Feeding practices in public hospitals' neonatal intensive care units: An exploration into the ways in which COVID-19 affected the best practice in Gauteng.

Background:  South Africa's healthcare system has a multitude of pre-existing challenges prior to the onset of the coronavirus disease 2019 (COVID-19) pandemic, ranging from reduced number of staff, lack of resources and units being at overcapacity both in the adult and paediatric populations. The neonatal intensive care units (NICUs) require a team approach to ensure best practice with vulnerable infants, but little is known about how the onset of the COVID-19 pandemic and the resultant lockdown restrictions impacted the feeding practices within the NICU.

Objectives:  This study aimed to explore the impact that COVID-19 had on the feeding practices within the NICU settings in public hospitals in Gauteng.

Methods:  A qualitative design was employed with data collected in two NICUs in Gauteng. Data were collected in the form of observations and semi-structured interviews with healthcare workers (HCWs) in the NICU. Data were analysed using inductive thematic analysis.

Results:  Although the sample size of participants was limited, social distancing proved to be a challenge resulting in mothers and healthcare workers being given restricted access. This had effects on the ability to provide adequate feeding practices and resulted in anxiety for the mothers and mental health challenges for the HCWs when feeding these at-risk infants. A limitation of this study was the use of only two sites.

Conclusion:  COVID-19 amplified the existing challenges in the NICU. A multidisciplinary and family-centred approach to address feeding challenges is required to offset the challenges resulting from the pandemic and subsequent lockdown.