Changes in breastfeeding support in maternity hospitals due to the COVID-19 pandemic from the perspective of healthcare professionals in Germany.

PURPOSE: The COVID-19 pandemic had an impact on obstetrics and breastfeeding, but data from hospital experiences are rare. This study assessed routines of breastfeeding management in maternity hospitals before and during the pandemic.

METHODS

In the SINA study (Breastfeeding in North Rhine-Westphalia, Germany) between October 2021 and March 2022 hospitals had experienced the pandemic for more than one year. In the statewide cross-sectional survey, chief physicians and responsible ward staff were interviewed by phone about breastfeeding support structures and practices before the pandemic, as well as any changes due to the pandemic. The Recommendations of the German National Breastfeeding Committee based on the 'Ten Steps to Successful Breastfeeding' of the World Health Organization and the United Nations Children's Fund, served as a reference for creating a Breastfeeding Promotion Index (scaled 0-10 points) and analyze associations between breastfeeding promotion and hospital characteristics.

RESULTS

In the study sample (n = 36 hospitals) the BPI did not differ in terms of perinatal care level, annual birthrate, staff qualification or maternal length of stay, but was higher for Breastfeeding Friendly certification and higher breastfeeding rate at discharge. Core components of breastfeeding support were not affected by the pandemic. Extent and formats of staff training and antenatal breastfeeding information changed drastically, mostly to digital formats, which most hospitals planned to retain beyond the pandemic.

CONCLUSION

As an experiment born out of necessity the pandemic may raise awareness of challenging trends as shortened maternal stay and may encourage hospitals to expand digital formats of breastfeeding information for staff and mothers.