Breastfeeding Rates During the COVID-19 Pandemic in Germany: Data
                    from the CRONOS Registry

Ann Carolin Longardt; Janine Zöllkau; Nadine Mand; Feline Wowretzko; Johanna Büchel; Kristin Andresen; Bimba Franziska Hoyer; Katrina Kraft; Ulrich Pecks; Collaborating authors

doi:10.1055/a-2222-6491

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Z Geburtshilfe Neonatol 2024; 228(01): 88-96
DOI: 10.1055/a-2222-6491

Original Article

Breastfeeding Rates During the COVID-19 Pandemic in Germany: Data from the CRONOS Registry

Stillraten während der COVID-19-Pandemie in Deutschland: Daten aus dem CRONOS-Register

Ann Carolin Longardt

¹Klinik für Kinder- und Jugendmedizin I / Neonatologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany

,

Janine Zöllkau

²Obstetrics, Jena University Hospital, Jena, Germany

,

Nadine Mand

³Neonatology and Pediatric Intensive Care, University of Marburg, Marburg, Germany

,

Feline Wowretzko

⁴Obstetrics and Gynaecology, Buchholz Hospital, Buchholz in der Nordheide, Germany

,

Johanna Büchel

⁵Department of Obstetrics and Gynecology, LMU, München, Germany

,

Kristin Andresen

⁶Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Kiel Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany

,

Bimba Franziska Hoyer

⁷Rheumatologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany

,

Katrina Kraft

⁸Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lubeck, Germany

,

Ulrich Pecks

⁹Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel, Germany

¹⁰Maternal Health and Midwifery Science, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany

,

Collaborating authors

› Author Affiliations

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Abstract

SARS-CoV-2 infection and COVID-19 disease are thought to have an impact on breastfeeding rate – besides other known peripartal issues. Data of the national CRONOS registry regarding breastfeeding behavior in 6,746 women was analyzed regarding the time window between maternal SARS-CoV-2 infection and time of delivery. In addition, other influencing factors like the predominant viral variant, maternal disease severity, and gestational age at delivery were taken into account. Our data suggest that within the variables analyzed, in the case of acute maternal infection (<14 days before birth), breastfeeding behavior improved with increasing gestational age at birth (p<0.0001), with less severe maternal illness (p<0.0001) and as the pandemic progressed with less virulent viral variants (p=0.01). When adjusting for COVID-19-associated and non-associated factors, rooming-in remains the most important factor positively influencing breastfeeding behavior. With regards to the benefits for mother and infants from breastfeeding, a separation of mother and child even in case of infectious settings should be avoided.

Zusammenfassung

Neben anderen peripartalen Faktoren, wird davon ausgegangen, dass SARS-CoV-2 und eine COVID-19-Erkrankung einen Einfluss auf die Stillrate haben. Daten des nationalen CRONOS-Registers zum Stillverhalten von 6.746 in der Schwangerschaft mit SARS-CoV-2 infizierten Frauen wurden im Hinblick auf das Zeitfenster zwischen mütterlicher Infektion und dem Zeitpunkt der Entbindung analysiert. Außerdem wurden weitere Einflussfaktoren wie die vorherrschende Virusvariante, der mütterliche Krankheitsschweregrad und das Gestationsalter bei der Geburt berücksichtigt. Unsere Daten deuten darauf hin, dass sich innerhalb der analysierten Variablen das Stillverhalten im Falle einer akuten mütterlichen Infektion (<14 Tage vor der Geburt) mit zunehmendem Gestationsalter bei der Geburt (p <0,0001), mit einer weniger schweren mütterlichen Erkrankung (p <0,0001) und mit dem Fortschreiten der Pandemie mit weniger virulenten Virusvarianten (p=0,01) verbessert. Wenn man die mit COVID-19 assoziierten und nicht assoziierten Faktoren berücksichtigt, bleibt das Rooming-in der wichtigste Faktor, der das Stillverhalten positiv beeinflusst. Im Hinblick auf die Vorteile des Stillens für Mutter und Kind sollte eine Trennung von Mutter und Kind auch im Falle einer Infektion möglichst vermieden werden.

