Maintaining human milk bank services throughout the COVID‐19 pandemic: A global response
Shenker, N., Staff, M., Vickers, A., Aprigio, J., Tiwari, S., Nangia, S., ... & Virtual Collaborative Network of Milk Banks and Associations. Maintaining human milk bank services throughout the COVID‐19 pandemic: A global response. Maternal & Child Nutrition, e13131. January 2021. https://doi.org/10.1111/mcn.13131
Shenker et al. evaluated the impacts of the COVID-19 pandemic on Human Milk Bank (HMB) services worldwide. The authors not only identified 7 pandemic-related vulnerabilities to service provision: insufficient donors, prescreening disruption, DHM availability, logistics, communication, safe handling, and contingency planning, but also offered operational guidance for milk banks during the pandemic.
Community‐based doulas and COVID‐19: Addressing structural and institutional barriers to maternal health equity
Ogunwole, M. S., Bennett, A.N.W, & Bower, K.M. Community‐based doulas and COVID‐19: Addressing structural and institutional barriers to maternal health equity. Perspectives on Sexual and Reproductive Health. January 2021. https://doi.org/10.1363/psrh.1216
The authors of this publication highlight how the use of community based doulas can mitigate US racial disparities in birth outcomes during the COVID-19 pandemic. Specific strategies and policies for expanding doula care are also provided.
Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization recommendations
Hoang, D. V., Cashin, J., Gribble, K., Marinelli, K., & Mathisen, R. Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization recommendations. BMJ nutrition, prevention & health. December 2020. doi:10.1136/bmjnph-2020-000184
BMJ publication presents findings from a review of 68 international COVID-19 guidance documents, from 33 countries, on the care of infants with suspected or confirmed COVID-19 positive mothers for alignment with WHO recommendations. The authors reviewed guidance on (1) skin-to-skin contact; (2) early initiation of breastfeeding; (3); rooming-in; (4) direct breastfeeding; (5) provision of expressed breastmilk; (6) provision of donor human milk; (7) wet nursing; (8) provision of breastmilk substitutes; (9) psychological support for separated mothers; and (10) psychological support for separated infants. They noted an inconsistency in international guidelines and an overall undervaluing of the importance of maternal proximity and breastfeeding to infant health.
Bhasin, M., Nangia, S., & Goel, S. Role of Human Milk Banks Amid COVID 19: Perspective from a Milk Bank in India. International Breastfeeding Journal. December 2020. https://doi.org/10.1186/s13006-020-00346-0
This commentary provides a perspective from a milk bank in India on procedural modifications necessary to promote breastfeeding and human milk donation during the pandemic. The authors reinforce the need to minimize the impact of the pandemic on the health and well-being of the vulnerable infants, despite its adverse effect on the functioning of human milk banks throughout the world.
Anxiety, depression, and knowledge level in postpartum women during the COVID-19 pandemic
Guvenc, G., Yesilcinar, İ., Ozkececi, F., Öksüz, E., Ozkececi, C. F., Konukbay, D., ... & Karasahin, K. E. Anxiety, depression, and knowledge level in postpartum women during the COVID-19 pandemic. Perspectives in psychiatric care. December 2020. https://doi.org/10.1111/ppc.12711
Cross-sectional descriptive survey assesses anxiety, depression, and knowledge level in postpartum women during the COVID-19 pandemic. The authors explore the relationship between measures, such as COVID-19 breastfeeding knowledge and fear of COVID-19 transmission to baby via breastfeeding, and maternal mental health
Kaufman, D.A. & Puopolo, K.M. Infants Born to Mothers With COVID-19—Making Room for Rooming-in. JAMA Pediatrics. December 2020. https://doi:10.1001/jamapediatrics.2020.5100
Multicenter study from Italy describes the outcomes of 62 infants born to SARS-CoV-2–infected mothers who felt well enough to care for their infants at the time of delivery. The study findings support the most recent updates to the AAP neonatal guidance, which recommend rooming-in unless mothers are too ill to care for their newborn.
Stowe, J., Smith, H., Thurland, K. et al. Stillbirths During the COVID-19 Pandemic in England, April-June 2020. JAMA. December 2020. https://doi:10.1001/jama.2020.21369
Stowe et al. reported in a JAMA research letter that there was no evidence of any increase in stillbirths, regionally or nationally, during the COVID-19 pandemic in England. This contrasts with previous findings from a single UK hospital and is reassuring given the concerns about patients, including pregnant women, receiving fewer services or being hesitant to access health care during the pandemic.
Fox, A., Marino, J., Amanat, F., Krammer, F., Hahn-Holbrook, J., Zolla-Pazner, S., & Powell, R. L. Robust and specific secretory IgA against SARS-CoV-2 detected in human milk. Iscience, 23(11), 101735. November 2020. https://doi.org/10.1016/j.isci.2020.101735
Recent study findings indicate that breastmilk might contain antibodies to the SARS-CoV-2 virus. The researchers studied breast milk samples from 15 women and detected antibodies which indicates that mothers could be passing viral immunity to babies.
Aborode, A. T., Ogunsola, S. O., & Adeyemo, A. O. A Crisis within a Crisis: COVID-19 and Hunger in African Children. The American journal of tropical medicine and hygiene,10.4269/ajtmh.20-1213. Advance online publication. November 2020. https://doi.org/10.4269/ajtmh.20-1213
Perspective piece explores the ways in which the COVID-19 pandemic has led to increases in food insecurities in low- and middle-income countries (LMICs), particularly in sub-Saharan Africa and South Asia. The authors also stress the importance of investing in maternal and child nutrition through pregnancy, infancy, and early childhood by protecting breastfeeding and preventing inappropriate marketing of infant formula during the pandemic.
Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 - United States, July 15-August 20, 2020
Perrine, C. G., Chiang, K. V., Anstey, E. H., Grossniklaus, D. A., Boundy, E. O., Sauber-Schatz, E. K., & Nelson, J. M. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 - United States, July 15-August 20, 2020. MMWR. Morbidity and mortality weekly report, 69(47), 1767–1770. November 2020. https://doi.org/10.15585/mmwr.mm6947a3
According to this CDC publication,17.9% of hospitals reported a decrease in in-person lactation support and 72.9% reported discharging mothers and their infants <48 hours after birth, because of the COVID-19 pandemic. The authors suggest that additional post-discharge breastfeeding support and newborn follow-up might be needed during the ongoing pandemic.
Martenot, A., Labbassi, I., Delfils-Stern, A., Monroy, O., Langlet, C., et al. Favorable outcomes among neonates not separated from their symptomatic SARS-CoV-2-infected mothers. Pediatr Res. November 2020. https://doi.org/10.1038/s41390-020-01226-3
Retrospective study in Pediatric Research assessed if guidelines in two hospitals in Alsace, France- which instituted careful follow up and infection prevention measures in place of systematic separation- were safe for infants born to SARS-CoV-2 positive mothers. The findings show that separation may have more significant negative consequences than providing early skin-to-skin and breastfeeding, with good infection prevention measures.
Bellos I., Pandita, A., & Panza, R. Maternal and perinatal outcomes in pregnant women infected by SARS-CoV-2: A meta-analysis. Eur J Obstet Gynecol Reprod Biol. November 2020. https://doi:10.1016/j.ejogrb.2020.11.038
Bellos et al. conducted a meta-analysis to evaluate maternal and neonatal outcomes in SARS-CoV-2 infected pregnancies with perinatal viral transmission. Their findings suggest that the risk of vertical transmission is low and may not be affected by the severity of the maternal
Mental Health Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic - United States
Leeb, R.T., Bitsko, R.H., Radhakrishnan, L., Martinez, P., Njai, R., & Holland, K.M. (2020). Mental Health Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic - United States. MMWR Morb Mortal Wkly Rep. November 2020. https://doi:10.15585/mmwr.mm6945a3
The proportion of children's mental health related emergency department (ED) visits in the U.S. increased from 2019 levels during the COVID-19 pandemic. The authors found that the pandemic may have increased the demand for children's mental health care and they recommend that tele-health be considered to prevent this group from seeking care in the ED.
Multi-centre Study Showed Reduced Compliance with the World Health Organization Recommendations on Exclusive Breastfeeding During COVID-19
Eapen, V., Hiscock, H., & Williams, K. Adaptive innovations to provide services to children with developmental disabilities during the COVID-19 pandemic. J Paediatr Child Health. November 2020. doi:10.1111/jpc.15224
This opinion piece summarizes the disparities in healthcare access among children with developmental disabilities heightened due to school closures, self-isolation, and financial losses. To prevent these children from falling behind in their health check-ups, the authors argue that innovative care delivery models like telehealth visits must be prioritized and subsidized both during and after the current pandemic.
Building for the Future: Strong Policies for Babies and Families After COVID-19. Zero to Three
Cole, P.A. Building for the Future: Strong Policies for Babies and Families After COVID-19. Zero to Three. November 2020. https://www.zerotothree.org/resources/3728-building-for-the-future-strong-policies-for-babies-and-families-after-covid-19
ZERO TO THREE published a report on the policy landscape for babies and families before the pandemic, as well as observations on how they have been faring during the pandemic and economic upheaval. The report also identifies policy gaps that have left families of color and low income families particularly vulnerable.
COVID-19 Poses Pregnancy Risks
Kuehn, B.M. COVID-19 Poses Pregnancy Risks. JAMA. November 2020. doi:10.1001/jama.2020.21129
AMA article reports on surveillance data, comparing admissions data and outcomes of symptomatic and asymptomatic pregnant women infected with SARS-CoV-2, from hospitals in 13 U.S states. Findings indicate that a greater percentage of symptomatic women experienced pregnancy loss, premature delivery, ICU care, mechanical ventilation, and death in comparison to asymptomatic pregnant women, between March and August 2020.
Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status.
Zambrano, L.D., Ellington, S., Strid, P., et al. (2020). Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status. MMWR Morb Mortal Wkly Rep. November 2020. http://dx.doi.org/10.15585/mmwr.mm6944e3
The CDC's recent morbidity and mortality weekly report (MMWR) indicates that pregnant women with COVID-19 are at increased risk for severe illness, compared with non-pregnant women with COVID-19. They recommend that pregnant women should be counseled about the risk for severe COVID-19 associated illness, including death, and that measures for SARS-CoV-2 prevention should be emphasized for pregnant women and their families.
