Aleitamento materno em tempos de COVID-19: uma <i>scoping review</i>

Souza, Silvana Regina Rossi Kissula; Pereira, Ana Paula; Prandini, Naiane Ribeiro; Resende, Ana Clara Antunes Pereira; de Freitas, Efigênia Aparecida Maciel; Trigueiro, Tatiane Herreira; Wall, Marilene Loewen

doi:10.1590/1980-220X-REEUSP-2021-0556pt

RESUMO

Objetivo:

identificar como a pandemia de COVID-19 tem influenciado as puérperas no aleitamento materno.

Método:

scoping review, com busca em sete bases de dados. Incluíram-se estudos disponíveis na íntegra, em inglês, português ou espanhol, publicados de dezembro/2019-abril/2021. A análise deu-se por categorização de temas comuns.

Resultados:

incluíram-se 25 estudos, agrupados em cinco categorias, apresentando a influência da pandemia: na rotina de cuidados ao aleitamento materno, evidenciando medidas preventivas contra COVID-19; nas taxas do aleitamento materno, destacando mudanças nas práticas alimentares; na rede de apoio para o aleitamento materno, apontando falta de assistência de serviços; nas emoções das puérpera, predominando preocupação e estresse; no uso da tecnologia para apoio ao aleitamento materno, com teleatendimento facilitando a assistência.

Conclusão:

a pandemia de COVID-19 influenciou novas formas de assistência, na oferta e no tempo de amamentação, na saúde emocional e na fragilidade da rede de apoio. Espera-se contribuir para que profissionais da saúde proporcionem assistência com maior assertividade diante dessa nova situação.

DESCRITORES
Período Pós-Parto; Aleitamento Materno; COVID-19; Revisão

ABSTRACT

Objective:

to identify how the COVID-19 pandemic has influenced postpartum women in breastfeeding.

Method:

a scoping review, with a search in seven databases. Studies available in full, in English, Portuguese or Spanish, published from December/2019-April/2021 were included. The analysis was carried out by categorizing common themes.

Results:

25 studies were included, grouped into five categories, presenting the influence of the pandemic: in the routine of breastfeeding care, evidencing preventive measures against COVID-19; in breastfeeding rates, highlighting changes in dietary practices; in the support network for breastfeeding, indicating a lack of service care; in the postpartum women’s emotions, with predominance of concern and stress; in the use of technology to support breastfeeding, with teleservice facilitating care.

Conclusion:

the COVID-19 pandemic has influenced new forms of care, in the offer and duration of breastfeeding, in emotional health and in the support network fragility. It is expected to contribute so that health professionals provide care with greater assertiveness in the face of this new situation.

DESCRIPTORS
Postpartum Period; Breast Feeding; COVID-19; Review

RESUMEN

Objetivo:

identificar cómo la pandemia de COVID-19 ha influido en las puérperas en la lactancia.

Método:

scoping review, con búsqueda en siete bases de datos. Se incluyeron estudios disponibles en su totalidad, en inglés, portugués o español, publicados entre diciembre/2019 y abril/2021. El análisis se llevó a cabo mediante la categorización de temas comunes.

Resultados:

se incluyeron 25 estudios, agrupados en cinco categorías, que presentan la influencia de la pandemia: en la rutina de cuidados de la lactancia materna, evidenciando medidas preventivas contra la COVID-19; en las tasas de lactancia materna, destacando los cambios en las prácticas dietéticas; en la red de apoyo a la lactancia materna, indicando falta de asistencia en el servicio; en las emociones de las puérperas, con predominio de preocupación y estrés; en el uso de tecnología para apoyar la lactancia materna, con teleservicio facilitando la asistencia.

Conclusión:

la pandemia de COVID-19 influyó en las nuevas formas de asistencia, en la oferta y duración de la lactancia materna, en la salud emocional y en la fragilidad de la red de apoyo. Se espera contribuir para que los profesionales de la salud brinden asistencia con mayor asertividad ante esta nueva situación.

