580 women out of 669 responders were enrolled (Figure 1). The basic characteristics of the study population are presented in Table 1. Participant’s mean age was 32.55 (std. 4.197) range 21-48. The majority of participants were multiparous. The mean infant age was 3.04 months. Most mothers were still on maternity leave at the time of the questionnaire.
Table 1
Background characteristics of women who completed the survey:
Data
|
Category
|
Count (%)
|
Mother’s age
|
≤ 21
|
2 (3)
|
|
22-29
|
125 (21.6)
|
|
30-39
|
428 (73.8)
|
|
≥ 40
|
25 (4.3)
|
|
Total: mean 32.55 st.d* 4.197
|
|
Baby's age (months)
|
Mean: 3.04, st.d* 1.671
|
|
Parity
|
First child
|
203 (35)
|
Had other kids
|
377 (65)
|
Marital status
|
Married
|
572 (98.6)
|
Not married
|
8 (1.4)
|
Type of birth
|
Regular
|
497 (85.6)
|
Cesarean
|
83 (14.3)
|
Currently employed
|
yes
|
70 (12)
|
Maternity leave
|
324 (56)
|
No
|
186 (32)
|
Partner working status
|
works
|
457 (79)
|
Does not work
|
115 (20)
|
Do not have a partner
|
8 (1)
|
Education
|
Less than 12 years
|
2 (0.3)
|
High school
|
30 (5)
|
Professional diploma
|
34 (6)
|
Bachelor's degree
|
276 (47.5)
|
Master’s degree and above
|
238 (41)
|
Participants were asked about their breastfeeding during the quarantine and if they received support from friends, family, and/or breastfeeding consultation since the birth (Table 2). Most of the women had not been in quarantine due to Covid-19 disease or exposure since the birth. Of those who were, less than 1% were separated from their children during the quarantine. Most women reported support from their partner, mother, mother-in-law, and friends. At the time of survey completion, 74% of the children were breastfed. Most women reported breastfeeding consultation in the hospital, but less than 50% received such consultation after discharge.
Table 2
Summary of survey answers regarding breastfeeding
Data
|
Number of Women answered Yes (Percent %)
|
Number of Women answered No (Percent %)
|
In quarantine since birth
|
51 (9)
|
529 (91)
|
Separate from the baby
|
4 (0.7)
|
578 (99.3)
|
Taking a stroll to unwind
|
493 (85)
|
87 (15)
|
Breastfeeding consult in the hospital
|
393 (67.8)
|
187 (32.2)
|
Breastfeeding consult at home
|
261 (45)
|
319 (55)
|
Breastfeeding consult in the hospital and at home
|
216 (37.2)
|
363 (62.8)
|
No consult (hospital or home)
|
438 (75.5)
|
142 (24.5)
|
Influence on Breastfeeding
Participants were asked to rank in their opinion, the influence of different steps which can influence and encourage breastfeeding. They could fill in their opinion if the step will help, will not help or is irrelevant to them. More than 90% of the women reported a positive impact of extending maternity leave, receiving breastfeeding consultation at home and in the hospital. More than 80% of the women reported a positive impact from instruction on pumping milk, having the opportunity to work from home, receiving telephone breastfeeding consulting and watching guidance videos for breastfeeding. However, only 70% of the women believed virtual meeting groups with other mothers would encourage breastfeeding.
Participants were also given the opportunity to provide free-text answers regarding association of lactation and the COVID-19 pandemic. Out of 580 participants, 96 women answered this question and discussed challenges they faced during the first lockdown. The main issues raised were lack of spare time due to other children in the house, financial difficulty, mental stress, and dissatisfaction with breastfeeding consultations they received.
Women were asked what was the effect of the COVID-19 pandemic on their planned breastfeeding duration. Out of 580 women, 127 (22%) women reported changes in their lactation plans. Of these, 85 (15%) said the COVID-19 pandemic extended their lactation and 42 (7%) said it shortened it.
Table 3
Logistic regression analyzing factors associated with longer than planned breastfeeding due to the pandemic.
Criterion
|
Odds ratio
|
95% Confidence interval
|
|
|
2.50%
|
97.50%
|
(Intercept)
|
0.03
|
0
|
0.41
|
Baby younger than 3.5 months
|
1
|
reference
|
|
Baby older than 3.5 months
|
1.47
|
0.91
|
2.36
|
Marital status- not married
|
1
|
reference
|
|
Marital status - married
|
1.71
|
0.2
|
14.59
|
Baby has siblings
|
1
|
reference
|
|
Baby is the only child
|
1.2
|
0.73
|
1.96
|
Returned to work at the expected time
|
1
|
reference
|
|
Returned to work later than expected
|
2.4
|
1.47
|
3.92***
|
Mother's age
|
1
|
0.98
|
1.02
|
No academic education
|
1
|
reference
|
|
University degree
|
2.03
|
0.83
|
4.97
|
***p <0.001
Table 3 shows the results of a logistic regression analyzing factors associated with longer than planned breastfeeding due to the pandemic. Participants who reported their maternity leave was de-facto extended due to the pandemic were 2.38 times more likely to breastfeed for a longer period than they expected.