Multi-centre Study Showed Reduced Compliance with the World Health Organization Recommendations on Exclusive Breastfeeding During COVID-19
Del Rio, R., Dip Perez, E. & Marin Gabriel, M.A. Multi-centre Study Showed Reduced Compliance with the World Health Organization Recommendations on Exclusive Breastfeeding During COVID-19. Acta Paediatr. October 2020. doi:10.1111/apa.15642
A descriptive study of the impact of COVID-19 pandemic restrictions on exclusive breastfeeding across 15 hospitals in Spain finds that the WHO COVID-19 recommendations, which include some of the Baby-Friendly steps, were not immediately applied. There was evidence that compliance with these steps, such as skin-to-skin contact at birth and no mother-infant separation, had a positive impact on breastfeeding initiation and maintenance. Link to report here
Multisystem inflammatory syndrome in children associated with novel coronavirus SARS-CoV-2: Presentations to a pediatric emergency department in Michigan
Sethuraman, U., Kannikeswaran, N., Ang, J., et al. Multisystem inflammatory syndrome in children associated with novel coronavirus SARS-CoV-2: Presentations to a pediatric emergency department in Michigan. Am J Emerg Med. October 2020. https://doi.org/10.1016/j.ajem.2020.10.035
Sethuraman et al. describe the presentations of children to a pediatric emergency department in Michigan and the association they have seen between multisystem inflammatory syndrome and COVID-19. They hope that the information presented will aid clinicians with early recognition, evaluation, and management of MIS-C in the emergency department
Sullivan, S.E. & Thompson, L.A. Best Practices for COVID-19–Positive or Exposed Mothers—Breastfeeding and Pumping Milk. JAMA Pediatr. October 2020. doi:10.1001/jamapediatrics.2020.3341
The authors of this JAMA Pediatrics article outline two sets of guidelines for a) breastfeeding mothers who have tested positive for COVID-19, and b) breastfeeding women who have been exposed to or have a high risk of contracting the virus through their jobs etc.
COVID-19 and Parent-Child Psychological Wellbeing
Gassman-Pines, A., Ananat, E.O., & Fitz-Henley, J. COVID-19 and Parent-Child Psychological Wellbeing. Pediatrics. October 2020. doi:10.1542/peds.2020-007294
Pediatrics study finds that the current pandemic crisis has worsened the psychological well-being of both parents and children. They urge for immediate increase in social support and additional interventions addressing families' economic and mental health needs. They also recommend that pediatricians screen for mental health problems among the children in their practice, especially children whose families are vulnerable to the crisis's economic and disease aspects.
Kuehn, B.M. COVID-19 Halts Reproductive Care for Millions of Women. JAMA. October 2020. doi:10.1001/jama.2020.19025
Since the lockdowns and other limitations in movement that have characterized the COVID-19 pandemic, London-based Marie Stopes International reported that roughly 2 million fewer women have received reproductive care services through its programs in 37 countries. The article assesses innovative approaches with which agencies have responded to this need.
Missed Nursing Care During Labor and Birth and Exclusive Breast Milk Feeding During Hospitalization for Childbirth
Simpson, K.R. et al. Missed Nursing Care During Labor and Birth and Exclusive Breast Milk Feeding During Hospitalization for Childbirth. MCN. October 2020. doi: 10.1097/NMC.0000000000000644
Study published in the Journal of Maternal Child Nursing examines associations between missed nursing care and nurse staffing during labor & birth, and exclusive breast milk feeding at hospital discharge, at the start of the pandemic in Philadelphia. The researchers found that nurses have substantial responsibility for direct support of infant feeding during the childbirth hospitalization, and they recommend that maternity units focus on improving nurse staffing in order to avoid missed nursing care.
Supporting Clinicians during Covid-19 and Beyond — Learning from Past Failures and Envisioning New Strategies
Shapiro, J & McDonald T.B. Supporting Clinicians during Covid-19 and Beyond — Learning from Past Failures and Envisioning New Strategies. NEJM. October 2020. DOI: 10.1056/NEJMp2024834
Shapiro and McDonald share their perspectives on the need for immediate action to improve the emotional health of clinicians. They identify common stressors that physicians face in the course of their duties (especially during the COVID-19 pandemic), highlight barriers to eliminating the stressors, and offer strategies that medical institutions could use to design successful emotional-support programs for clinicians.
Spatz, D.L. & Froh, E.B. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN. October 2020. doi: 10.1097/NMC.0000000000000672
Journal of Maternal Child Nursing article presents the hospital birth and breastfeeding experiences of three first-time, healthy mothers and babies, during the start of the pandemic in Philadelphia. The authors hope that nurses and other health care providers can learn from these mothers' experiences and proactively work to ensure that they provide better guidance, communication, and evidence-based lactation care and support.
Outcomes of Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection at a Large Medical Center in New York City
Dumitriu, D., Emeruwa, U.N., & Hanft, H. (2020). Outcomes of Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection at a Large Medical Center in New York City. JAMA Pediatrics. October 2020. doi:10.1001/jamapediatrics.2020.4298
JAMA study assesses the risk of mother-to-newborn transmission of SARS-CoV-2 virus through an analysis of neonates born to mothers with perinatal COVID infections. They found that no infants got sick, despite rooming-in with their mothers and direct breastfeeding. The authors assert that the separation of mother and newborns may be unwarranted and direct breastfeeding is safe.
Antivirals for COVID-19 and Breastfeeding
Anderson, P.O. Antivirals for COVID-19 and Breastfeeding. Breastfeeding Medicine. October 2020. https://doi.org/10.1089/bfm.2020.0268
Research column article reviews the use of the most prominent drugs against the SARS-CoV-2 virus in relation to breastfeeding.
Salvatori, G., De Rose, D.U., Amadio, P., Reposi, M.P., et al. Universal Screening for SARS-CoV-2 of all Human Milk Bank Samples. J Hum Lact. September 2020. https://doi:10.1177/0890334420962074
In this study, published in the Journal of Human Lactation, the authors tested the role of sampling containers and donated human breast milk in the transmittance of SARS-CoV-2. None of the samples tested positive and the authors determined that breastfeeding is safe practice for COVID positive mothers and that donor milk is safe for use, provided the necessary measures and eligibility criteria are met.
Key Messages Related to Evidence on Transmission of COVID in Breastmilk
United States Agency for International Development (USAID). Key Messages Related to Evidence on Transmission of COVID in Breastmilk. September 2020.
