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doi: 10.1097/ANC.0000000000000128, 65. (2021) 6:e004575. The authors are grateful for the facilitation of the Roundtable discussion provided by Medela AG through the efforts of Severine Liabat, Angela Heer, Nania G. Schrer-Hernndez, Ph.D., and Leon R. Mitoulas, Ph.D. (2021) 110:935936. This survey study uses data from the National Immunization SurveyChild to examine trends in early formula supplementation by race/ethnicity among US children born during the period from 2009 to 2015. Human milk is all a baby needs for the first six months of life, said Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC, lead author of the reports, written by the AAP Section on Breastfeeding. This cohort study assesses the concentration of SARS-CoV-2 antibodies in the breast milk of women who received vaccines for COVID-19 and their correlation with serum antibody levels. Post-discharge support will also be crucial with the development of both in-person and virtual lactation support programs, in particular for the immediate post-discharge period to benefit mothers who experience an early discharge process. Am J Perinatol. doi: 10.1001/jamapediatrics.2022.0084, 22. These techniques use highly targeted algorithms and cross promotional techniques across various digital platforms. Breastmilk provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a childs nutritional needs during the second half of the first year, and up to one third during the second year of life. There are roughly 90 social media posts a day by formula milk companies reaching 229 million users. The AAP outlines its recommendations and evidence of significant health benefits to infant and mother within an updated policy statement and technical report, both titled, Breastfeeding and the Use of Human Milk Published in the July 2022 issue of Pediatrics and available online June 27. Over 820 000 children could be saved yearly if all children 0-23 months were optimally breastfed. We know globally, breastfeeding rates are low, so in the first guidance report, WHO surveyed 8,500 parents, pregnant women and health workers on their exposure to formula milk marketing in a range of countries such as China, Mexico and the United Kingdom. BMC Pregn Childb. Ferraz Dos Santos L, Borges RF, de Azambuja DA. The current antenatal paradigm is neither allowing all families to make an informed feeding decision nor is it effectively preparing families about the physiology of lactation and the science of human milk (36). Improving human milk and breastfeeding practices in the NICU. (2020) 37:S14. Hurst NM. In this regard, it is important that hospital practices and protocols take into account maternal lactation risk factors known to impact the initiation of lactation, e.g., preterm birth, gestational diabetes, maternal obesity, cesarean section and primiparity, mother-infant separation, and that these are included in the breastfeeding plan (4957). As part of an international network of charities, we have been funding life-saving research, influencing global public health policy and educating the public since 1982. Of particular importance is the immediate post discharge period, especially considering the Academy of Breastfeeding current recommendation that all breastfed infants be seen by a healthcare provider at 35 days of life or within 4872 h of discharge (71). JAMA Pediatr. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Theres a place for you in the Academy no matter where you are in your career. Some of these techniques include promotions, sponsored and targeted advertisements when thinking about breastfeeding or not. doi: 10.1080/14767058.2021.1986482. The policy also notes that children of gender-diverse parents may have less access to human milk because of both social and biological constraints. It was interesting to learn that formula milk companies reach 3x as many people through social media than non-commercial accounts on breastfeeding. Vu Hoang D, Cashin J, Gribble K, Marinelli K, Mathisen R. Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization recommendations. Does insulin explain the relation between maternal obesity and poor lactation outcomes? doi: 10.1038/s41390-021-01902-y, 16. Ronchi A, Pietrasanta C, Zavattoni M, Saruggia M, Schena F, Sinelli MT, et al. (2020) 15:53845. doi: 10.3201/eid1002.030736, 19. (2020) 150:184188. Birth. doi: 10.1111/j.1523-536X.2010.00446.x, 43. Snyder K, Worlton G. Social support during COVID-19: perspectives of breastfeeding mothers. Am J Obstet Gynecol MFM. Please note, Internet Explorer is no longer up-to-date and can cause problems in how this website functionsThis site functions best using the latest versions of any of the following browsers: Edge, Firefox, Chrome, Opera, or Safari. Juncker HG, Mulleners SJ, Coenen ERM, van Goudoever JB, van Gils MJ, van Keulen BJ. Indeed, person-centered, emotional care may be as important as the educational content of a breastfeeding support program (42). Breastfeed Med. (2022). Therefore, it is incumbent upon healthcare professionals to adapt to the current COVID-19 environment and conditions with respect to the development of protocols and practices that support breastfeeding. It appears you are using Internet Explorer as your web browser. Telehealth and breastfeeding: an integrative review. 30. World Breastfeeding Week is an opportunity to showcase the positive benefits of breastfeeding (where possible) and drive the noise away from the harmful marketing tactics used by the formula industry. doi: 10.1136/archdischild-2020-319791, 17. Matern Child Nutr. Copyright 2022 American Academy of Pediatrics. This cohort study measures -9-tetrahydrocannabinol levels in breast milk and serum samples from women who were newly abstinent from marijuana and had just delivered an infant. (2021) 175:26066. MCN Am J Matern Child Nurs. Meier PP, Patel AL, Hoban R, Engstrom JL. Up to what age can a baby stay well nourished by just being breastfed? The editor and reviewer's affiliations are the latest provided on their Loop research profiles and may not reflect their situation at the time of review. Front. (2021) 8:633700. doi: 10.3389/fped.2020.633700, 23. An overview of the literature. Of particular concern was the issue of vertical transmission between mother and infant. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. 63. Adv Neonatal Care. doi: 10.1089/bfm.2015.0141, 67. Getting it right the critical window to effectively establish lactation. 9. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Fox A, Marino J, Amanat F, Krammer F, Hahn-Holbrook J, Zolla-Pazner S, et al. doi: 10.1097/NMC.0000000000000672, 5. Markwei M, Goje O. Optimizing mother-baby wellness during the 2019 coronavirus disease pandemic: a case for telemedicine. Families deserve nonjudgmental support, information and help to guide them in feeding their infant.. Exclusive breastfeeding for the first 6 months. 2022 American Medical Association. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Breastfed children perform better on intelligence tests, are less likely to be overweight or obese and less prone to diabetes later in life. doi: 10.1001/jamapediatrics.2020.5086, 69. 6. (2017) 41:17586. Dtsch Arztebl Int. Home - Public Policy - Breastfeeding across the world in 2022. (2020) 40(Suppl. (2021) 16:3945. Hobbs AJ, Mannion CA, McDonald SW, Brockway M, Tough SC. J Med Internet Res. doi: 10.1038/s41372-020-0753-7, 25. 73. For mothers with known risk factors to initiation, such as preterm birth, gestational diabetes mellitus, cesarean section and primiparity (4952, 5557), or those who experience difficulties during the initiation stage, the second line-of-action interventions also need to be viewed using a COVID-19 lens. doi: 10.1542/peds.112.3.607, 56. Breastfeed Med. In Ireland, my home country, breastfeeding rates have continued to decline. As the pandemic continues, there is the concern that this disruption to recognized quality standards of care will continue over the long term, as a sort of system inertia in hospitals (5), at the expense of practices known to promote and protect breastfeeding (22). WCRF International welcomes plans for WHO to introduce new guidance on digital marketing restrictions for breastmilk substitutes. Inappropriate marketing of breast-milk substitutes continues to undermine efforts to improve breastfeeding rates and duration worldwide. In this regard, it is important to emphasize that known or suspected infection of SARS-CoV-2 of a mother does not necessitate the automatic separation of mother and infant (27, 35). By engaging with parents-to-be in this phase, there is an opportunity to educate them on the importance of the initiation of lactation and to develop a holistic breastfeeding plan that works within the hospital breastfeeding initiation protocols. JG serves as member of the National Health Council and is also director of the Dutch National Human Milk Bank. While