Infectious Disease

The research confirms that moms with COVID-19 shouldn’t be separated from newborns

February 18, 2021

2 min read

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Bartick reports being an unpaid board member of the Academy of Breastfeeding Medicine. In the study you will find all relevant financial information from all other authors.

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Temporarily separating mothers with confirmed or suspected COVID-19 from their newborns and disrupting skin care, placement, and direct breastfeeding has been “harmful and potentially unnecessary,” according to researchers.

The results come from the COVID maternal study.

Reference: Bartick MC et al. Breastfeeding Med. 2021; doi: 10.1089 / bfm.2020.0353.

When less was known about COVID-19, the AAP recommended that mothers with suspected or confirmed COVID-19 be temporarily separated from their infants. Since then, AAP has withdrawn its recommendation.

Melissa Bartick

“When we started the study, infants were routinely separated from infected mothers with no evidence that they would benefit.” Melissa Bartick, MD, MS, FABM, A hospital doctor at Mount Auburn Hospital and co-author of the COVID Mothers Study told Healio Primary Care, “We had to answer an urgent question about whether this was necessary and whether it did harm.”

Bartick and colleagues carried out a retrospective cohort study with 357 mothers who had confirmed or suspected SARS-CoV-2 infection. Study participants were part of an anonymous, global online survey conducted between May 4 and September 30, 2020. Most of the responses came from the US, Europe, and Latin America. There were no “eligible responses” from women in China, Japan or India.

According to the researchers, 7.4% of their newborns had a positive test in mothers who had SARS-CoV-2 infection within 3 days of birth.

Bartick and colleagues reported a nonsignificant decrease in hospital risk in neonates who were in-room, directly breastfed, or had uninterrupted skin care routine (P> 0.2 for all). Newborns who did not breastfeed directly, experienced skin-to-skin care, or had space within arm’s reach were significantly less likely to be exclusively breastfed for the first 3 months after the researchers adjusted maternal symptoms (P 0.02 in each case ).

In addition, after adjusting for maternal symptoms in the first three months of life, the researchers found no “statistically significant protective effect of exclusive breastfeeding” on the combined outcome of SARS-CoV-2 infection or symptomatic disease in infants less than 1 month old. Of 129 women with confirmed or suspected infection, 27.9% said they were separated from their newborns “due to COVID-19”. Of this group of women, 58% said they felt “very angry or distressed” because of the breakup, 78% said they felt at least “moderately distressed” and 29% said they had their child after the Couldn’t still reunion even though they tried. These mothers and newborns were separated for an average of 6 to 7 days.

“We expected mothers who did not conceive [skin-to-skin care, rooming-in and direct breastfeeding] It is less likely to be exclusively breastfed, but the extent to which this is true is remarkable, ”said Bartick. “The insignificant trend in the decrease in hospital admissions for infants who received these practices was also surprising.”

Bartick also said that a doctor’s decision to discourage mother and newborn babies from skin-to-skin care, placement, and direct breastfeeding should only be made after a very careful assessment of the risks to the mother and child when a new pathogen is present. ”

“Breastfeeding is indispensable in a pandemic,” she added. “On the contrary, it is important that it be preserved.”

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Emily Barrows, MD)

Emily Barrows, MD

As in every part of life since the outbreak of the COVID-19 pandemic, standard practices for a woman’s work, childbirth, and postpartum experience have had to change over the past year. With no data to inform their decisions, obstetricians and pediatricians around the world have had to decide how restrictive their recommendations on mother-child contact should be for known or suspected COVID-19 infection. For many, this meant completely isolating an infected mother from her brand new child. As one can imagine, this breaking of the mother-baby dyad has serious implications for the mother’s emotional well-being, as well as her baby’s early development, especially with regard to infant breastfeeding.

This study by Bartick and colleagues is a useful addition to our understanding of COVID-19 transmission, especially in the obstetric and pediatric communities. Similar to some previous studies, the researchers here note that there is likely no need to separate mothers from their babies.

In addition, Bartick and colleagues found that direct contact and continued breastfeeding between mother and child are likely to be safe and beneficial, even with a maternal infection with COVID-19. The positive implications of this finding include the associated decrease in maternal stress and the increase in continued breastfeeding, which result from enabling closeness between mother and child. This study has some design limitations and its results should be interpreted in this context. As part of a larger body of evidence, this study is helping evidence providers provide informed recommendations to their postpartum patients while managing the uncertainty of life during the COVID-19 pandemic.

Emily Barrows, MD

Peer Perspective Board member of Healio Primary Care
Assistant Professor, Department of Obstetrics and Gynecology, Virginia Commonwealth University

Disclosure: Barrows does not report any relevant financial information.

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