Ongoing Impact of the COVID-19 Pandemic on Direct Breastfeeding Rates in Premature Infants: A Retrospective Cohort Study

Objective Changes to parental presence and engagement in neonatal intensive care units (NICUs) during the COVID-19 pandemic were associated with marked reductions in direct breastfeeding among premature infants. Whether these rates have recovered following the removal of pandemic-related restrictions remains unclear. This study examined direct breastfeeding rates 1 year after the pandemic among premature infants admitted to a NICU. Methods A retrospective cohort study was conducted in a level II-III NICU. Sixty-four infants born at ≤34 weeks’ gestation whose mothers intended to breastfeed were included. Infants were grouped as pre-pandemic ( n = 28), in-pandemic ( n = 12), or post-pandemic ( n = 24). The occurrence of direct breastfeeding at the first oral feeding attempt and at hospital discharge was evaluated. Results There was a statistically significant difference in the proportion of infants receiving direct breastfeeds at hospital discharge across the three groups: 20/28 (71%) pre-pandemic, 1/14 (8%) in-pandemic, and 2/24 (8%) post-pandemic ( p = .001). Conclusion Direct breastfeeding rates among premature infants have not returned to pre-pandemic levels despite the removal of visitation restrictions. These findings underscore the continued need for targeted parental engagement and lactation support strategies within NICUs.