PGY-2 Resident Physician West Virginia University School of Medicine Charleston, West Virginia, United States
Background: Exclusive breastfeeding is recommended for the first six months of life, offering optimal nutrition and immunoprotection against various diseases, including SARS-CoV-2 infection. The COVID-19 pandemic potentially influenced breastfeeding practices during birth hospitalization. Objective: This study aimed to assess the rates of exclusive breastfeeding before and during the COVID-19 pandemic at the time of newborn discharge among nulliparous women intending to exclusively breastfeed infants born in West Virginia. Design/Methods: We employed a cross-sectional study design for a secondary analysis of data from 89,456 pregnant women who stated their intent regarding feeding preference for their newborns from March 2018 through April 2023. Data was restricted to nulliparous women with intentions to breastfeed, who had gestational periods of 35 weeks or more, had singleton births, and no NICU admissions. The final dataset comprised 15,170 pregnant women. Pre-pandemic births were defined as births that occurred before March 11, 2020, while all other births took place during the COVID-19 pandemic. Multiple log-linear regression was used to estimate the risk ratio (RR) and its 95% confidence interval (CI) to assess the association between exclusive breastfeeding at hospital discharge during the COVID-19 pandemic compared to pre-pandemic, adjusting for potential confounding variables. Results: In the analyzed group of nulliparous mothers from West Virginia, 58.95% (n=8,943) exclusively breastfed, while 41.05% (n=6,227) did not exclusively breastfeed their newborns at discharge. There was a decline in exclusive breastfeeding rates from pre-pandemic (62.01%) to during the pandemic (57.08%) (adj. Risk Ratio = 1.077, 95% CI 1.05-1.11; p< 0.0001), after adjusting for maternal education, health insurance, race, maternal smoking or substance use, history of diabetes, gestational age, and birth weight.
Conclusion(s): Compared to the pre-pandemic period, we observed a notable decrease in the number of first-time mothers exclusively breastfeeding their newborns at the time of discharge during the COVID-19 pandemic in West Virginia. Unfortunately, this window of decreased breastfeeding initiation could have long-term negative impacts on these mothers and infants. Future research should focus on strategies to restore pre-pandemic breastfeeding rates and monitor the health outcomes of these mother-infant dyads.
