key: cord-0706591-ojw8b1xw
authors: Inzoli, A.; Zanini, A.; Miglietta, M.; Zanini, U.; Terraneo, M.
title: IN RESPONSE TO “COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems”
date: 2021-03-08
journal: J Affect Disord
DOI: 10.1016/j.jad.2021.02.072
sha: 4af31f760b2ae91a4a893233964ed5e7d36ad682
doc_id: 706591
cord_uid: ojw8b1xw

nan

have proven that COVID 19 is a major stressor for childbirth and postpartum, causing a lower bonding with the newborn and breastfeeding issues. These issues have been also observed in women who tested negative for COVID 19.

With regard to your interesting study, we would like to report our case experience at a "spoke" centre in northern Italy, Hospital "Sacra Famiglia", Fatebenefratelli, Erba (Como). In Italy, hospitals ae divided into two groups: "spoke" centres and "hub" centres. "Spoke" centres, i.e. hospitals are in charge of treating patients presenting simpler and milder cases. "Hub" centres, i.e. bigger health centres, are in charge of patients who require more advanced equipment and resources for the treatment. During the COVID 19pandemic, northern Italy became sadly renowned for being one of the first cluster. We faced for the first time in the Western World the anxiety of crowded hospital, and our National Health System was close to collapse.

Moreover, the first in Europe, our Prime Minister was forced to declare a national health emergency and to impose a lockdown with severe containment measures.

The "Sacra Famiglia" Hospital belongs to the global WHO/UNICEF Babyfriendly Hospital Initiative (BFHI) 2 , which aims to ensure that mothers and infants receive timely and appropriate care before and during their stay in a birth point. This requires a set of early and appropriate care practices, and ongoing support from trained professionals. In Italy there are 451 birth points, among which only 30 belong to BFHI initiative. Belonging to BFHI initiative, the presence of the partner in labour and delivery was always guaranteed. Midwives have to provide personalized assistance to the pregnant woman (personal attention), creating a protective environment, providing her with psychological support, giving her peace of mind and reassuring her about the conditions of the foetus.

The Hospital recorded 590 childbirths for 2019 and 507 for 2020. At the admission, pregnant women had to undergo a checklist and a nasopharyngeal swab test, and positive women were transferred to the hub centre.

We considered the following outcomes: the skin-to-skin contact (SCS) for at least 1 hour, early bonding to breast within first 2 hours, exclusive breastfeeding upon discharge, complementary breastfeeding upon discharge and avoiding breastfeeding (Table 1) . For what concerns breastfeeding, according to BFHI guidelines, we have excluded non physiological cases, such as preterm birth, small for gestational age or severe pathologies of newborn or mother. Odds ratio analysis demonstrated that the differences between the exposed population (2020) and non-exposed population (2019) were not statistically significant for all outcomes with the 95% confidence interval (CI) overlapping the null value (OR = 1).

We hypothesize that this emotional support led to no changes between 2019 and 2020 in relation to breastfeeding and bonding with the newborn. Thereby the childbirth experience was less stressful, although everybody was facing a one time in life pandemic.

Author Statement 

COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems

Implementation Guidance: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services: The Revised Baby-Friendly Hospital Initiative

The authors contributed equally to the drafting of the article. We declare we received no fundings.

The authors declare that there is no conflict of interest Acknowledgment none