Protecting Breastfeeding during the COVID-19 Pandemic: A Scoping Review of Perinatal Care Recommendations in the Context of Maternal and Child Well-Being

This scoping review examined how perinatal care recommendations during the COVID-19 pandemic protected breastfeeding and maternal-child well-being. The researchers analyzed 86 publications from March 2020 to May 2021 covering delivery mode, labor support, skin-to-skin contact, breastfeeding, and visitor policies. While most recommendations correctly advised that COVID-19 infection alone did not warrant cesarean delivery, many recommendations limited maternal support during labor and birth. Early pandemic guidelines discouraged direct breastfeeding, though later recommendations better considered maternal health status, though alternative feeding options were rarely discussed.

Key points

• Most recommendations correctly stated that COVID-19 infection was not sufficient reason for cesarean section, yet cesarean rates remained high in severely ill patients
• A significant number of perinatal care recommendations deprived mothers of necessary support during labor and maternity ward stay
• Shared decision-making models were rarely evident in the recommendations reviewed
• Early COVID-19 recommendations suspended direct breastfeeding; later recommendations considered mother's health status but still rarely discussed alternative natural feeding options

Limitations

This is a scoping review of recommendations rather than an evaluation of actual clinical practice or outcomes, so it cannot determine whether recommended practices were implemented or what effects they had on breastfeeding rates and child health outcomes. The review is limited to English-language publications and may not capture all perinatal guidance issued globally.