Impact of Lockdown and Visiting Restrictions For COVID-19 on Breast Milk and Short-Term Morbidities in a Tertiary Neonatal Intensive Care Unit in Türkiye

Abstract

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.

Keywords

• Breastfeeding
• Breast milk
• COVID-19
• Neonatal morbidities
• Visiting restrictions

COVID-19 nedeniyle sokağa çıkma yasakları ve ziyaret kısıtlamasının Türkiye’de üçüncü basamak bir yenidoğan yoğun bakım ünitesinde anne sütü ve kısa dönem morbiditeler üzerine etkisi

Abstract

Amaç: COVİD-19 pandemi sürecinde ziyaret kısıtlamaları ve sokağa çıkma yasaklarının anne sütü ile beslenme ve anne-bebek ilişkisinde sorunlar yaratacağından endişe edildi. Bu çalışmanın amacı ülkemizde ziyaret yasağı sürecinin (13 Mart 2020-20 Haziran 2020) anne sütü ile beslenme, emzirme ve ilişkili morbiditeler üzerine etkisini değerlendirmektir. Gereç ve Yöntemler: Yenidoğan yoğun bakım ünitesinde (YYBÜ) COVİD-19 pandemisi öncesi ve ziyaret yasağının uygulandığı dönemde yatan bebekler kontrol ve çalışma gruplarını oluşturdu. Bulgular: Çalışma ve kontrol gruplarını 197 ve 193 anne-bebek çifti oluşturdu. Çalışma grubu daha düşük gestasyonel yaş, doğum ağırlığı ve daha yüksek prematürite oranına sahipti ancak istatistiksel anlamlı değildi. Ortanca ilk enteral beslenme ve anne sütü alma günleri benzerdi. Kontrol grubunda ilk beslenmenin anne sütü ile yapılma oranı daha fazlaydı ancak istatistiksel anlamlı değildi. Tam enteral beslenmeye geçişteki anne sütü oranı benzerdi. Ortanca tam enteral beslenmeye geçiş zamanı, tam enteral beslenmede anne sütü oranı ve intravenöz sıvı süresi çalışma grubunda daha yüksekti (p<0.050). Tam enteral beslenmenin anne sütü ile yapılması yatış sürecinde çalışma grubunda daha azken (78.1 ve %87, p<0.050) taburculuk sırasında benzerdi (%78.1 vs %81.3). Beslenme intoleransı (%23.8 vs %14.6) ve yatış süresi (13.5 ve 12 gün) çalışma grubunda daha yüksekken istatistiksel anlamlı değildi. Sonuç: Ziyaretin yasaklanmasının emzirme, anne sütü sağlanması ve ilişkili morbiditeler üzerine olumsuz etkileri mevcuttur. Aileler COVİD-19 pandemisi öncesinde olduğu gibi anne sütü ve emzirmenin önemi hakkında gebelik süreci, doğum ve YYBÜ yatış sürecinde bilgilendirilmeli ve önlemler alınmalıdır.

Keywords

• Emzirme
• Anne sütü
• COVİD-19
• Neonatal morbiditeler
• Ziyaret kısıtlamaları

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