some countries do have legislation in place, implementation and enforcement can often be weak and exploited. Accordingly, global health organizations such as the WHO, UNICEF and other non-governmental entities were already engaged in programs to improve breastfeeding initiation and duration rates worldwide. (2016) 4:102536. As discharge timeframes have shortened significantly (31), although not universally (5) and lactation support staff and education has been reduced (22), post discharge clinical support for breastfeeding is more important than ever before. doi: 10.1001/jama.2020.7563, 24. Shek CC, Ng PC, Fung GPG, Cheng FWT, Chan PKS, Peiris MJS, et al. Implementation Guidance: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services the Revised Baby-Friendly Hospital Initiative. In addition to the development of adaptive protocols as a first line to protect and promote breastfeeding and lactation, it is also important to adjust any anticipatory guidance to the same COVID-19 circumstances. Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Am J Perinatol. iScience. (2021) 46:3035. As such, it is important to establish an institutional culture that prioritizes the use of human milk (64) to facilitate the implementation of interventions supporting breastfeeding. Cheema R, Partridge E, Kair LR, Kuhn-Riordon KM, Silva AI, Bettinelli ME, et al. Merewood A, Davanzo R, Haas-Kogan M, Vertecchi G, Gizzi C, Mosca F, et al. The AAP is dedicated to the health of all children and the pediatric professionals who care for them. Multi-centre study showed reduced compliance with the World Health Organization recommendations on exclusive breastfeeding during COVID-19. When separation is not the answer: breastfeeding mothers and infants affected by COVID-19. JAMA. (2021) 106:112113. AAP recommends that birth hospitals or centers implement maternity care practices that improve breastfeeding initiation, duration, and exclusivity. Davanzo R, Merewood A, Manzoni P. Skin-to-skin contact at birth in the COVID-19 era: in need of help! A control framework to optimize public health policies in the course of the COVID-19 pandemic. Lancet Diabetes Endocrinol. In addition, the establishment of a hospital culture that values breastfeeding and prioritizes the use of human milk will be integral for the motivation of health care professionals. Harriel KL, Nolt D, Moore S, Kressly S, Bernstein HH. doi: 10.3945/ajcn.2010.29192, 54. However, the COVID-19 pandemic with its multiple lockdown episodes resulted in a reduction of face-to-face professional and peer support (43) although this has been at least partially addressed by the rapid implementation of telemedicine services (44). 8. WHO UNICEF. Indeed, the value of breastfeeding and human milk to public health has been well-documented (7). Am J Clin Nutr. Spatz DL. Melchior H, Kurch-Bek D, Mund M. The prevalence of gestational diabetes. The critical window of opportunity: lactation initiation following cesarean birth. Additionally, specific post-discharge challenges like latch difficulties may be better addressed in-person. Long-term breastfeeding is associated with protections against diabetes, high blood pressure, and cancers of the breast and ovaries. Breastfeed Med. Incidence of SARS-CoV-2 vertical transmission: a meta-analysis. Current data on SARS-CoV-2 and vertical transmission have agreed with the historical data, with no active virus being found in human milk (15) and very limited evidence of confirmed congenital SARS-CoV-2 infection (16, 17). Engagement of health care professionals via quality improvement (QI) programs has been shown to be one way to address institutional barriers to human milk usage; indeed staff education and motivation is one QI initiative that can be used to obtain stakeholder buy in (65), as is a multidisciplinary approach (66). (2019) 46:11320. Sci Rep. (2021) 28:13403. doi: 10.1038/s41598-021-92636-8, 3. J Pediatr. Interventions for promoting the initiation of breastfeeding. status of implementation of the International Code (2022) 107:21621. (2016) 36:4939. Global Breastfeeding Scorecard, 2018: Enabling Women to Breastfeed Through Better Policies and Programmes. of Marketing of Breast-milk Substitutes (BMS) and Digital technologies are increasingly used for marketing food products throughout the world. Almohanna AA, Win KT, Meedya S. Effectiveness of internet-based electronic technology interventions on breastfeeding outcomes: systematic review. Pediatr. Learn how your gifts makes that possible. (COVID-19) pandemic. Lastly, recognized protocols for the storage and use of the collected milk also need to be set in place. All Rights Reserved. Acta Obstet Gynecol Scand. doi: 10.1089/bfm.2015.0120, 51. Breastfeed Med. However, nearly 2 out of 3 infants are not exclusively breastfed for the recommended 6 monthsa rate that has not improved in 2 decades. Schmied V, Beake S, Sheehan A, McCourt C, Dykes F. Women's perceptions and experiences of breastfeeding support: a metasynthesis. Infants should be breastfed on demand that is as often as the child wants, day and night. 