This two-page brief presents key messages on research related to COVID-19 transmission through human breastmilk. The brief was recently prepared on behalf of the COVID-19 Infant Feeding Working Group and it emphasizes three key points: 1)breast milk from COVID positive mothers is safe to consume, 2) breastfeeding is more critical now given the anticipated negative impacts of the ongoing pandemic on child nutrition and health, and 3) preventive measures and precautions must be taken when COVID positive mothers breastfeed, to maintain the low risk of transmission.
Brown, A., & Shenker, N. Experiences of breastfeeding during COVID‐19: Lessons for future practical and emotional support. Matern Child Nutr. September 2020. doi: 10.1111/mcn.13088
Brown and Shenker found that the COVID-19 lockdown had positive and negative effects on breastfeeding rates in the UK. These findings have important considerations for those working in breastfeeding support and policy, especially regarding disproportionately affected groups.
Pregnant Women's Reports of the Impact of COVID-19 on Pregnancy, Prenatal Care, and Infant Feeding Plans
Burgess, A., Breman, R. B., Bradley, D., Dada, S., & Burcher, P. Pregnant Women's Reports of the Impact of COVID-19 on Pregnancy, Prenatal Care, and Infant Feeding Plans. MCN: The American Journal of Maternal/Child Nursing. September 2020. doi: 10.1097/NMC.0000000000000673
Survey-based cross sectional study aimed to describe how the COVID-19 pandemic has affected pregnancy, prenatal maternity care practices, and infant feeding plans among pregnant women in the United States. The authors emphasize the need for healthcare providers and policy makers to listen to the collective voices of women about how COVID-19 has affected their birth and infant feeding plans, and their perceptions of changes in prenatal care.
Ng, Y. P. M., Low, Y.F., Goh, X.L., Fok, D, & Amin, Z. Breastfeeding in COVID-19: A Pragmatic Approach. Am J Perinatol. September 2020. doi:10.1055/s-0040-1716506
Authors propose three options for infant feeding when mother is COVID-positive, after conducting a review of guidelines and published literature. They conclude that breastfeeding should be encouraged with reasonable precautions to reduce viral transmission.
Delaying Pregnancy during a Public Health Crisis — Examining Public Health Recommendations for Covid-19 and Beyond
Rasmussen, S. A., Lyerly, A. D., & Jamieson, D. J. Delaying Pregnancy during a Public Health Crisis — Examining Public Health Recommendations for Covid-19 and Beyond. NEJM. September 2020. doi:10.1056/NEJMp2027940
Article in the New England Journal of Medicine addresses the discourse around delaying conception due to risk of COVID-19. The authors discuss the ethical issues and concerns around such recommendations, and the criteria that need to be met for pregnancy-avoidance to be a justifiable advice from public health agencies.
Ahlberg, M., Neovius, M., Saltvedt, S., et al. Association of SARS-CoV-2 Test Status and Pregnancy Outcomes. JAMA. September 2020. doi:10.1001/jama.2020.19124
In this JAMA study comparing pregnant persons with SARS-CoV-2 and those who were uninfected, the investigators found that positive results in laboring women was associated with a higher prevalence of preeclampsia and lower prevalence of induction. They conclude that COVID-19 is less severe in pregnancy than the two previous coronavirus infections (SARS and MERS).
Sacks, E., Sripad, P., Ndwiga, C., Waiswa, P., & Warren, C.E. Protecting newborn infants during the COVID-19 pandemic should be based on evidence and equity. Acta Paediatr. September 2020. doi:10.1111/apa.15568
Sacks et al. suggest that a lack of equitable distribution of protection and mitigation efforts for newborns during the COVID-19 pandemic has led to sub-standard infection control at under-funded and over-burdened health facilities. They assert that future efforts should be based on up-to-date science and distributed equitably.
Palmquist, A.E.L., Parry, K.C., Wouk, K., et al. Ready, Set, BABY Live Virtual Prenatal Breastfeeding Education for COVID-19. Journal of Human Lactation. September 2020. doi:10.1177/0890334420959292
Case report from the Carolina Global Breastfeeding Institute(CGBI) details the adaptation of their breastfeeding and prenatal education to a remote learning format.The authors suggest that breastfeeding support organizations adopt similar strategies and utilize remote learning and telehealth services to support expectant parents.
Adoption of Breastfeeding Recommendations in the Context of COVID-19: Key Findings from an Online Survey in Low-and Middle-Income Countries
United Nations Children Fund (UNICEF). Adoption of Breastfeeding Recommendations in the Context of COVID-19: Key Findings from an Online Survey in Low-and Middle-Income Countries. September 2020. https://mcusercontent.com/Breastfeeding_survey_COVID19_Brief_final.pdf
UNICEF shares key findings from an online survey they conducted in all seven regions of the world, to assess the extent to which breastfeeding recommendations have been adopted in the context of COVID-19.
Clinical and Immunologic Features Among COVID-19-Affected Mother-Infant Pairs: Antibodies to SARS-CoV-2 Detected in Breast Milk
Gao, X., Wang, S., Zeng, W., et al. Clinical and Immunologic Features Among COVID-19 Affected Mother-Infant Pairs: Antibodies to SARS-CoV-2 Detected in Breast Milk. New Microbes New Infect. September 2020. doi:10.1016/j.nmni.2020.100752
Retrospective study of the clinical and immunological features, as well as infection risk through breastfeeding, found that passive acquisition of antibodies can occur through breast milk ingestion from COVID-19 infected mothers. The authors encourage continued breastfeeding as the risk of SARS-CoV-2 transmission to neonates is low.
