Impact of lockdown and visiting restrictions for COVID-19 on breast milk and short-term morbidities in a tertiary neonatal intensive care unit in Turkey

Objective: In the COVID-19 pandemic era, visiting restrictions and lockdown measures have been leaded to serious concerns in breastfeeding and maternal-infant interaction. We aimed to evaluate the effects of visiting restrictions as no physical visits allowed period (March 13th and June 20th, 2020) on feeding with breast milk, breastfeeding and associated morbidities. Material and Methods: Neonates admitted to neonatal intensive care unit in pre-COVID-19 pandemic and during strict visiting restrictions constituted control and study groups. Results: Study and control groups included 197 and 193 mother-baby dyads. Study group had insignificant lower gestational age, birthweight and higher prematurity rate. Median first enteral feeding and first breast milk days were similar. First enteral feeding with breast milk was insignificantly higher in control group. Median breast milk percentage at full enteral feeding (FEF) did not differ. Median time of FEF, FEF with only breast milk and intravenous fluid duration were higher in study group (p<0.050). Full enteral feeding with breast milk during NICU stay was less in study group (78.1 vs 87%, p<0.050) while at discharge there was no difference (78.1% vs 81.3%). Feeding intolerance was insignificantly higher in study group (23.8% vs 14.6%). Median duration of NICU stay was higher in study group but not significant (13.5 vs 12 d, p>0.050). Conclusion: No visits allowed period leaded to impaired breastfeeding, breast milk supply and associated morbidities. Parents should be informed about breastfeeding and breast milk in prenatal period, after birth and during NICU stay in COVID-19 era as before and precautions should be taken.