DESCRIPTORES
Periodo Posparto; Lactancia Materna; COVID-19; Revisión

INTRODUÇÃO

A pandemia da Doença do Coronavírus 2019 (COVID-19), declarada em 11 de março de 2020, pela Organização Mundial da Saúde (OMS), causada pelo novo Coronavírus 2 da Síndrome Respiratória Aguda Grave (SARS-CoV-2), surgiu em Wuhan, na China, no final de 2019, alastrando-se por todos os continentes, infectando e vitimando milhões de pessoas(¹1. DiLorenzo MA, O’Connor SK, Ezekwesili C, Sampath S, Zhao M, Yarrington C, et al. COVID-19 guidelines for pregnant women and new mothers: A systematic evidence review. Int J Gynaecol Obstet. 2021;153(3):373-82. DOI: https://doi.org/10.1002/ijgo.13668
https://doi.org/10.1002/ijgo.13668... ,²2. Brasil. Ministério da Saúde. Nota Informativa Nº 13/2020 – SE/GAB/SE/MS. Manual de Recomendações para a Assistência à Gestante e Puérpera frente à Pandemia de COVID-19 [Internet]. Brasília; 2020 [cited 2021 Jan 07]. Available from: https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2020/09/Manual-de-Recomenda-es-para-Gestante-1.pdf
https://portaldeboaspraticas.iff.fiocruz... ), com 235.175.106 casos confirmados no mundo até 05 de outubro de 2021(³3. World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. Geneva: WHO; 2021 [cited 2021 July 26]. Available from: https://covid19.who.int/
https://covid19.who.int/... ).

O primeiro caso notificado no Brasil foi em 26 de fevereiro de 2020, e até 17 de julho de 2021, foram registrados 19.342.448 casos confirmados de COVID-19 no país(⁴4. Brasil. Ministério da Saúde. 72 – Boletim epidemiológico especial: Doença pelo Coronavírus COVID-19 [Internet]. Brasília; 2021 [cited July 26]. Available from: https://www.gov.br/saude/pt-br/media/pdf/2021/julho/23/boletim_epidemiologico_covid_72_final23jul21-c-1.pdf
https://www.gov.br/saude/pt-br/media/pdf... ). Entre gestantes e puérperas, notificaram-se 544 óbitos em 2020, e até 26 de maio de 2021, já foram registrados 911 óbitos(⁵5. Fiocruz. Ministério da Saúde. Boletim observatório Covid-19 [Internet]. Rio de Janeiro: Fundação Oswaldo Cruz; 2021 [cited 2021 July 16]. Available from: https://agencia.fiocruz.br/sites/agencia.fiocruz.br/files/u34/boletim_covid_2021-semanas_20-21-red.pdf
https://agencia.fiocruz.br/sites/agencia... ). Puérperas apresentam manifestações clínicas semelhantes às da população em geral, e, para o Ministério da Saúde (MS), as mulheres até o 14º dia de pós-parto são consideradas grupo de risco para COVID-19(²2. Brasil. Ministério da Saúde. Nota Informativa Nº 13/2020 – SE/GAB/SE/MS. Manual de Recomendações para a Assistência à Gestante e Puérpera frente à Pandemia de COVID-19 [Internet]. Brasília; 2020 [cited 2021 Jan 07]. Available from: https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2020/09/Manual-de-Recomenda-es-para-Gestante-1.pdf
https://portaldeboaspraticas.iff.fiocruz... ).

Diante do isolamento social recomendado, ocorreram mudanças comportamentais e incertezas, tais como mulheres vivenciando seu trabalho de parto sem acompanhante e puérperas, sendo separadas de seus filhos após o nascimento. A possibilidade de o vírus ser transmitido pelo leite materno também foi motivo de preocupações para puérperas, sendo algumas vezes informadas de que a amamentação não era segura(⁶6. Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
https://doi.org/10.1111/mcn.13088... ).

