BACKGROUND: The COVID-19 pandemic has posed several challenges to the provision of newborn nutrition and care interventions including maternal support, breastfeeding and family participatory care . Italy was the first country to be exposed to SARS-CoV-2 in Europe . One of the measures adopted by the Italian government during COVID-19 pandemic was the total lockdown of the cities with complete confinement at home . We aimed to examine the impact of the lockdown caused by COVID-19 pandemic on exclusive breastfeeding in non-infected mothers .
METHODS: We prospectively enrolled 204 mother-baby dyads during lockdown (9 March to 8 May 2020) that we compared to previously studied 306 mother-baby dyads admitted during the year 2018 . To reduce the possible effect of confounding factors on exclusive breastfeeding, a 1:1 matching was performed by using an automatized procedure of stratification that paired 173 mother-baby dyads . Feeding modality was collected at discharge , 30 and 90 days of newborn's life . Exclusive breastfeeding was considered when the infant received only breast milk and no other liquids or solids were given with the exception of vitamins, minerals or medicines .
RESULTS: At discharge 69.4% of infants were exclusively breastfed during lockdown versus 97.7% of control group , 54.3% at 30 days vs 76.3 and 31.8% vs 70.5% at 90 days (p <0.001). The proportion of breastfeeding remaining exclusive from discharge to 30-day was similar between groups (about 80 %), but it was lower in lockdown group than in control cohort (58.5% vs 92.4%, p <0.001) from 30- to 90-days .
CONCLUSIONS: Lockdown and home confinement led to a decrease of exclusively breastfeeding in the studied population . Considering the timing to shift from exclusive to non-exclusive breastfeeding, differences between study groups were concentrated during hospital stay and from 30- to 90 days of a newborn's life, confirming that the hospital stay period is crucial in continuing exclusive breastfeeding at least for the first 30 days, but no longer relevant at 90 days of life.