Changes in moderately low birthweight infant feeding, care, and health outcomes before compared to during the Covid-19 pandemic in Malawi

Bibliographic Data

ID19550174
AuthorsFriday Saidi (0000-0003-1190-1499, University of North Carolina at Chapel Hill), Rana R Mokhtar (0000-0002-0796-6313, Brigham and Women's Hospital), Irving Hoffman (0000-0003-0059-5991, University of North Carolina at Chapel Hill), Irving F Hoffman (UNC Project Malawi, Lilongwe, Malawi), Melda Phiri (UNC Project Malawi, Lilongwe, Malawi), Fadire Nyirenda (UNC Project Malawi, Lilongwe, Malawi), Kingsly Msimuko (0000-0003-2820-6695, UNC Project Malawi, Lilongwe, Malawi), Msandeni Chiume (0000-0002-3083-8563, Kamuzu Central Hospital), Linda Vesel (0000-0003-3753-4172, Brigham and Women's Hospital), Katherine E A Semrau (0000-0002-8360-1391, Brigham and Women's Hospital), Katherine EA Semrau, Tisungane Mvalo (0000-0002-6775-7919, University of North Carolina at Chapel Hill)
Year2023
Volume13
Pages06025-06025
Publication date2023-06-30
Open AccessYes
TypeARTICLE
VenueJournal of Global Health (JOURNAL)
Journal identifiersISSN: 2047-2978 • E-ISSN: 2047-2986
PublisherInternational Society of Global Health (PUBLISHER • GB)
DOI10.7189/jogh.13.06025
PMID37387545
OpenAlexW4382631589
LanguageEN
References cited31

Background: The coronavirus disease 2019 (COVID-19) and the measures taken to minimise its spread have significantly impacted mother- and infant-related healthcare. We describe the changes in newborn feeding, lactation support, and growth outcomes before compared to during the COVID-19 pandemic among moderately low birthweight infants (LBW) (1.5 to <2.5kg) in Malawi. Methods: The data presented here are part of the Low Birthweight Infant Feeding Exploration (LIFE) study, a formative, multisite, mixed methods observational cohort study. In this analysis, we included infants born at two public hospitals in Lilongwe, Malawi between 18 October 2019 and 29 July 2020. We categorised births as "pre-COVID-19 period" (before 1 April 2020) and "during COVID-19 period" (on or after 2 April 2020) and used descriptive statistics and mixed effects models to examine differences in birth complications, lactation support, feeding, and growth outcomes between the two time periods. Results: We included 300 infants and their mothers (n = 273) in the analysis. Most infants (n = 240) were born during the pre-COVID-19 period; 60 were born during the pandemic period. The latter group had a lower prevalence of uncomplicated births (35.8%) compared to pre-pandemic period group (16.7%) (P = 0.004). Fewer mothers reported early initiation of breastfeeding in the pandemic period (27.2%) compared to the pre-pandemic period (14.6%) (P = 0.053), along with significantly less breastfeeding support, particularly in view of discussion of proper latching (44.9% during COVID-19 vs 72.7% pre-COVID-19; P < 0.001) and physical support with positioning (14.3% vs 45.5% pre-COVID-19 P < 0.001). At 10 weeks of age, the prevalence of stunting was 51.0% pre-COVID-19 vs 45.1% during COVID-19 (P = 0.46), the prevalence of underweight was 22.5% pre-COVID-19 vs 30.4% during COVID-19 (P = 0.27), and the prevalence of wasting was 0% pre-COVID-19 vs 2.5% during COVID-19 (P = 0.27). Conclusions: Our findings highlight the continued need to optimise early initiation of breastfeeding and lactation support for infants during COVID-19 and future pandemics. More studies are needed to evaluate the long-term outcomes of moderately LBW born during the COVID-19 pandemic (including growth outcomes) and determine the impact of restrictive measures on access to lactation support and promotion of early initiation of breastfeeding

Biology · Breast feeding · Breastfeeding · Cohort study · Disease · Lactation · Observational study · Pandemic · Pregnancy · Breastfeeding Practices and Influences · COVID-19 Impact on Reproduction · Demography · Maternal Mental Health During Pregnancy and Postpartum · Medicine · Pediatrics

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