208 - Providing Breastfeeding Care in a Rural Community During the COVID-19 Pandemic: Experiences of Healthcare Professionals

Poster Number: 208
Publication Number: 208.320

Christine D. Garner, Texas Tech University Health Sciences Center, Amarillo, TX, United States; Hana F. Setterquist, TTUHSC School of Medicine, Amarillo, TX, United States; Jasmine L. Chan, Texas Tech University Health Sciences Center School of Medicine, Carrollton, TX, United States; Emily E. Hecox, Texas Tech University Health Sciences Center School of Medicine, Schertz, TX, United States; Skye McLaurin-Jiang, Texas Tech University Health Sciences Center, Amarillo, TX, United States

Background: Breastfeeding support from healthcare professionals (HCPs) is known to impact breastfeeding initiation and duration. The COVID-19 pandemic disrupted care broadly, as well as the provision of numerous allied health services, particularly in community health care settings serving rural populations.

Objective: The aim of this study was to explore HCPs’ experiences and perceptions related to breastfeeding care (education, lactation services, clinician management, ambulatory lactation support) during the first year of the COVID-19 pandemic.

Design/Methods: Qualitative, semi-structured interviews were conducted via Zoom from February to May 2021 with 19 purposively sampled HCPs (obstetricians, pediatricians, nurses, and lactation consultants described in Table 1) who provided perinatal care in two community hospitals (neither were “baby-friendly”). This study took place in a mid-sized city situated in a rural area in the Texas Panhandle. Interviews were audio-recorded, transcribed verbatim, and verified. Data saturation was reached after 16 interviews. Two or more researchers coded each interview using content analysis in ATLAS.ti, then discussed and agreed on coding and analysis.

Results: An overarching theme emerged that breastfeeding care decreased during the pandemic (Figure 1). There were 4 supporting subthemes (Table 2). 1- HCPs perceived that less breastfeeding support was available before and during the hospital stay, as prenatal breastfeeding classes were canceled and visitors who could have supported breastfeeding were not allowed in the hospital. 2- HCPs perceived that mothers less often sought outpatient services due to fears of exposure to COVID-19. At the same time, HCPs visited rooms with COVID-19 positive cases less frequently. 3- Variation existed in staffing of lactation services, including furloughs and repurposing staff, and COVID-related policies regarding breastfeeding, rooming-in and skin-to-skin care during different phases of the pandemic. 4- Disrupted outpatient lactation services and canceled breastfeeding support groups early on during the pandemic resulted in greater reliance on hospital-based HCPs to teach more breastfeeding skills during a shortened newborn hospitalization.Conclusion(s): HCPs discussed multiple ways in which the pandemic had negative effects on breastfeeding-related care and on mothers’ abilities to begin or continue breastfeeding. A full spectrum of prenatal, hospital-based, and postnatal lactation services needs to be preserved during pandemic situations to support breastfeeding for the health of both mothers and infants.
Table 1. Participant characteristics of healthcare professionals (Nf19).
Figure 1. Healthcare professionals perceived an overall decrease in breastfeeding care because of the COVID-19 pandemic.Breastfeeding care decreased before, during, and after perinatal hospitalization as a result of changes in policies and public health concerns.