Breastfeeding During COVID-19 Stay-at-Home Orders: Implications for Future Maternal Work Policies and Health Equity

• Published in: Maternal and child health journal 2024-11, Vol.28 (11), p.1961-1973
• Main Authors: Pritz, Haley, Henkes, Zoe, Graham, Valerie M, Romo-Palafox, Maria J.
• Format: Article
• Language: English
• Subjects: Adult; Breast feeding; Breast Feeding - psychology; Breast Feeding - statistics & numerical data; Breastfeeding & lactation; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; False information; Female; Global health; Gynecology; Health disparities; Health Equity; Health policy; Humans; Infant; Infant, Newborn; Infants; Maternal and Child Health; Maternity & paternity leaves; Medicine; Medicine & Public Health; Mothers - psychology; Pandemics; Pediatrics; Population Economics; Public Health; Qualitative analysis; Qualitative Research; SARS-CoV-2; Shelter in place; Sociology; Stress; Surveys and Questionnaires; Telemedicine; United States - epidemiology; Work at home
• ISSN: 1092-7875; 1573-6628; 1573-6628
• DOI: 10.1007/s10995-024-03990-8

Objectives This study aimed to explore the impact of the COVID-19 pandemic and associated stay-at-home orders on the breastfeeding experiences of U.S. people a identify facilitators and barriers to breastfeeding during this period, and to assess the effects of maternal stress and misinformation on breastfeeding practices. Methods U.S. women with infants were selected through purposive and convenience sampling. An online survey, distributed during summer 2020, measured changes in infant feeding practices, maternal stress levels, use of lactation support resources, and the influence of misinformation on feeding decisions. Quantitative data were analyzed using descriptive statistics, and qualitative responses underwent thematic analysis. Results Our sample (n = 1,861) revealed that 34% of U.S. women realized the pandemic affected their feeding practices, 544 women provided qualitative data. Major themes from qualitative analysis included ease of breastfeeding at home, bonding, increased breastfeeding duration, and challenges like limited access to lactation support. Logistic regressions highlighted demographic influences on breastfeeding practices, with no significant effects found related to the child's age or women's income on changes in feeding practices. Conclusions for Practice The COVID-19 pandemic substantially impacted breastfeeding experiences of U.S. women, yielding insights for future policy and healthcare practices. The findings underscore the potential benefits of telehealth lactation support services and flexible remote work environments for breastfeeding people. Clear and scientifically-grounded communication regarding breastfeeding, mental health support, and policy development, are essential to promote equitable and flexible work and maternity leave options for breastfeeding people especially during global health crises. Significance This study provides new insights into how the COVID-19 pandemic's stay-at-home orders uniquely impacted breastfeeding practices among a large and diverse sample of U.S. women across various regions, income levels, and racial/ethnic backgrounds. By capturing a wide range of experiences, we address a critical gap in understanding the effects of sudden societal changes on breastfeeding across different demographics. Our findings highlight both facilitators—such as increased time at home leading to easier breastfeeding, stronger mother-infant bonding, and extended breastfeeding duration—and barriers—including limited