Lactancia materna en tiempos de COVID-19: una <i>scoping review</i>

scoping review, con búsqueda en siete bases de datos. Se incluyeron estudios disponibles en su totalidad, en inglés, portugués o español, publicados entre diciembre/2019 y abril/2021. El análisis se llevó a cabo mediante la categorización de temas comunes.

Resultados:

se incluyeron 25 estudios, agrupados en cinco categorías, que presentan la influencia de la pandemia: en la rutina de cuidados de la lactancia materna, evidenciando medidas preventivas contra la COVID-19; en las tasas de lactancia materna, destacando los cambios en las prácticas dietéticas; en la red de apoyo a la lactancia materna, indicando falta de asistencia en el servicio; en las emociones de las puérperas, con predominio de preocupación y estrés; en el uso de tecnología para apoyar la lactancia materna, con teleservicio facilitando la asistencia.

Conclusión:

la pandemia de COVID-19 influyó en las nuevas formas de asistencia, en la oferta y duración de la lactancia materna, en la salud emocional y en la fragilidad de la red de apoyo. Se espera contribuir para que los profesionales de la salud brinden asistencia con mayor asertividad ante esta nueva situación.

DESCRIPTORES
Periodo Posparto; Lactancia Materna; COVID-19; Revisión

Country/year	Objective	Population
USA/2021(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323 https://doi.org/10.1089/bfm.2020.0323... )	Build support and promotion of breastfeeding in the community, change health behavior through peer support, and address the social and economic determinants of health as a means of addressing breastfeeding as a public health imperative.	Pregnant women and postpartum women (n = 110)
Brazil/2021(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012 https://doi.org/10.1590/1806-9304202100S... )	Analyze the clinical conditions for breastfeeding, which is a crucial opportunity for postpartum women and their children, in addition to preexisting guidelines on this topic. The study also observed the impacts of the SARS-CoV-2 pandemic on the affective mother-fetus dyad bond.	Postpartum women
China/2020(²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752 https://doi.org/10.1016/j.nmni.2020.1007... )	Assess the clinical and immunological characteristics of mother-infant pairs affected by COVID-19, breast milk specifically tested for pathogens, SARS-CoV-2 neutralizing antibodies and immune components. Explore the feasibility of breastfeeding and related transmission possibilities.	Pregnant women and postpartum women (n = 14)
USA/2021(²⁴24. Mayopoulos GA, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, et al. COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. J Affect Disord. 2021;282:122-5. DOI: https://doi.org/10.1016/j.jad.2020.12.101 https://doi.org/10.1016/j.jad.2020.12.10... )	Study a large sample of women who gave birth during the first spikes of COVID-19 and compare them with women who gave birth before the pandemic. Ask whether COVID-19 is associated with stressful childbirth and whether acute childbirth stress mediates the association between the presence of COVID-19 in communities and long-term post-traumatic stress and maternal bonding problems.	Postpartum women (n = 1274)
Vietnam/2021(²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837 https://doi.org/10.1111/apa.15837... )	To describe the use of Early Essential Newborn Care (EENC) for the first childbirth of COVID-19 in Vietnam, at Hoa Vang Medical Center, a 170-bed district hospital in Da Nang City designated to manage COVID-19 cases.	Postpartum women (n = 1)
USA/2020(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf https://www.cdc.gov/mmwr/volumes/69/wr/p... )	Ask about current hospital practices.	Hospital institution professionals
Italy/2021(²⁷27. Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286 https://doi.org/10.1016/j.earlhumdev.202... )	Explore psycho-emotional distress, tested by the Edinburg Postnatal Depression Scale (EPDS) in early postpartum and breastfeeding initiation practices, defined according to the WHO among quarantined women who gave birth in a COVID-19 hotspot in northeastern Italy.	Postpartum women (n = 299)
USA/2020(²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320 https://doi.org/10.1016/j.semperi.2020.1... )	Describe Infection Prevention and Control (IPC) policies and practices for women in labor, childbirth and postpartum and for newborns (NB) of SARS-CoV-2 positive mothers who were seen at the Well Infant Nurseries (WBN) and Neonatal Intensive Care Units (NICU) and after hospital discharge, which were implemented during the first weeks of the first wave of the COVID-19 pandemic in New York, i.e. from mid-March to mid-May.	Hospital institution professionals
Spain/2021(²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006 https://doi.org/10.1016/j.enfcli.2021.01... )	Determine the maternal and perinatal repercussions of pregnant women infected by SARS-CoV-2 during childbirth and clinical puerperium in several centers in the Valencian Community. The secondary objectives were to determine the absence or existence of vertical transmission and to describe the maternal care provided during the epidemic and the type of breastfeeding performed.	Pregnant women and postpartum women (n = 13)