Key words

breastfeeding - COVID-19 - SARS-CoV-2 - CRONOS - neonate

Schlüsselwörter

Stillen - COVID-19 - SARS-CoV-2 - CRONOS - Neonat

Publication History

Received: 30 July 2023

Accepted: 23 November 2023

Article published online:
08 February 2024

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

References
1 Hale T, Angrist N, Goldszmidt R. et al. A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker). Nat Hum Behav 2021; 5: 529-538

Crossref PubMed Search in Google Scholar
2 Longardt AC, Winkler VP, Pecks U. [SARS-CoV-2 and Perinatal Aspects]. Z Geburtshilfe Neonatol 2020; 224: 181-186

Thieme Connect PubMed Search in Google Scholar
3 Zollkau J, Heimann Y, Hagenbeck C. et al. Breastfeeding behavior within the COVID-19-Related Obstetric and Neonatal Outcome Study (CRONOS). J Hum Lact 2023; 8903344231190623

Crossref PubMed Search in Google Scholar
4 Gross R, Conzelmann C, Muller JA. et al. Detection of SARS-CoV-2 in human breastmilk. Lancet 2020; 395: 1757-1758

Crossref PubMed Search in Google Scholar
5 Wu Y, Liu C, Dong L. et al Viral shedding of Covid-19 in pregnant women. In: SSRN 2020. Available from: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3562059

PubMed
6 Fewtrell M, Bronsky J, Campoy C. et al. Complementary feeding: A position paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017; 64: 119-132

Crossref PubMed Search in Google Scholar
7 World Health Organization. Breastfeeding. WHO Website. Available from: https://www.who.int/health-topics/breastfeeding#tab=tab_1 Accessed June 25, 2023

PubMed
8 American Academy of Pediatrics. Where we stand: Breastfeeding. 2023

PubMed
9 Nationale Stillkommission. 2023. Available from: https://www.mri.bund.de/de/themen/nationale-stillkommission

PubMed
10 Briana DD, Malamitsi-Puchner A. Breastfeeding provides a protective hug and the benefits have outweighed the risks during the COVID-19 pandemic. Acta Paediatr 2023; 112: 1177-1181

Crossref PubMed Search in Google Scholar
11 Zollkau J, Hagenbeck C, Hecher K. et al. [Update on Recommendations for SARS-CoV-2/COVID-19 During Pregnancy, Birth and Childbed]. Z Geburtshilfe Neonatol 2020; 224: 217-222

Thieme Connect PubMed Search in Google Scholar
12 Zollkau J, Hagenbeck C, Hecher K. et al. [Recommendations for SARS-CoV-2/COVID-19 during Pregnancy, Birth and Childbed – Update November 2021 (Short Version)]. Z Geburtshilfe Neonatol 2022; 226: 16-24

Thieme Connect PubMed Search in Google Scholar
13 Zollkau J, Hagenbeck C, Hecher K. et al. [Recommendations for SARS-CoV-2/COVID-19 during Pregnancy, Birth and Childbed – Update November 2021 (Long Version)]. Z Geburtshilfe Neonatol 2022; 226: e1-e35

Thieme Connect PubMed Search in Google Scholar
14 Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. Überblick über die Empfehlungen für Schwangere und Stillende (DGGG e.V.). 2023. Available from: https://www.dggg.de/presse/pressemitteilungen-und-nachrichten/covid-19-kreisssaalempfehlungen-der-dggg-faq-fuer-schwangere-und-weitere-informationen

PubMed
15 Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. SARS-CoV-2 und Schwangerschaft/Stillen. 2023. Available from: https://www.dggg.de/fileadmin/data/Stellungnahmen/DGGG/2021/PM_Update_November_2021_finalV2.pdf

PubMed
16 Ganho-Avila A, Guiomar R, Sobral M. et al. The impact of COVID-19 on breastfeeding rates: An international cross-sectional study. Midwifery 2023; 120: 103631

