Feeding practices of perinatal Sars-CoV-2-positive parents and their infants: a retrospective review and survey at a large US hospital system

Birthing parents with confirmed Sars-CoV-2 infection around the time of delivery may differ in their birthing experience and infant feeding decisions. This study aimed to explore characteristics, feeding practices, and experiences of parents who tested positive for Sars-CoV-2 around delivery. Adult parents at time of delivery who delivered infants (gestational age ≥ 35 weeks) between March 1, 2020, and January 1, 2022, who tested positive for Sars-CoV-2 within seven days prior to or following delivery were identified. Inpatient birthing parent and infant characteristics and feeding choices were retrospectively reviewed from the electronic medical record. Surveys were sent electronically to collect additional information on feeding decisions and experiences. Of the 72 eligible dyads, 52.8% (n = 38) were exclusively breastfed and 25.0% (n = 18) received human milk or were breastfeeding and formula feeding on day of discharge. Two infants (2.8%) tested positive for Sars-CoV-2 at 24 h of life. Five parents completed a survey reporting challenges of low milk production, lack of breastfeeding support, a need to wear personal protective equipment, birth parent COVID-19 symptoms, conflicting advice from healthcare providers, access to healthcare providers, adequate birth parent nutrition, and formula attainment. Parental feelings of guilt, stress, inadequacy, regret, loneliness, and desperation in relation to feeding choices were also reported. Sars-CoV-2-positive parents face unique challenges that influence their feeding choices and experiences that healthcare providers should be aware of and ensure appropriate support.