Becoming a parent is challenging at the best of times – but the COVID-19 pandemic and global lockdown measures have intensified this. Many new parents have had to adapt to changing and uncertain circumstances, such as expectant mothers having to attend antenatal appointments or having labour induced alone. The amount of breastfeeding support being offered by healthcare professionals has also significantly reduced.
Although breastfeeding is a biologically normal way to feed a baby, that doesn’t always make it easy. Yet even before the pandemic, a lack of investment in breastfeeding services had already made support from health professionals, drop-in groups and specialists overstretched. This increases the probability of women finding breastfeeding insurmountable and has already resulted in the UK having some of the lowest breastfeeding rates in the world.
But with lockdown, what little in-person support was available has often disappeared. Many health visitors were redeployed into nursing roles, face-to-face support groups were moved online or cancelled, and some antenatal care moved to remote delivery.
Parents have also been left feeling isolated because support from other family members had been removed due to social distancing. While video calling allowed some to stay connected, low-income families don’t always have access to high-speed wifi, and video screens cannot replace human contact in any case. There were also articles circulating on social media claiming that breastfeeding was unsafe because of COVID-19. They have since been removed, with UK public health bodies and the World Health Organization insisting that breastfeeding should still be encouraged.
Our new research with over 1,200 mothers who breastfed during the pandemic revealed how they were affected by the lockdown. Around 40% of mothers said they felt it had a positive impact on their experience. They valued the privacy, having a supportive partner at home, and having more time to focus on their baby. This made them more confident and they breastfed for longer as a result.
However, around 30% of mothers felt lockdown had a very negative impact on them. These mothers felt isolated, abandoned and overwhelmed at the intensity of being alone with their baby. Although some managed to continue breastfeeding, around 82% of this group stopped – typically before they were ready. They directly blamed the lack of face-to-face support.
Notably, lockdown hit those less privileged the hardest. Mothers living in high-rise flats, with no private garden or green space nearby, or who didn’t have high-speed wifi, struggled the most. The difficulty accessing online support combined with the stress of cramped living conditions would make anything feel more challenging.
Mothers from BAME backgrounds also stopped breastfeeding at a higher rate (32%) than White women (18%). This was likely because BAME mothers reported less access to support. This statistic is particularly concerning given that women from BAME populations typically breastfeed for longer than White women in the UK.
Inaccurate messaging and safety fears relating to COVID-19 and breastfeeding played a role for those who felt a negative impact from lockdown. A third of mothers who needed to contact a health professional due to breastfeeding difficulties did not do so because they were worried about safety or feared that the NHS was overloaded.
One in six were worried breastfeeding was unsafe, with a fifth of those who stopped breastfeeding doing so as a result. One in 20 mothers were directly told by a health professional that breastfeeding may not be safe or that they would not be “allowed” to breastfeed if they had symptoms. This is despite research that shows direct transmission of COVID-19 into breastmilk is unlikely. In fact, SARS-CoV-2 antibodies have been found in the milk of infected mothers, likely offering the infant protection.
We also found that mothers of premature or sick babies whose vulnerability means they need human milk the most faced particular challenges. Some mothers were separated from their baby due to COVID-19 symptoms or restricted from visiting the neonatal care unit, meaning that breastfeeding was more difficult. Of these mothers, 80% stopped breastfeeding in the first six weeks.
This unnecessary impact on breastfeeding is deeply concerning. Breastfeeding support should always be considered a critical service. We have ample evidence that breastfeeding protects maternal and infant health and wellbeing, while also benefiting the NHS by reducing health care costs and appointments, and the environment through reduced landfill and CO₂ emissions.
There is an urgent need to ensure that breastfeeding support is reinstated. Face-to-face support must be available where it is safe to do so. Online support must also reach all families – not just those who can afford it.
We cannot change what has already occurred, but we can offer further support to mothers to ensure they and their families receive the support they need in the future. Unfortunately guidance on what face-to-face support is available is changing frequently. Some breastfeeding support groups are working towards opening back up, with restrictions, but this may vary between groups. However, your health professional should be able to offer face-to-face support. Some private lactation consultants are also able to offer home visits.
Lots of information about feeding your baby is also available on the internet, but always check the person providing it is qualified to do so. Some trusted websites include Global Health Media and [KellyMom]. The Association of Breastfeeding Mothers has also collated vetted resources on its website, including videos, factsheets and other information. Books may also be a useful source of information and support.
If restrictions are tightened, be reassured that there is professional and peer support available online and over the phone. You can find more details via the National Breastfeeding Helpline , Association of Breastfeeding Mothers, La Leche League and National Childbirth Trust (NCT). Regardless of the situation, never be afraid to seek support.
Amy Brown has previously received funding from the ESRC, NIHR, HEFCW, Infant feeding charities and Public Health Wales. She is a trustee for First Steps Nutrition Trust. She is author of six infant feeding and parent books published by Pinter and Martin Ltd.
Natalie Shenker receives funding from UKRI in the form of a Future Leaders Fellowship at Imperial College London. She is the cofounder and Trustee of The Human Milk Foundation.