Crossref PubMed Search in Google Scholar
17 Lapillonne A, Pichon C, Renaudin B. et al. Breastfeeding success and newborn health before and during the covid-19 pandemic: A single-centre comparative study. Neonatology 2023; 1-8

Crossref PubMed Search in Google Scholar
18 Cinquetti M, Marchiotto C, Fingerle M. et al. Breastfeeding rates fell in an Italian baby friendly hospital during the 2020 COVID-19 pandemic year and difficulties increased. Acta Paediatr 2023; 112: 770-775

Crossref PubMed Search in Google Scholar
19 Aabakke AJM, Petersen TG, Wojdemann K. et al. Risk factors for and pregnancy outcomes after SARS-CoV-2 in pregnancy according to disease severity: A nationwide cohort study with validation of the SARS-CoV-2 diagnosis. Acta Obstet Gynecol Scand 2023; 102: 282-293

Crossref PubMed Search in Google Scholar
20 Iannaccone A, Mand N, Schmidt B. et al. Is the risk of still and preterm birth affected by the timing of symptomatic SARS-CoV-2 infection during pregnancy? Data from the COVID-19 Related Obstetrics and Neonatal Outcome Study Network, Germany. Am J Obstet Gynecol 2023; 228: 351-352 e352

Crossref PubMed Search in Google Scholar
21 Piekos SN, Roper RT, Hwang YM. et al. The effect of maternal SARS-CoV-2 infection timing on birth outcomes: a retrospective multicentre cohort study. Lancet Digit Health 2022; 4: e95-e104

Crossref PubMed Search in Google Scholar
22 Pecks U, Mand N, Kolben T. et al. SARS-CoV-2 Infection During Pregnancy. Dtsch Arztebl Int 2022; 119: 588-594

Crossref PubMed Search in Google Scholar
23 Robert Koch Institut. Dritte Aktualisierung der „Retrospektiven Phaseneinteilung der COVID-19-Pandemie in Deutschland“. Epidemiologisches Bulletin – Ausgabe 38/22. Available from: https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2022/Ausgaben/38_22.pdf?__blob=publicationFile

PubMed
24 Enengl S, Pecks U, Oppelt P. et al. Antibody response and maternofetal antibody transfer in SARS-CoV-2-positive pregnant women: A multicenter observational study. Geburtshilfe Frauenheilkd 2022; 82: 501-509

Thieme Connect PubMed Search in Google Scholar
25 DeYoreo M, Kapinos K, Lawrence R. et al. Changes in breastfeeding and lactation support experiences during COVID. J Womens Health (Larchmt) 2023; 32: 150-160

Crossref PubMed Search in Google Scholar
26 Matyas M, Valeanu M, Hasmasanu M. et al. The effect of maternal SARS-CoV-2 infection on neonatal outcome. Children (Basel) 2023; 10: 771

Crossref PubMed Search in Google Scholar
27 Mufdlilah M, Kusuma NI, Suryaningsih EK. Mother’s experience with COVID-19 in breastfeeding: A phenomenological study. SAGE Open Nurs 2023; 9 23779608231172360

Crossref PubMed Search in Google Scholar
28 Koc E, Dilli D. How does COVID-19 affect maternal and neonatal outcomes?. J Perinat Med 2023; 51: 277-283

Crossref PubMed Search in Google Scholar
29 Dowse G, Perkins EJ, Stein HM. et al. Born into an isolating world: family-centred care for babies born to mothers with COVID-19. EClinicalMedicine 2023; 56: 101822

Crossref PubMed Search in Google Scholar
30 Vik ES, Kongslien S, Nedberg IH. et al. Women’s experiences and views on early breastfeeding during the COVID-19 pandemic in Norway: quantitative and qualitative findings from the IMAgiNE EURO study. Int Breastfeed J 2023; 18: 15

Crossref PubMed Search in Google Scholar
31 Magnazi MB, Sartena G, Goldberg M. et al. Impact of the COVID-19 pandemic on breastfeeding in Israel: a cross-sectional, observational survey. Int Breastfeed J 2022; 17: 61

Crossref PubMed Search in Google Scholar