Optimising mother-baby contact and infant feeding in a pandemic

Optimising close, ongoing contact between mothers and newborn infants and enabling women to breastfeed/feed with breastmilk, or to use breastmilk substitutes as effectively and safely as possible, are key elements of maternity and neonatal care. They are especially important during the COVID-19 pandemic. Extensive evidence-based positive developments in policy and practice to promote and support mother-baby contact, attachment, and
breastfeeding have been implemented across maternity and neonatal care in the UK and many other countries in the last 15-20 years, though such changes have not been universally implemented and barriers still exist in many settings. The coronavirus pandemic and the inevitable focus on reducing infection has disrupted many of these positive developments and adversely affected mother-baby contact and infant feeding in many contexts, augmenting existing barriers. Societal changes such as hygiene measures and social distancing, lockdown, isolation, fear, and food security challenges complicate the lives of women and families. Health service changes in the UK and other countries have included
virtual contact between women and staff, increased separation of mothers and babies, restrictions on parental visiting in neonatal units, the use of masks and personal protective equipment, staff redeployment and shortages, and the interruption of Unicef UK Baby Friendly Initiative accreditation programmes. Taken together, these changes pose a risk to immediate, close and loving contact between the mother and newborn infant and with the other parent and the wider family, to the initiation and continuation of breastfeeding, and to
future individual and family well-being and public health. Some reports are emerging about potential positive impacts of the restrictions on postnatal visiting and increased levels of virtual contact for some families in some countries.
In the context of the COVID-19 pandemic and the need to prevent or reduce infection, this rapid analytic review considers:
o What is the evidence base and best practice on optimising mother-baby contact?
o What is the evidence base and best practice on optimising infant feeding?
o What are the implications of this knowledge for guidance for health professionals, the care of women and babies, and information for women and families?