COVID-19 and MCH Research

Nature article discusses findings from various studies on the potential effects of vaccines for breastfeeding, and pregnant people. It explores and addresses concerns about benefits and safety of vaccination for pregnant and breastfeeding people, as well as their babies, and provides insights into future research in this area.

Recently published article in the International Journal for Equity in Health describes the Breastfeeding Heritage and Pride Program (BHP), a program that provides breastfeeding support to predominantly low-income minority mothers in Connecticut and Massachusetts.

Villar et al. conducted a multinational cohort study to evaluate the risks associated with COVID-19 during pregnancy on maternal and neonatal outcomes. The findings indicate that pregnant individuals with COVID-19 diagnosis, and their newborns had increased risks mortality and morbidity postpartum.

​Exclusive breastfeeding, child mortality, and economic cost in Sub-Saharan Africa

​In this recent Pediatrics publication, Pretorius and colleagues assess the impact of exclusive breastfeeding (EBF) practices as it relates to the mortality rates of children under 5 years and economic growth at the country level in Sub-Saharan Africa. The authors concluded that EBF implementation has economic benefits and should be prioritized within the region. This article is also accompanied by a commentary from World Bank leadership about the worldwide economic importance of exclusive breastfeeding.

​Acta paediatrica publication provides evidence that excluding mothers who have tested positive for SARS-CoV-2 from donating breast milk is no longer appropriate in light of current data. They recommend that symptomatic mothers should be allowed to donate when they are no longer contagious and provide a three point plan to ensure that adequate milk supply is available for preterm infants who need it.

​Rollins et al. present the Lives Saved Tool, an approach for deciding public health policy on infant feeding and mother–infant contact which balances the risks that are associated with viral infection against child survival, lifelong health, development, and also maternal health. Using this tool, they assessed the effect of various policies on infant mortality and found that greater infant deaths are predicted if COVID positive mothers are separated from their newborns and asked to avoid breastfeeding.

​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.

​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.

​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

​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 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.

​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 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.

​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.

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.

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.

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.

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.

​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.

​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.