Association of Severe Acute Respiratory Syndrome Coronavirus 2 Infection With Early Breastfeeding.

Abstract

ObjectiveThe association of maternal SARS-CoV-2 status before delivery with breastfeeding is unknown. This study compares breastfeeding initiation, exclusivity, and duration between SARS-CoV-2-positive (+) and SARS-CoV-2-negative (-) mothers during the first two months of their newborns’ lives.MethodsA single center, retrospective cohort study of pediatric contacts during the first two months in a diverse mother-infant population (n=285) compared breastfeeding outcomes by maternal SARS-CoV-2 status during a pandemic surge. Infants of SARS-CoV-2 positive mothers were also tested before discharge. Comparison of maternal demographics (age, race, ethnicity), maternal/infant characteristics (parity, insurance, delivery mode, infant sex, hospital length of stay), and pediatric contacts by maternal SARS-CoV-2 status included Fisher's exact and Wilcoxon tests and Poisson regression for count outcomes. Logistic regression compared breastfeeding outcomes between the two groups, adjusting for potential confounders and effect modifiers.ResultsMaternal demographics and maternal/infant characteristics were similar. While 19% of mothers tested positive for SARS-CoV-2 (n=54), their infants were all negative. SARS-CoV-2 positive mothers had fewer in-person, but more virtual pediatric contacts. After controlling for the above variables, SARS-CoV-2 positive mothers had lower odds of breastfeeding initiation within 1 to 7 days of life (78% vs 88%; aOR=0.40, 95% CI: 0.17, 0.96) and of any breastfeeding during month 2 (54% vs 76%; aOR=0.37, 95% CI: 0.16, 0.86) compared with SARS-CoV-2 negative mothers.ConclusionsMaternal SARS-CoV-2 positivity at delivery was independently associated with less initiation and shorter duration of any breastfeeding during month 2. SARS-CoV-2 positive women would likely benefit from additional breastfeeding support during pandemic surges.