Breastfeeding Practices and Morbidity among Infants Born to Covid-19 Mothers at a Tertiary Care Hospital Karachi, Pakistan: A Prospective Cohort Study

Abstract: Background: The novel coronavirus disease 2019 has affected general population including pregnancy due to physiological changes that can causes partial immune compression in women and increases risk of acquiring severe infections. It has also shown an impact on infants born to Covid-19 mothers. The aim of the study was to compare breastfeeding and Morbidity among infants born to Covid positive and negative mothers at the age of six months. Objective: The study aimed to evaluate the long-term impact of breastfeeding and morbidity of infants among Covid 19 mothers. Materials and Methods: This is a prospective cohort study which was conducted at the Aga Khan University Hospital (AKUH) from 20th November 2020 to 2nd July 2021, after obtaining the permission from the Research Ethics Board at Shaheed Zulfiqar Ali Bhutto Institute of Science and Technology (SZABIST) (IERB(7)/SZABIST-KHI(LIFE)/19104121/200118) and the AKUH Ethical Review Committee (ERC#:-Ped-ERC- 2020-5576-14891). Mothers were identified from hospital medical records and were followed-up at the age of six months. Participants were recruited via a non-probability purposive sampling method. Antenatal, perinatal, postnatal outcomes and neonatal data was collected via structured questionnaire. Result: Altogether 208 neonates were enrolled in the study, (n=104) in each group. Early initiation of breastfeeding within first hour of life was observed in 69 (33.3%) neonates (p value=0.049). Altogether, 120 (58.5%) neonates were exclusively breastfed during hospital stay. It was observed that exclusive breastfeeding was higher (68.9%) in non-exposed group immediately after birth. There was no significant difference in breastfeeding practices (RR; 1.0, 95% CI: 0.76-1.32; p value= 0.99) and morbidity status (RR; 1.07, 95% CI: 0.82-1.41; p value= 0.579) of infants at the age of six months among both groups. Conclusion: COVID-19 has impacted maternal and early neonatal outcomes, necessitating prompt interventions to reduce complications. Encouraging timely breastfeeding initiation can enhance benefits, lower infant morbidity, and support sustained exclusive breastfeeding. Keywords: Breastfeeding, COVID-19, Morbidity, Neonate, Pregnancy, Exclusive breastfeeding, Infants, Women, Nutrition.