1. Bauerl C, Randazzo W, Snchez G, Selma-Royo M, Garca Verdevio E, Martnez L, et al. (2022) e220084. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. From looking into the situation in Ireland, I found that many mothers both expecting parents and those already with a young child fall victim of destructive marketing tactics used by formula milk companies through targeted promotions, marketing techniques and digital media. doi: 10.1055/s-0040-1714255, 27. Indeed, there is growing evidence for the embracing of telemedicine methodologies (45), including for breastfeeding support (43, 46, 47). (2020). Spatz DL, Davanzo R, Mller JA, Powell R, Rigourd V, Yates A, et al. doi: 10.1136/bmjgh-2020-004575, 45. One-on-one and face-to-face support is favored due to its ability to deliver both practical advice as well as emotional support. Policies that protect breastfeeding, including universal paid maternity leave; the right of a woman to breastfeed in public; insurance coverage for lactation support and breast pumps; on-site child care; universal workplace break time with a clean, private location for expressing milk; the right to feed expressed milk; and the right to breastfeed in child care centers and lactation rooms in schools are all essential to supporting families in sustaining breastfeeding. doi: 10.2196/17361, 47. Separation of the infant from the mother at birth was also shown to negatively correlate with breastfeeding at discharge (32, 33) and Bartick et al. The updates include a recommendation to support parents who choose to breastfeed their infant to age 2 and beyond. The COVID-19 pandemic has impacted breastfeeding and lactation globally, with clinical practices implemented early in the pandemic being mostly anti-breastfeeding, e.g., separation of mothers from their infants, and not evidence based. American Academy of Pediatrics Calls for More Support for Breastfeeding Mothers Within Updated Policy Recommendations, Long-term Follow-up Care for Childhood, Adolescent and Young Adult Cancer Survivors, Roadmap for Care of Cancer Survivors: Joint Report Updates Recommendations, American Academy of Pediatrics Offers Guidance for Caring and Treatment of Long-Term Cancer Survivors, Childhood Cancer Survivors: What to Expect After Treatment, Transition Plan: Advancing Child Health in the Biden-Harris Administration, Childrens Health Care Coverage Fact Sheets, Prep- Pediatric Review and Education Programs, Practice Research in the Office Setting (PROS). Greenville, NC: East Carolina University (2021). Joint statement by UNICEF Executive Director Catherine Russell and WHO Director-General Dr Tedros Adhanom Ghebreyesus on the occasion of World Breastfeeding Week, Launch of the COVID-19 impact on nutrition Analytical Framework, WHO reveals shocking extent of exploitative formula milk marketing, More than half of parents and pregnant women exposed to aggressive formula milk marketing WHO, UNICEF, Webinar series: the problem with the formula milk industry, Launch of new WHO report on the scope and impact of digital marketing for the promotion of breast-milk substitutes, Call for proposals Support for the development of WHO guidelines on donor human milk banking, Call for proposals BFHI Internal Monitoring Manual, Call for consultant on Infant and Young Child Feeding. J Obstet Gynecol Neonatal Nurs. However, it should be recognized that despite these encouraging outcomes, some mothers still have mixed feelings in relation to telehealth services and desire the emotional care that comes from in-person support from family, friends and lactation healthcare professionals (43, 77). Semin Perinatol. doi: 10.1089/bfm.2020.0200, Keywords: human milk, COVID-19, pandemic, breastfeeding, clinical practice, Citation: van Goudoever JB, Spatz DL, Hoban R, Dumitriu D, Gyamfi-Bannerman C, Berns M, McKechnie L and Davanzo R (2022) Updating