Dhir, S.K., Kumar, J., Meena, J., & Kumar, P. Clinical Features and Outcome of SARS-CoV-2 Infection in Neonates: A Systematic Review. J Trop Pediatr. August 2020. doi:10.1093/tropej/fmaa059
This systematic review aimed to synthesize the currently available literature on various modes of transmission, clinical features, and outcomes of SARS-CoV-2 infection in neonates. The review suggests that the risk of SARSCoV-2 infections in neonates is extremely low, and unlike children, most COVID positive neonates were symptomatic and required intensive care.
Telehealth Uptake into Prenatal Care and Provider Attitudes during the COVID-19 Pandemic in New York City: A Quantitative and Qualitative Analysis
Madden, N., Emeruwa, U.N., Friedman, A.M., et al. Telehealth Uptake into Prenatal Care and Provider Attitudes during the COVID-19 Pandemic in New York City: A Quantitative and Qualitative Analysis. Am J Perinatol. August 2020. doi:10.1055/s-0040-1712939
Madden et al. sought to determine to what degree prenatal care was able to be transitioned to telehealth at two affiliated hospitals in New York City during the novel COVID-19 pandemic, and to determine providers' experience with this transition.
Moscola, J., Sembajwe, G., Jarrett, M., et al. Prevalence of SARS-CoV-2 Antibodies in Health Care Personnel in the New York City Area. JAMA. August 2020. doi:10.1001/jama.2020.14765
Considering the high exposure risk of healthcare personnel (HCP), JAMA research article investigated the prevalence of COVID-19 antibodies in Health Care Personnel in the New York City Area. They found a 13.7% prevalence of SARS-CoV-2 antibodies in the study cohort and concluded that providing HCP with data about their COVID exposure is important so they can protect themselves, their patients, their colleagues, and their families.
Busch-Hallen, J., Walters, D., Rowe, S., Chowdhury, A., & Arabi, M. Impact of COVID-19 on Maternal and Child Health. The Lancet. August 2020. doi.org/10.1016/S2214-109X(20)30327-2
Lancet article discusses the impact of separating newborns from mothers and discouraging breastfeeding because of unfounded fears of transmission of COVID-19 through breast milk. This analysis highlights
the need for continued support, promotion and protection of breastfeeding by revealing substantial morbidity and mortality repercussions from pandemic related disruptions to breastfeeding
the need for continued support, promotion and protection of breastfeeding by revealing substantial morbidity and mortality repercussions from pandemic related disruptions to breastfeeding
Erwin, P.C., & Braund, W.E. A Public Health Lens on Rural Health. AJPH. August 2020. doi:10.2105/AJPH.2020.305863
American Journal of Public Health (AJPH) published a collection of scholarly articles which examine rural health issues through a public health lens. The COVID-19 global pandemic has exposed the constraints and limitations of the nation’s public health infrastructure and heightened awareness of the importance of, and need for, prevention, protection, equity, and system change.
Palmquist, A.E.L., Asiodu, I.V., & Quinn, E.A.. The COVID-19 Liquid Gold Rush: Critical Perspectives of Human Milk and SARS-CoV-2 Infection. American Journal of Human Biology. August 2020. doi.org/10.1002/ijgo.13333
Palmquist et al. argue that studying human milk outside of human lived experiences is not only extremely limited but potentially harmful to vulnerable populations. They assert that the science used to support perinatal separation policies for COVID‐19, including strongly advising against breastfeeding or provision of human milk with SARS‐CoV‐2 infection, are disproportionately harming BIPOC.
Bhaskar, M.E., & Arun, S. SARS-CoV-2 Infection Among Community Health Workers in India Before and After Use of Face Shields. JAMA. August 2020. doi:10.1001/jama.2020.15586
JAMA study found that face shields were effective in protecting community health workers in India from becoming infected with SARS-CoV- 2. Adding face shields to their personal protective equipment spared 50 uninfected health workers from becoming infected, despite interactions with 2682 infected persons in the line of duty.
Vertical transmission risk of SARS-CoV-2 infection in the third trimester: a systematic scoping review.
Thomas, P., Alexander, P. E., Ahmed, U., Elderhorst, E.,... & Alhazzani, W. Vertical transmission risk of SARS-CoV-2 infection in the third trimester: a systematic scoping review. The Journal of Maternal-Fetal & Neonatal Medicine. August 2020. doi.org/10.1080/14767058.2020.1786055
This systematic scoping review article summarizes the current evidence on the vertical transmission potential in the third trimester and its effects on the neonate. 18 studies were reviewed, consisting of 157 mothers and 160 neonates, and the findings suggest that no vertical transmission of COVID-19 occurred
Iida, M., & Tanaka, M. Screening maternity populations during the COVID‐19 pandemic. BJOG: An International Journal of Obstetrics & Gynaecology. August 2020. doi:10.1111/1471- 0528.16439
Research commentary highlights the challenges that asymptomatic transmission of SARS-CoV-2 poses to containing the virus during childbirth. The authors also discussed the elevated risk of cross-infection between laboring women and midwives and advocate for the COVID-19 testing of pregnant women to reduce risk of transmission and provide optimal medical management to mothers and their newborns
Chambers C, Krogstad P, Bertrand K, et al. Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women. JAMA. August 2020. doi:10.1001/jama.2020.15580
This research letter provides evidence supporting the unlikelihood of transmission of SARS-CoV-2 from mother to infant through breast milk, highlighting the safety of breast milk and donor milk among SARS-CoV-2-infected women. Out of the 64 breast milk samples from 18 SARS-CoV-2-infected women in the US analyzed in this study, only one tested positive for presence of viral RNA, and none tested positive for presence of active virus.
Davanzo, R., Merewood, A., & Manzoni, P. (2020). Skin-to-Skin Contact at Birth in the COVID-19 Era: In Need of Help! American Journal of Perinatology. August 2020. doi: 10.1055/s-0040-1714255
Editorial stresses the importance of skin-to-skin contact in the immediate postpartum period in the COVID-19 era, given the numerous benefits of the practice for both infant and mother.
