Ganho-Ávila A. , Guiomar R. , Sobral M. , Pacheco F. , Caparros-Gonzalez R.A. , Diaz-Louzao C. , MOTRICO MARTINEZ, EMMA, DOMÍNGUEZ SALAS, SARA, Mesquita A. , Costa R. , Vousoura E. , Hadjigeorgiou E. , Bina R. , Buhagiar R. , Mateus V. , Contreras-García Y. , Wilson C.A. , Ajaz E. , Hancheva C. , Dikmen-Yildiz P. , de la Torre-Luque A.
No
Midwifery
Article
Científica
2.6
0.906
01/02/2023
000996654100001
2-s2.0-85149949430
Background: Breastfeeding promotes children\'s health and is associated with positive effects to maternal physical and mental health. Uncertainties regarding SARS-CoV-2 transmission led to worries experienced by women and health professionals which impacted breastfeeding plans. We aimed to investigate the impact of self-reported and country-specific factors on breastfeeding rates during the COVID-19 pandemic. Methods: This study is part of a broader international prospective cohort study about the impact of the COVID-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19). We analysed data from 5612 women, across 12 countries. Potential covariates of breastfeeding (sociodemographic, perinatal, physical/mental health, professional perinatal care, changes in healthcare due to the pandemic, COVID-19 related, breastfeeding support, governmental containment measures and countries’ inequality levels) were studied by Generalized Linear Mixed-Effects Models. Results: A model encompassing all covariates of interest explained 24% of the variance of breastfeeding rates across countries (first six months postpartum). Overall, first child (ß = -0.27), age of the child (ß = -0.29), preterm birth (ß = -0.52), admission to the neonatal/pediatric care (ß = -0.44), lack of breastfeeding support (ß = -0.18), current psychiatric treatment (ß = -0.69) and inequality (ß = -0.71) were negatively associated with breastfeeding (p <.001). Access to postnatal support groups was positively associated with breastfeeding (ß = 0.59; p <.001). In countries with low-inequality, governmental measures to contain virus transmission had a deleterious effect on breastfeeding (ß = -0.16; p <.05) while access to maternity leave protected breastfeeding (ß = 0.50; p <.001). Discussion: This study shows that mother\'s COVID-19 diagnosis and changes in healthcare and birth/postnatal plans did not influence breastfeeding rates. Virtual support groups help women manage breastfeeding, particularly when their experiencing a first child and for those under psychiatric treatment. The complex associations between covariates and breastfeeding vary across countries, suggesting the need to define context-specific measures to support breastfeeding. © 2023 Elsevier Ltd
Breastfeeding; COVID-19; Cross-countries; Perinatal health; SARS-CoV-2