Monitoring the Sustainability of a Breastfeeding Guideline During the COVID-19 Pandemic: A Mixed-Methods Study

Abstract

Aim

To analyse the impact of the COVID-19 pandemic on the sustainability of a breastfeeding (BF) clinical practice guideline (CPG) for women without COVID-19, throughout the 5 waves of the pandemic.

Desing

A mixed-methods design was utilised.

Methods

For the quantitative approach, an interrupted time series design was utilised, as well as the analysis of CPG sustainability reports as a qualitative approach. The study setting was in a health area in the Spanish health system from April 2019, until October 2021. The sample was composed of 2239 mother–infant dyads.

Results

The exclusive-BF rate at hospital discharge obtained values between 90% and 94.8%, without statistically significant changes. A significant increase in the risk of not starting BF in the first feeding was observed (adjusted odds ratio = 9.36; 95% CI: 1.04–84.13), between the pre-pandemic period and the first wave. Skin-to-skin contact (SSC) decreased in the first wave to 82.20%, and the oscillations observed throughout the pandemic were not statistically significant. In general, the qualitative indicators were maintained. A decrease was observed in the spaces used for postpartum care due to the re-assigning to the intensive care unit. Also, the acquisition of materials and equipment decreased.

Conclusions

The measures implemented for the sustainability of the BF CPG during the 5 waves of the pandemic were positive. The programmes of implementation of BF guidelines were shown to resist the COVID-19 pandemic.

Impact

Our findings contribute to the understanding and evolution of the main indicators of the sustainability of a BF CPG on COVID-19 context, providing details on the magnitude of the effect and the process of change.

Reporting Method

The Preferred Reporting Items for observational studies (STROBE) checklist was followed.

Patient or Public Contribution

No Patient or Public Contribution.