Uma revisão identificou material genético ácido ribonucleico (RNA) de SARS-CoV-2 no leite materno(⁷7. Caparros-Gonzalez RA, Pérez-Morente MA, Hueso-Montoro C, Álvarez-Serrano MA, de la Torre-Luque A. Congenital, Intrapartum and Postnatal Maternal-Fetal-Neonatal SARS-CoV-2 Infections: A Narrative Review. Nutrients. 2020;12(11):3570. DOI: https://doi.org/10.3390/nu12113570
https://doi.org/10.3390/nu12113570... ), porém as evidências ainda não estão claras sobre o potencial de transmissão desse vírus por esta via. Portanto, a OMS e instituições, como o MS(²2. Brasil. Ministério da Saúde. Nota Informativa Nº 13/2020 – SE/GAB/SE/MS. Manual de Recomendações para a Assistência à Gestante e Puérpera frente à Pandemia de COVID-19 [Internet]. Brasília; 2020 [cited 2021 Jan 07]. Available from: https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2020/09/Manual-de-Recomenda-es-para-Gestante-1.pdf
https://portaldeboaspraticas.iff.fiocruz... ), a Federação Brasileira das Associações de Ginecologia e Obstetrícia(⁸8. Federação Brasileira das Associações de Ginecologia e Obstetrícia. Infecção pelo Coronavírus SARS-CoV-2 em obstetrícia. Enfrentando o desconhecido! [Internet]. São Paulo: FEBRASGO; 2020 [cited 2022 Jan 21]. Available from: https://www.febrasgo.org.br/pt/noticias/item/948-infeccao-pelo-coronavirus-sars-cov-2-em-obstetricia-enfrentando-o-desconhecido?highlight=WyJhbGVpdGFtZW50byJd
https://www.febrasgo.org.br/pt/noticias/... ,⁹9. Federação Brasileira das Associações de Ginecologia e Obstetrícia. Nótula complementar sobre COVID-19 e Aleitamento Materno [Internet]. São Paulo: FEBRASGO; 2020 [cited 2022 Jan 21]. Available from: https://www.febrasgo.org.br/pt/noticias/item/949-notula-complementar-sobre-covid-19-e-aleitamento-materno?highlight=WyJhbGVpdGFtZW50byJd
https://www.febrasgo.org.br/pt/noticias/... ), a Sociedade Brasileira de Pediatria(¹⁰10. Sociedade Brasileira de Pediatria. O Aleitamento Materno nos Tempos de COVID-19! [Internet]. SBP; 2020 [cited 2022 Jan 21]. Available from: https://www.sbp.com.br/fileadmin/user_upload/22393c-Nota_de_Alerta_sobe_Aleitam_Materno_nos_Tempos_COVID-19.pdf
https://www.sbp.com.br/fileadmin/user_up... ) e a Academia Americana de Pediatria, recomendam a continuidade do aleitamento materno, pois a prática diminui os riscos de os bebês apresentarem sintomas respiratórios graves(¹¹11. World Health Organization. Breastfeeding and COVID-19 [Internet]. WHO; 2020 [cited 2021 Jan 13]. Available from: https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19
https://www.who.int/news-room/commentari... ,¹²12. Almeida M, Shrestha AD, Stojanac D, Miller LJ. The impact of the COVID-19 pandemic on women’s mental health. Arch Womens Ment Health. 2020;23(6):741-8. DOI: https://doi.org/10.1007/s00737-020-01092-2
https://doi.org/10.1007/s00737-020-01092... ). Além disso, anticorpos para SARS-CoV-2 foram encontrados no leite materno, sugerindo proteção contra infecção pelo vírus(¹³13. Mitoulas LR, Schärer-Hernández NG, Liabat S. Breastfeeding, Human Milk and COVID-19—What Does the Evidence Say? Front Pediatr. 2020;8:613339. DOI: https://doi.org/10.3389/fped.2020.613339
https://doi.org/10.3389/fped.2020.613339... ). A amamentação traz proteção às mulheres sobre muitas doenças, apresentam menos sintomas relacionados a problemas emocionais, reforça o vínculo entre o binômio mãe-filho, gerando diminuição pela busca de atendimento médico pelas lactantes(¹⁴14. Del Ciampo LA, Del Ciampo IRL. Breastfeeding and the Benefits of Lactation for Women’s Health. Rev Bras Ginecol Obstet. 2018;40(6):354-9. DOI: https://doi.org/10.1055/s-0038-1657766
https://doi.org/10.1055/s-0038-1657766... ).