Rodriguez-Lonebear, D., Barceló, N.E., Akee, R., & Carroll, S.R. American Indian Reservations and COVID-19: Correlates of Early Infection Rates in the Pandemic. Journal of Public Health Management and Practice. August 2020. doi: 10.1097/PHH.0000000000001206
An interdisciplinary team of professionals found that the rate of COVID-19 cases per 1000 people was more than four times higher for populations residing on reservations than the entire U.S. The analysis focused on the relationship between community and household characteristics and the rate of COVID-19 spread on tribal lands.
Kovich, H. Rural Matters - Coronavirus and the Navajo Nation. NEJM. July 2020. doi: 10.1056/NEJMp2012114
Dr. Heather Kovich shares her experience as a healthcare provider in Navajo Nation during the peak of the COVID-19 pandemic.The article not only explores the infrastructural and cultural realities that influence the spread of the virus, but also highlights the diversity of talent, experience, and resourcefulness of the people
Infectious Diseases Diagnoses of Children Admitted with Symptoms of Coronavirus Disease 2019 During an Outbreak in New York City
Acker, K. P., Schertz, K., Abramson, E. L., DeLaMora, P., Salvatore, C. M., & Han, J.-Y. Infectious Diseases Diagnoses of Children Admitted with Symptoms of Coronavirus Disease 2019 During an Outbreak in New York City. Clinical Pediatrics. July 2020. doi.org/10.1177/0009922820944399
Retrospective study of 42 children (median age of 2 years) sought to determine how frequently children admitted with COVID-19 like symptoms actually have the virus. The results suggest that most children admitted with COVID-19-like symptoms did not have SARS-CoV-2 infection, even during the outbreak in New York.
Review of Guidelines and Recommendations from 17 Countries Highlights the Challenges that Clinicians Face Caring for Neonates Born to Mothers with COVID‐19.
Yeo, K. T., Oei, J. L., De Luca, D., Schmölzer, G. M., Guaran, R., ... & Kusuda, S. Review of Guidelines and Recommendations from 17 Countries Highlights the Challenges that Clinicians Face Caring for Neonates Born to Mothers with COVID‐19. Acta Paediatrica. July 2020. https://doi.org/10.1111/apa.15495
A systematic review of guidelines and recommendations from 17 countries for managing neonates born to mothers with COVID-19, and how applicable they were to the evolving pandemic.
Onwuzurike, C., Diouf, K., Meadows, A. R., & Nour, N. M. Racial and ethnic disparities in severity of COVID‐19 disease in pregnancy in the United States. International Journal of Gynecology & Obstetrics. July 2020. doi.org/10.1002/ijgo.13333
An academic hospital based obstetrics practice in Boston found racial disparities in cases of COVID-19 among non-Hispanic Black and Hispanic women, and disproportionate adverse outcomes including hospitalization, ICU care, and mechanical ventilation for these populations. The authors conclude that these findings reflect the health consequences of the social, environmental, and structural effects of racism in the United States.
Perinatal COVID-19 Infection Prevention: Infographics for Patients and Providers
Lakshminrusimha, S., Sridhar, A., Guerra, A.A.H., Higgins, R.D., & Saade, G. Perinatal COVID-19 Infection Prevention: Infographics for Patients and Providers. Am J Perinatol. July 2020. doi:10.1055/s-0040-1714387
Pulling from established national guidelines on obstetric care, the authors developed patient-centered infographics that highlight major consideration for pregnancy and newborn care during the COVID-19 pandemic. They are available in English and Spanish on the journal's website, designed for display in clinician's offices, delivery rooms, or nurseries, and can be used to create informative brochures for patients/parents.
Marshall, J., Kihlström, L., Buro, A., ... & Hood, K. Statewide Implementation of Virtual Perinatal Home Visiting During COVID-19. Matern Child Health J. July 2020. doi:10.1007/s10995-020-02982-8
This paper describes the implementation of virtual perinatal home visiting in high-risk communities and staff adaptations to working remotely in Florida, USA. The authors discuss factors to consider in implementing effective virtual home visits and they conclude that these visits seem to be feasible and to provide an essential connection to support families.
Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: A prospective cohort study
Prabhu, M., Cagino, K., Matthews, K. C., ... & Riley, L.E. Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: A prospective cohort study. BJOG. July 2020. doi.org/10.1111/1471-0528.16403
Prahbu et al. assessed the differences in birth outcomes between pregnant women with and without COVID-19 in three NY hospitals. They reported an increased cesarean delivery rate and frequency of postpartum maternal complications among pregnant women with COVID-19.
Healthy Eating Research. Strengthening WIC's Impact During and After the COVID-19 Pandemic. Research Brief. July 2020. https://healthyeatingresearch.org/research/strengthening-wics-impact-during-and-after-the-covid-19-pandemic/
This research brief focuses on how to strengthen WIC’s impact during and after COVID-19. The brief summarizes the evidence of WIC’s benefits and challenges the program and participants are facing due to COVID-19, and it addresses what additional actions are needed to support increases in WIC enrollment.
Johns Hopkins University Center for Humanitarian Health
This resource provides an overview of what peer-reviewed journal articles currently state on COVID-19, maternal and child health (including infants), and nutrition, specifically as it relates to Human Milk and Breastfeeding.
