University of Wisconsin–Madison Medical College of Wisconsin

Enablers and Challenges of Breastfeeding During the COVID-19 Pandemic

Caitlin J. Regner, MD; Aleksandra E. Zgierska, MD, PhD; Robert P. Lennon, MD, JD; Ellen Goldstein, PhD, MFT

WMJ. 2024;123(6):508-514.

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ABSTRACT

Introduction: The COVID-19 pandemic greatly affected access to breastfeeding support. Limited research has evaluated the pandemic’s impact on postpartum individuals’ decisions to breastfeed during this time. This qualitative survey study described breastfeeding-related attitudes, decision-making, and experience of postpartum people early in the COVID-19 pandemic.

Methods: New mothers (< 6 months postpartum) were identified via electronic health records at 2 academic health care systems located in Northeastern and Midwestern United States and were invited via mailings and phone to complete a cross-sectional online survey assessing the impact of COVID-19 on mental and physical health and coping. Thematic analysis was conducted to organize responses into categories of impact (positive, negative, neutral), highlighting the major themes of the influence of COVID-19 on breastfeeding.

Results: A total of 216 participants responded (66 Northeast, 150 Midwest), and the majority (64.6%) were age 31 to 45 years old. The predominance of positive themes associated with the pandemic that enabled participants’ decisions to breastfeed were health benefits, convenience and ease, and changes in work routines, whereas the major challenges exacerbated by the pandemic were access to lactation support, mental health/stress, and COVID-19 restrictions. Breastfeeding decisions that were not explicitly affected by the pandemic included prior feeding intention and experience, as well as knowledge of importance and benefits.

Conclusions: Findings from this survey study enrich our understanding of the pandemic’s impact on breastfeeding motivations and practices. As health care systems and policymakers seek to improve support for breastfeeding, feedback from postpartum mothers may suggest new ways to overcome barriers that arise in times of crisis.


Author Affiliations: Access Community Health Centers, Madison, Wisconsin (Regner); Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Regner); Department of Family and Community Medicine, College of Medicine, Penn State, Hershey, Pennsylvania (Zgierska, Lennon); Departments of Anesthesiology and Perioperative Medicine, and Public Health Sciences, College of Medicine, Penn State, Hershey, Pennsylvania (Zgierska); Department of Population Health Science Nursing Science, University of Illinois at Chicago, Chicago, Illinois (Goldstein).
Corresponding Author: Caitlin Regner, MD, Family Medicine Physician and Assistant Clinical Professor, Joyce & Marshall Erdman Clinic, 2202 S Park St, Madison WI 53713; email Caitlin.Regner@accesshealthwi.org; ORCID ID 0000-0002-5815-0306
Funding/Support: This study was supported by funds from the University of Wisconsin School of Medicine and Public Health and Department of Family Medicine and Community Health and from the Penn State Social Science Research Institute and the Huck Institutes of the Life Sciences.
Financial Disclosures: None declared.
Ethical Approval: The University of Wisconsin Health Sciences Institutional Review Board conducted an expedited review and approved this study (Submission ID: 2020-1350) as minimal risk on November 23, 2020. The Penn State Institutional Review Board conducted an expedited review and approved this study (Submission ID: 00015505) as minimal risk on July 22, 2020.
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