Devido à pandemia, para reduzir o deslocamento das pacientes, com intuito de diminuir a exposição ao SARS-CoV-2, houve reorganização no atendimento à saúde voltado a essa população, sendo algumas consultas realizadas por videochamada, quando possível, ou por telefone(²2. Brasil. Ministério da Saúde. Nota Informativa Nº 13/2020 – SE/GAB/SE/MS. Manual de Recomendações para a Assistência à Gestante e Puérpera frente à Pandemia de COVID-19 [Internet]. Brasília; 2020 [cited 2021 Jan 07]. Available from: https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2020/09/Manual-de-Recomenda-es-para-Gestante-1.pdf
https://portaldeboaspraticas.iff.fiocruz... ,⁶6. Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
https://doi.org/10.1111/mcn.13088... ,¹⁵15. Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
https://doi.org/10.1016/j.appet.2020.104... ). No Reino Unido, puérperas que deram à luz durante o lockdown devido à COVID-19 tiveram contato mais frequente com profissional de saúde do que aquelas que deram à luz antes desse período. Das 1.049 puérperas que tiveram o parto antes do lockdown, 57% (n = 601) relataram diminuição do apoio na alimentação infantil neste período(¹⁵15. Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
https://doi.org/10.1016/j.appet.2020.104... ). Em relação ao aleitamento materno, algumas puérperas optaram por não amamentar, porém, para a maioria das mães, a prática do aleitamento materno permaneceu. Houve inúmeras mudanças comportamentais na rotina das puérperas(¹⁶16. Ahlers-Schmidt CR, Hervey AM, Neil T, Kuhlmann S, Kuhlmann Z. Concerns of women regarding pregnancy and childbirth during the COVID-19 pandemic. Patient Educ Couns. 2020;103(12):2578-82. DOI: https://doi.org/10.1016/j.pec.2020.09.031
https://doi.org/10.1016/j.pec.2020.09.03... ).

Diante da problemática do aleitamento materno em tempos de pandemia e a importância para a saúde que esta prática representa, tanto para a criança quanto para a puérpera, este estudo objetivou identificar como a pandemia de COVID-19 tem influenciado as puérperas no aleitamento materno.

MÉTODO

Tipo do Estudo

Trata-se de uma scoping review, baseada no método proposto pelo Joanna Briggs Institute (JBI). Uma scoping review objetiva mapear conceitos que sustentam uma área de pesquisa, relatar os tipos de evidências disponíveis, independentemente da qualidade metodológica, e identificar lacunas existentes no campo de pesquisa(¹⁷17. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editores. JBI Manual for Evidence Synthesis. JBI; 2020. DOI: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12... ). Assim, seguiram-se as etapas propostas pelo JBI, que compreenderam: a definição do objetivo e da questão de pesquisa; desenvolvimento dos critérios de inclusão; descrição da abordagem para busca, seleção, extração de dados e apresentação das evidências; busca; seleção; extração; análise das evidências; apresentação dos resultados; e resumo das evidências(¹⁷17. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editores. JBI Manual for Evidence Synthesis. JBI; 2020. DOI: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12... ).

