Background:

Early in the COVID-19 pandemic, many birth hospitals separated SARS-CoV-2-positive mothers from their newborn infants and advised against breastfeeding to decrease postnatal SARS-CoV-2 transmission. Information on how these practices impacted breastfeeding postdischarge is limited.

Objectives:

In a statewide sample of SARS-CoV-2-positive mothers, we aimed to determine the extent to which (1) mother–infant separation and (2) a lack of breastfeeding initiation in-hospital were associated with breast milk feeding postdischarge.

Design/Methods:

From 11 birthing hospitals in Massachusetts, we identified 187 women who tested positive for SARS-CoV-2 from 14 days before to 72 hours after delivery (March 1–July 31, 2020) and their newborn infants. We abstracted chart data from the delivery hospitalization on main exposure variables (mother–infant separation, in-hospital breast milk feeding [expressed milk feeding and/or direct breastfeeding]) and from outpatient visits until 30 days postdischarge. We evaluated associations of in-hospital practices with outcomes up to 30 days postdischarge, adjusting for confounders using multivariable logistic and linear regression.

Results:

Mother–infant separation in-hospital was associated with a shorter duration of any breast milk feeding (regression coefficient estimate −5.29 days, 95% confidence intervals [CI] [−8.89 to −1.69]). Direct breastfeeding in-hospital was associated with higher odds of any breast milk feeding (adjusted odds ratios [AOR] 5.68, 95% CI [1.65–23.63]) and direct breastfeeding (AOR 8.19, 95% CI [2.99–24.91]) postdischarge; results were similar for any breast milk feeding in-hospital.

Conclusions:

Perinatal hospital care practices implemented early in the COVID-19 pandemic, specifically mother–infant separation and prevention of breast milk feeding initiation, were associated with adverse effects on breast milk feeding outcomes assessed up to 1 month postdischarge.