of health benefits to newborns as they grow, including immune-boosting effects. Breastfeeding has been shown to have health benefits for mothers as well.

Many Hospitals Are Still "Baby Friendly"

Tracey Leimkuhler, BSN, RNC, is a labor and delivery nurse at Virtua Hospital in Voorhees, NJ. She explains that COVID has not impacted her hospital's breastfeeding support, and their "Baby Friendly" protocol is still in place. That protocol encourages bonding with the baby through rooming, skin-to-skin contact, and breastfeeding.

If families haven’t been tested prior to admission, Virtua tests everyone upon arrival. Leimkuhler states that everyone is treated as though they’re positive until they are confirmed negative, which means that staff is wearing full protective gowns and masks. Staff still wear masks in the presence of negative patients, and doulas are still allowed to assist at births.

What has changed at Virtua is the delivery room policy. According to Leimkuhler, “Before COVID, we allowed the support person and two visitors for the birth. After they delivered there was no limit on visitation—they could have a block party if they wanted. Now, moms are allowed one support person and no visitors.” Patients are encouraged to FaceTime with family members, and many are greeted at home by loved ones.

The length of hospital stays aren't affected, and the doctor checks in with parents and babies after 24 hours to see if everyone feels healthy enough to leave. They are discharged when the pediatrician and patient agree, and that is often after that 24-hour check-in. It is ultimately up to the parent who gave birth.

Lactation Support Is Still Available

Kristen O’Connell is an outpatient lactation consultant who will soon move to an inpatient setting. Her workload has not been impacted by the pandemic. “Many women request help while they are pregnant, then get support while they are still in the hospital. Once they’re discharged, if they are having difficulty,  their insurance may still cover these services.”

What This Means For You

The recent guidelines from leading pediatric organizations point to hospitals that have discouraged bonding and breastfeeding being able to revert to old practices, while encouraging mask use. Lactation consultant Kristen O’Connell says, “If you are having difficulty breastfeeding or producing milk, ask your pediatrician or insurance company about how to obtain a lactation consultant on an outpatient basis.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

1 Source
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  1. Perrine CG, Chiang KV, Anstey EH, et al. Implementation of hospital practices supportive of breastfeeding in the context of COVID-19 — United States, July 15–August 20, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1767–1770. doi:10.15585/mmwr.mm6947a3