van Goudoever Johannes B, Spatz Diane L, Hoban Rebecca, Dumitriu Dani, Gyamfi-Bannerman Cynthia, Berns Monika, McKechnie Liz, Davanzo Riccardo
Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, Netherlands.
University of Pennsylvania School of Nursing & Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Front Pediatr. 2022 Apr 26;10:867540. doi: 10.3389/fped.2022.867540. eCollection 2022.
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. As the pandemic has progressed, evidence has emerged reconfirming the value of human milk and the importance of protecting and supporting breastfeeding, especially the initiation of lactation. 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. We participated in a round table conference aiming to rescue and develop protocols and practices that support breastfeeding during the COVID-19 pandemic. One key area to target will be to maximize the use of the antenatal period. The early identification of lactation risk factors together with the development of person-centered methods to deliver breastfeeding information and education to parents-to-be will be critical. 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. That culture will also support active management of the initiation of lactation and the development of a 'back-up plan' toolkit to support the mother experiencing lactation difficulties. 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. These measures will allow for a new, adapted framework of practice that acknowledges the current COVID-19 paradigm and maintains the emphasis on the need to protect and support breastfeeding and the use of human milk.
新冠疫情对全球母乳喂养和泌乳产生了影响，疫情初期实施的临床做法大多是反母乳喂养的，例如将母亲与婴儿分开，而且并非基于证据。随着疫情的发展，有证据再次证实了母乳的价值以及保护和支持母乳喂养的重要性，尤其是泌乳的启动。然而，很明显新冠疫情改变了围绕母乳喂养和泌乳支持的临床护理模式，因此，做法必须适应和演变，以继续强调泌乳支持。我们参加了一次圆桌会议，旨在挽救和制定在新冠疫情期间支持母乳喂养的方案和做法。一个关键的目标领域将是最大限度地利用产前阶段。尽早识别泌乳风险因素，并开发以个人为中心的方法，向准父母提供母乳喂养信息和教育，将至关重要。此外，建立重视母乳喂养并优先使用母乳的医院文化，对于激励医护人员将不可或缺。这种文化还将支持对泌乳启动进行积极管理，并开发一个“备用计划”工具包，以支持遇到泌乳困难的母亲。出院后的支持也很关键，要开展面对面和虚拟的泌乳支持项目，特别是在出院后的 immediate 时期，以使经历早期出院过程的母亲受益。这些措施将促成一个新的、经过调整的实践框架，该框架承认当前的新冠疫情模式，并继续强调保护和支持母乳喂养以及使用母乳的必要性。
