부산대학교 도서관

The impact of the COVID‐19 pandemic on breastfeeding (BF) practices in low‐ and middle‐income countries (LMICs) is not well understood. Modifications in BF guidelines and delivery platforms for breastfeeding education during the COVID‐19 pandemic are hypothesised to have affected BF practices. We aimed to understand the experiences with perinatal care, BF education and practice among Kenyan mothers who delivered infants during the COVID‐19 pandemic. We conducted in‐depth key informant interviews with 45 mothers who delivered infants between March 2020 and December 2021, and 26 health care workers (HCW) from four health facilities in Naivasha, Kenya. While mothers noted that HCWs provided quality care and BF counselling, individual BF counselling was cited to be less frequent than before the pandemic due to altered conditions in health facilities and COVID‐19 safety protocols. Mothers stated that some HCW messages emphasised the immunologic importance of BF. However, knowledge among mothers about the safety of BF in the context of COVID‐19 was limited, with few participants reporting specific counselling or educational materials on topics such as COVID‐19 transmission through human milk and the safety of nursing during a COVID‐19 infection. Mothers described COVID‐19‐related income loss and lack of support from family and friends as the major challenge to practising exclusive breastfeeding (EBF) as they wished or planned. COVID‐19 restrictions limited or prevented mothers' access to familial support at facilities and at home, causing them stress and fatigue. In some cases, mothers reported job loss, time spent seeking new means of employment and food insecurity as causes for milk insufficiency, which contributed to mixed feeding before 6 months. The COVID‐19 pandemic created changes to the perinatal experience for mothers. While messages about the importance of practising EBF were provided, altered HCW education delivery methods, reduced social support and food insecurity limit EBF practices for mothers in this context. Key messages: The COVID‐19 pandemic created new challenges to promoting and sustaining exclusive breastfeeding in Kenya, including changes to antenatal and postnatal breastfeeding counselling.While health care workers provided evidence‐based counselling on the safety of breastfeeding in the context of COVID‐19, changes to education formats away from group counselling and fears of accessing care at facilities created barriers for some mothers' access to breastfeeding guidance.Maternal social support, income and food security were negatively affected by the COVID‐19 pandemic, which increased stress and decreased milk sufficiency for mothers, challenging exclusive breastfeeding duration.Mothers with prior breastfeeding experience were less affected by the breastfeeding counselling constraints, and first‐time mothers more frequently reported stress and anxiety related to breastfeeding and childcare. [ABSTRACT FROM AUTHOR]