Maternal Death in Pregnancy due to COVID‐19
Cheng, S.O., Khan, S., & Alsafi, Z. Maternal Death in Pregnancy due to COVID‐19. Ultrasound Obstet Gynecol. July 2020. doi:10.1002/uog.22111
A review of changes in maternal mortality due to COVID-19 (SARS-CoV-2) in pregnant women. Cheng and colleagues sought to find out whether COVID-19 had a lower risk of mortality in pregnant women when compared to MERS-CoV and SARS-CoV, they concluded that even though there were changes observed, it was still too soon to establish an accurate comparison.
Khalil, A., von Dadelszen, P., Draycott, T., Ugwumadu, A., O’Brien, P., & Magee, L. Change in the Incidence of Stillbirth and Preterm Delivery During the COVID-19 Pandemic. JAMA. July 2020. doi:10.1001/jama.2020.12746
JAMA study demonstrates an increase in stillbirth rates during the pandemic. The authors predict that this could either be a direct result of undetected COVID-19, since most cases in pregnant women are asymptomatic, or an indirect effect of COVID related factors.
McCoy, M. B., & Heggie, P. In-hospital formula feeding and breastfeeding duration. Pediatrics. July 2020. https://doi.org/10.1542/peds.2019-2946
New study from the American Academy of Pediatrics links in-hospital formula to earlier weaning from breastfeeding. This study adds to the evidence that infants do not breastfeed as long when they are supplemented in the hospital. Additional commentary by Drs. Lori Feldman-Winter and Ann Kellams available here.
Rafael A. Caparros-Gonzalez, & Fiona Alderdice. The COVID-19 Pandemic and Perinatal Mental Health. Journal of Reproductive and Infant Psychology. July 2020. doi: 10.1080/02646838.2020.1786910
Recent study assesses how potential stress from COVID-19 may have immediate and long term mental health effects on both mother and baby. It specifically discusses the importance of monitoring how social distancing and other measures may be reducing the feelings of social support, elevating maternal anxiety and stress, and having long lasting genetic effects on baby during gestation.
Curtice, K., & Choo, E. Indigenous populations: left behind in the COVID-19 response. Lancet (London, England). June 2020. doi: 10.1016/S0140-6736(20)31242-3
Researchers describe the underlying historical, socioeconomic, and cultural factors that have influenced the spread and management of COVID-19 in Native Communities. They also provide recommendations for next steps and measures the government and other bodies can take to better include and aid indigenous populations in COVID-19 related efforts.
You Don't Have To Be Infected To Suffer: COVID-19 and Racial Disparities in Severe Maternal Morbidity and Mortality.
Howard Minkoff. You Don't Have To Be Infected To Suffer: COVID-19 and Racial Disparities in Severe Maternal Morbidity and Mortality. Am J Perinatol. June 2020. doi:10.1055/s-0040-1713852
This article explores other ways, besides direct viral infection, by which COVID-19 may impact maternal mortality in minority populations. It looks at ways in which COVID-19 has worsened the upstream factors that enable adverse maternal events, identifies opportunities for intervention, and calls for health providers to look for solutions to maternal mortality outside of their institutions.
Diane. L. Spatz. The COVID-19 pandemic: the role of childbirth educators in promoting and protecting breastfeeding. The Journal of Perinatal Education. June 2020. doi: 10.1891/J-PE-D-20-00024
Published in the journal of perinatal education, this article by Dr. Diane Spatz focuses on the important role of childbirth educators in ensuring that families receive appropriate evidence-based information about human milk and breastfeeding as a lifesaving medical intervention in the ongoing COVID-19 pandemic
International Comparison of Guidelines for Managing Neonates at the Early Phase of the SARS-CoV-2 Pandemic
Anna Lavizzari, Claus Klingenberg, Jochen Profit, John A. F. Zupancic, Alexis S. Davis, Fabio Mosca, Eleanor J. Molloy, & Charles C. Roehr, International comparison of guidelines for managing neonates at the early phase of the SARS-CoV-2 pandemic. Pediatric Research. June 2020. doi:10.1038/s41390-020-0976-5
At the rapid onset of the COVID-19 pandemic, all countries presented protocols in place for managing infants at risk of COVID-19, with a certain degree of variations among regions. The article presents a detailed review of ad hoc guidelines and highlight similarities and differences. The authors provide a broad overview of currently applied recommendations highlighting the need for international context-relevant coordination.
Yunzhu Dong , Xiangyang Chi , Hai Huang , Liangliang Sun , Mengyao Zhang , Wei-Fen Xie & Wei Chen. Antibodies in the breast milk of a maternal woman with COVID-19. Emerging Microbes & Infections. June 2020. doi: 10.1080/22221751.2020.1780952
The emerging microbes and infection journal published an article which states that antibodies were detected in the breastmilk of a mother who was positive tested for SARS-CoV-2 in throat swabs but negative tested in other body fluids.
Association Between Mode of Delivery Among Pregnant Women With COVID-19 and Maternal and Neonatal Outcomes in Spain
Martínez-Perez O, Vouga M, Cruz Melguizo S, et al. Association Between Mode of Delivery Among Pregnant Women With COVID-19 and Maternal and Neonatal Outcomes in Spain. JAMA. June 2020. doi:10.1001/jama.2020.10125
A recent JAMA study of 82 COVID positive women giving birth in Spain found that among the 95% who presented with mild symptoms, all 53% who delivered vaginally had excellent outcomes, and 13.5% who had cesarean births had severe maternal outcomes such as admission to the ICU. Even after adjusting for confounders, cesareans were independently associated with risk of clinical deterioration. 4.2% of newborns initially tested positive but repeat testing at 48 hours was negative and none developed COVID-19 symptoms.
Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children’s Hospital in New York City, New York
Zachariah P, Johnson CL, Halabi KC, et al. Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children’s Hospital in New York City, New York. JAMA Pediatr. June 2020. doi:10.1001/jamapediatrics.2020.2430
A new study published in JAMA pediatrics examines symptoms of 50 children hospitalized in NYC with COVID-19. Not all children had respiratory symptoms. Disease was least severe in infants.
