Effect of the COVID-19 pandemic and maternal SARS-CoV-2 status on breastfeeding practices in the COMBO cohort

ObjectivesTo investigate the role of prenatal maternal SARS-CoV-2 infection and delivery during the COVID-19 pandemic on breastfeeding practices through 6 months postpartum. Study designA cohort of mother-infant dyads who delivered at a large medical center in New York City and who had either documented history of prenatal SARS-CoV-2 infection, no history of SARS-CoV-2 infection, or who delivered in February 2020 prior to the COVID-19 pandemic were invited to participate in the COVID-19 Mother Baby Outcomes (COMBO) Initiative. These three groups of mothers completed surveys about their breastfeeding practices at 1, 2, 4, and/or 6 months postpartum, and responses were compared across enrollment group at each postpartum assessment period. ResultsData from 557 mother-infant dyads was included. The SARS-CoV-2 infected group reported significantly lower rates of mostly or exclusively breastfeeding at 1 month, 2 months, and 4 months postpartum. When analyses were separated by birth timing and maternal ethnicity, these differences between infected and uninfected mothers were only significant in the second pandemic wave delivery group and in Latina mothers. Conclusions for practiceMaternal SARS-CoV-2 infection during pregnancy was associated with lower rates of mostly or exclusively breastfeeding through 4 months postpartum. These differences may have been driven by delivery timing during the pandemic and self-reported maternal ethnicity. These results suggest a need to increase resources and support for breastfeeding during healthcare-disruptive events such as the pandemic, particularly for those belonging to groups historically underserved in healthcare.