Breastfeeding Practices for COVID-19 Infected Mothers. A Systematic Review and Meta-analysis of the current literature.

Abstract

Introduction: As the COVID-19 pandemic continues, more and more women are giving birth while battling SARS-CoV-2. Aim: The aim of this review is to investigate the risk of transmission of the coronavirus from mother to infant during breastfeeding, skin-to-skin contact, and Rooming-in and to explore ways of managing covid-19 positive maternal-infant dyads. Maternity care practices such as skin-toskin care, rooming-in, and direct breastfeeding are recommended, but it is unclear if these practices increase the risk of clinically significant COVID-19 in newborns, and if disruption of these practices adversely affects breastfeeding. Methods: searches were accomplished in various databases and specifically in Cochrane Library, PubMed Central and Scopus up to 30th November 2021, using the Matrix Method and guided by the PRISMA, to identify studies involving mothers infected with COVID-19 and their infants in the early postpartum period. Criteria included English Language, broad search terms, full-text reviews and articles published from December of 2019 as well as the first case that appeared then. A meta-analysis was also performed to estimate the infection of infants from infected mothers who breastfed, had Skin to skin contact and did Rooming-in. Findings: A total of 18 studies were included in this review. The rate of infected infants was 2,8%. The maternal practices were used in these studies varied from the direct separation of the dyad to direct skin-to-skin contact, Rooming-in and exclusive breastfeeding. One study examined the factors associated with positive tests in newborns. This study showed that the only factor was the maternal social vulnerability index>90. The type of delivery, Rooming-in, and if the mother had symptoms or not were associated with positive neonatal outcomes. Conclusion: The rate of perinatal infection is low. Breastfeeding, skin-to-skin contact, and Rooming-in are recommended to follow all protective measures such as strict hand hygiene, the use of masks and breast cleaning when it is necessary and not after each breastfeeding. Keywords: covid-19, coronavirus, SARS-CoV-2, breastfeeding, maternal practices, skin-to-skin contact, rooming in.