Arora KS, Mauch JT, Gibson KS. Labor and Delivery Visitor Policies During the COVID-19 Pandemic: Balancing Risks and Benefits. JAMA. May 2020; 323(24):2468–2469. doi:10.1001/jama.2020.7563
A commentary on the necessity of balancing risks and benefits in implementing a labor and delivery unit visitor policy in the face of uncertain and evolving information
Tomori, C., Gribble, K., Palmquist, A. E., Ververs, M. T., & Gross, M. S. When Separation is not the Answer: Breastfeeding Mothers and Infants affected by COVID‐19. Maternal & Child Nutrition. May 2020. https://doi.org/10.1111/mcn.13033
This paper from the Journal of Maternal and Child Nutrition spells out the problems that arise around separating moms and babies during the COVID 19 pandemic.
Salvatori G, De Rose DU, Concato C, Alario D, Olivini N, Dotta A, Campana A. Managing COVID-19-Positive Maternal–Infant Dyads: An Italian Experience. Mary Ann Liebert Inc. May 2020. doi:10.1089/bfm.2020.0095
This report documents the experience of providers with managing the positive mothers and babies during the viral outbreak in Italy.
Lori Feldman-Winter, Ann Kellams, Sigal Peter-Wohl, Julie Scott Taylor, Kimberly G. Lee, Mary J. Terrell, Lawrence Noble, Angela R. Maynor, Joan Younger Meek & Alison M. Stuebe. Pediatrics. April 2020, 145 (4) e20183696. https://doi.org/10.1542/peds.2018-3696
This review provides new evidence from the past 10 years on exclusive breastfeeding, with a focus on the early days of breastfeeding in healthy newborns ≥35 weeks’ gestation managed in the routine postpartum unit. With this evidence-based paper, the authors aim to provide clinical guidance in identifying medical indications for early supplementation and inform best practices for both birthing facilities and providers.
Rasmussen, S.A & Thompson, L.A. Coronavirus Disease 2019 and Children: What Pediatric Health Care Clinicians Need to Know. JAMA Pediatr. April 2020. doi:10.1001/jamapediatrics.2020.1224
JAMA viewpoint article provides recommendations on ways that pediatric healthcare clinicians can help to make accommodations and prep their offices, facilities, and communities for increased COVID-19 disease rate.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Children and Adolescents: A Systematic Review.
Castagnoli R, Votto M, Licari A, Brambilla I, Bruno R, Perlini S, Rovida F, Baldanti F, Marseglia GL. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Children and Adolescents: A Systematic Review. JAMA Pediatrics. April 2020. doi:10.1001/jamapediatrics.2020.1467
The systematic review that evaluates currently reported pediatric cases of SARS-CoV-2 infection. It presents findings, from an analysis of 18 studies, on the clinical features of pediatric patients with coronavirus disease 2019 (COVID-19).
Sutton D, Fuchs K, D’Alton M, Goffman D. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. New England Journal of Medicine. April 2020. doi:10.1056/NEJMc2009316
This article details the findings from universal screening to detect SARS-CoV-2 in women admitted for delivery in NYC between March 22 - April 4, 2020. Findings show that 4 women were symptomatic,13.7% of 211 asymptomatic women were positive, and 3 women developed some symptoms during hospital stay.
Rasmussen SA, Thompson LA. Coronavirus Disease 2019 and Children: What Pediatric Health Care Clinicians Need to Know. JAMA Pediatr. April 2020. doi:10.1001/jamapediatrics.2020.1224
Based on existing data, this article presents detailed information on the transmission, symptoms, prevalence, and important considerations for the management of COVID-19 in children.
Marinelli, K. A. International Perspectives Concerning Donor Milk Banking During the SARS-CoV-2 (COVID-19) Pandemic. Journal of Human Lactation. March 2020. https://doi.org/10.1177/0890334420917661
A portion of this article provides a situational analysis of donor milk banking in light of COVID-19 using reports from China, Italy, and the United States.
Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China
Zeng L, Xia S, Yuan W, et al. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatr. March 2020. doi:10.1001/jamapediatrics.2020.0878
The coronavirus disease 2019 (COVID-19) has spread rapidly across the world. With the sharp increase in the number of infections, the number of pregnant women and children with COVID-19 is also on the rise. This cohort study explores early onset infection in all neonates born to mothers with COVID-19 were recruited from Wuhan Children's Hospital, in Wuhan, Hubei Province, China.
Baud D, Giannoni E, Pomar L, Qi X, Nielsen-Saines K, Musso D, Favre G. COVID-19 in Pregnant Women-Author's Reply. The Lancet. March 2020. https://doi.org/10.1016/S1473-3099(20)30192-4
This article in the Lancet was written in response to concerns of about the previous guidelines for pregnant women with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It includes recommendations on cord clamping, breastfeeding, and the necessary precautions for maternal child care during COVID-19.
Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, Lu Y, Wang S, Xia L, Huang L, Wang K, Liang L, Zhang Y, Turtle L, Lissauer D, Lan K, Feng L, Yu H, Liu Y, Sun Z. Coronavirus Disease 2019 (COVID-19) During Pregnancy: A Case Series. February 2020. https://www.preprints.org/manuscript/202002.0373/v1
This case study describes the clinical characteristics of COVID-19 in pregnancy and their newborn infant, and explores whether the SARS-CoV-2 can be intrauterine vertically transmitted. The research concludes that there is no evidence to suggest the potential risk of intrauterine vertical transmission in the case series and further in-depth study is needed.