USA/2020(³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0 https://doi.org/10.1038/s41372-020-0695-... )	Discuss various care practices that have changed in the COVID-19 era, including the use of antenatal steroids, delayed cord clamping (DCC), mother-NB separation, and breastfeeding.	Hospital institution professionals
USA/2020(³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3 https://doi.org/10.1038/s41372-020-0765-... )	Describe the unique experience of Infant-friendly Hospital at the epicenter of the COVID-19 pandemic.	NB of mothers tested for COVID-19 (n = 118)
Belgium/2020(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766 https://doi.org/10.3390/ijerph17186766... )	Provide estimates of SARS-CoV-2 infections among pregnant women and breastfeeding women, as well as assess women’s perceived impact of the pandemic on their breastfeeding practices, medical advice, and social support during pregnancy and lactation.	Pregnant women (n = 2,647) and breastfeeding women (n = 3,823)
USA/2021(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200 https://doi.org/10.1089/bfm.2020.0200... )	Explore perceptions of social support among breastfeeding mothers during the COVID-19 pandemic.	Breastfeeding women (n = 29)
Spain/2020(³⁴34. Mejía Jiménez I, Salvador López R, García Rosas E, Rodriguez de la Torre I, Montes García J, Cruz Conty M, et al. Umbilical cord clamping and skin-to-skin contact in deliveries from women positive for SARS-CoV-2: a prospective observational study. BJOG. 2020;128(5):908-15. DOI: https://doi.org/10.1111/1471-0528.16597 https://doi.org/10.1111/1471-0528.16597... )	Demonstrate that DCC is safe in mothers with confirmed SARS-CoV-2 infection.	Pregnant women (n = 403)
India/2020(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.)	Present the case of a 26-year-old COVID-positive postpartum mother, separated from her premature infant at 28 weeks’ gestation, who was admitted to the NICU. In this case, the study will highlight the physical, psychosocial, spiritual concerns and stigma that she had to face during the quarantine period.	Postpartum women (n = 1)
Nepal/2020(³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938 https://doi.org/10.3126/kumj.v18i2.32938... )	Assess knowledge, attitude and practice (KAP) regarding COVID-19 among postpartum women who gave birth at a tertiary care center in Bharatpur, Chitwan, and to describe their experience during hospital admission.	Postpartum women (n = 203)
Brazil/2020(³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541 https://doi.org/10.1590/1806-9282.66.4.5... )	Guide the breastfeeding of mothers with suspected or confirmed COVID-19.	Postpartum women
Iran/2021(³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699 https://doi.org/10.7759/cureus.13699... )	Describe the experience of three mother-infant pairs who were offered a virtual bond during the COVID-19 pandemic in northern Iran.	Postpartum women (n = 3)
USA/2020(³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033 https://doi.org/10.1111/mcn.13033... )	Provide an overview of unintended consequences of separation policies and the harmful/harmful impacts of separation on breastfeeding.	Postpartum women
USA/2021(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672 https://doi.org/10.1097/NMC.000000000000... )	Present the experience of three healthy mothers and their infants for the first time, as they gave birth in the hospital and breastfed during the beginning of the pandemic in Philadelphia.	Postpartum women (n = 3)
Austria/2020(⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702 https://doi.org/10.1055/a-1207-0702... )	Assess the scientific literature available as of May 1, 2020 and discuss common questions about COVID-19 in the context of pregnancy and the postpartum period.	Postpartum women and pregnant women
Italy/2020(⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478 https://doi.org/10.3233/NPM-200478... )	Provide an overview of how care has been organized and how we are currently managing mothers and infants with suspected or proven SARS-CoV-2 infection before and after birth.	Hospital institution professionals
Spain/2021(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034 https://doi.org/10.3390/bs11030034... )	Review how the COVID-19 pandemic has impacted breastfeeding practices/plans and mothers’ expectations and investigate the effect that unmet breastfeeding expectations have on women’s mental health.	Postpartum women
SIBEN Network of Latin America and Equatorial Guinea/2020(⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47 https://doi.org/10.26633/RPSP.2020.47... )	Assess and report the clinical features and outcomes of SARS-CoV-2 infection in pregnant women and their NB in Latin America.	Mothers (n = 86)
Italy/2020(⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278 https://doi.org/10.1111/1471-0528.16278... )	Report the type of childbirth and the immediate neonatal outcome in women infected with SARS-CoV-2 observed in the early phase of the epidemic in Lombardy.	Mothers (n = 42)

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[1] Corresponding author: Ana Paula Pereira Rua Lothário Boutin, 220 Bl 23 Ap 305, Pinheirinho 81110-522 – Curitiba, PR, Brazil enfanapaulap@gmail.com