Clinical Practices to Promote and Protect Human Milk and Breastfeeding in a COVID-19 Era. J Matern Fetal Neonatal Med. Such a plan forms the intersection between maternal education/readiness and facility preparedness (i.e., the implementation of breastfeeding promoting protocols and processes), with respect to the early postpartum support of breastfeeding. (2020) 15:698702. (2020) 15:85. doi: 10.1186/s13006-020-00328-2, 42. Breastfeed Med. Protecting breastfeeding during the COVID-19 pandemic. All Rights Reserved. It is strongly suggested that healthcare professionals take ownership of the antenatal care phase and maximize this period when parents-to-be have more time to absorb and process information. Mothers who choose to breastfeed beyond the first year need support from their medical care providers, as well as protections against workplace barriers. Center for Humanitarian Health Johns Johns Hopkins Bloomberg School of Public Health Centre for Humanitarian Health Johns Hopkins University USA. Telehealth can promote breastfeeding during the COVID-19 pandemic. 10:867540. doi: 10.3389/fped.2022.867540. J Midwifery Womens Health. Dumitriu D, Emeruwa UN, Hanft E, Liao GV, Ludwig E, Walzer L, et al. (2019) 85:662670. New Breath-Driven Concept Set to Transform Access to Hand Prosthetics, Organoid Production Breakthrough to Help Accelerate Disease and Drug Development Research, Songbird Can Keep Time With the Best of Them, Wireless Activation of Targeted Brain Circuits in Less Than One Second, Stress Transmitter Wakes Your Brain More Than 100 Times a Night -- And It Is Perfectly Normal, Exploring Factors That May Underlie How Domestic Cats Can Live in Groups, Scent of a Friend: Similarities in Body Odor May Contribute to Social Bonding, Turn Up the Beat! Del Ro R, Dip Prez E, Marn Gabriel M. Virtual Lactation Support for Breastfeeding Mothers During the Early Postpartum Period [DNP Scholarly Project]. doi: 10.1089/bfm.2019.0298, 61. doi: 10.1111/mcn.13033, 26. doi: 10.1111/mcn.13010, 36. doi: 10.3945/an.115.011007, 52. Curr Opin Pediatr. Arch Dis Child Fetal Neonatal Ed. This cross-sectional study evaluated American Board of Medical Specialties member boards lactation-specific board examination accommodation policies and corroborated the outcomes of these policies by comparing the self-reported experiences of lactating or potentially lactating female physicians with board examinations. (2020) 16:5860. There is no need to introduce infant formula or other sources of nutrition for most infants. (2021) 16:18999. The introduction of extensive anti-breastfeeding practices early in the course of the pandemic was a consequence of the lack of information and preparedness in developing recommendations for pregnant and breastfeeding women and their infants (10). These protocols should be rescued and developed from the pre-pandemic era and appropriately integrated with the new science of coping with the risk of SARS-CoV-2 transmission (35). However, it is clear that COVID-19 has changed the clinical care paradigm around breastfeeding and lactation support and, as such, it is imperative that practices adapt and evolve to maintain the emphasis on lactation support. Questions? As such, it will be the adaptation of those known protocols to fit within post COVID-19 institutional restrictions that will be most critical. doi: 10.1016/j.jpeds.2020.08.004, 34. J Perinatol. Patel AL, Schoeny ME, Hoban R, Johnson TJ, Bigger H, Engstrom JL, et al. (2004) 10:168990. Parry KC, Tully KP, Hopper LN, Schildkamp PE, Labbok MH. doi: 10.3201/eid1009.040244, 14. (2021) 17:e13088. This cross-sectional study investigates the association between consumption of maternal breast milk and cardiac performance at age 1 year among individuals born preterm. Geneva: World Health Organization (2018). Figure 1. Views expressed here do not necessarily reflect those of ScienceDaily, its staff, its contributors, or its partners. Notably, the impact of a reduction in lactation support in this manner affects both mothers with and without COVID-19 (31). doi: 10.1097/MOP.0000000000000931, 74. Birth. When autocomplete results are available use up and down arrows to review and enter to select. Vertical transmission of coronavirus disease 2019: a systematic review and meta-analysis. Similar to antenatal support, telehealth or virtual strategies are one way of bridging the post-discharge follow-up gap and may be a way of creating an on-call, 24/7 support service for new mothers.