A questão norteadora foi elaborada a partir da estratégia População, Conceito e Contexto (PCC), sendo definido: P – puérperas; C – aleitamento materno durante a pandemia de COVID-19; C – sem delimitação de cenários. Diante disso, formulou-se a questão norteadora: como a pandemia de COVID-19 tem influenciado as puérperas no aleitamento materno?

Foi realizada busca inicial nas bases de dados da Biblioteca Virtual em Saúde (BVS) e PubMed/MEDLINE, para análise dos termos utilizados para descrever os artigos relevantes para o estudo. Em seguida, realizou-se a pesquisa nas bases de dados BVS, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, PubMed/MEDLINE, Scientific Electronic Library Online (SciELO), Scopus e Web of Science. A estratégia de busca no Quadro 1 foi desenvolvida com o auxílio de um bibliotecário da Universidade Federal do Paraná (UFPR), de acordo com os Descritores em Ciências da Saúde (DeCS) e Medical Subject Headings (MeSH), e a mesma estratégia de busca foi utilizada nas bases de dados que compuseram o estudo.

Quadro 1
Estratégia de busca da scoping review – Curitiba, PR, Brasil, 2021.

Critérios de Seleção

Para seleção dos estudos, os critérios de inclusão foram: envolver puérperas e/ou puerpério; investigar simultaneamente aleitamento materno e a pandemia de COVID-19; estar disponível na íntegra nos idiomas inglês, português ou espanhol; estar disponível via institucional; estudos primários, artigos de revisão, relatos de experiência, relatórios de pesquisa, comentários e artigos de opinião; ter sido publicado no período de dezembro de 2019, o tempo de início dos primeiros casos de pneumonia não identificada que começaram em Wuhan, na China e se veio a confirmar como sendo COVID-19, a abril de 2021, sendo o período de finalização da pesquisa. Os critérios de exclusão foram: constar como editoriais; cartas; vídeos; sites; notícias; pré-prints; resumos; e protocolos.

Coleta de Dados

A coleta de dados ocorreu de abril a junho de 2021. Inicialmente, os artigos encontrados foram incorporados no software EndNote, gerenciador de referências que auxilia os pesquisadores na operacionalização da seleção de estudos primários(¹⁸18. Mendes KDS, Silveira RC de CP, Galvão CM. Use of the bibliographic reference manager in the selection of primary studies in integrative reviews. Texto & Contexto Enfermagem. 2019;28:e20170204. DOI: https://doi.org/10.1590/1980-265X-TCE-2017-0204
https://doi.org/10.1590/1980-265X-TCE-20... ). Após remoção das duplicatas no software EndNote, os estudos foram inseridos no software Rayyan, aplicativo desenvolvido para agilizar a triagem inicial de títulos e resumos de estudos em revisões sistemáticas(¹⁹19. Ouzzani, M, Hammady, H, Fedorowicz, Z, Elmagarmid A. Rayyan – a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. DOI: https://doi.org/10.1186/s13643-016-0384-4
https://doi.org/10.1186/s13643-016-0384-... ), no qual ocorreu a remoção de duplicatas que não foram detectadas pelo software EndNote. Essas duplicatas removidas foram consideradas apenas uma vez, e não removidas em sua totalidade.

Os títulos e resumos foram analisados por um revisor no software Rayyan. Nas situações de dúvidas, os artigos permaneceram para a fase seguinte, que envolveu a leitura na íntegra por dois revisores independentemente. Nesta etapa, discutiram-se os resultados em uma reunião de consenso, e os estudos conflituosos (n = 5) foram resolvidos com a leitura na íntegra às cegas pelo terceiro revisor para definir a inserção ou exclusão dos estudos. Para apresentar o processo de seleção dos estudos da scoping review, foi utilizado o fluxograma Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA ScR), conforme recomendações do JBI(¹⁷17. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editores. JBI Manual for Evidence Synthesis. JBI; 2020. DOI: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12... ).

Para extração dos dados dos estudos selecionados, foi utilizado um instrumento disponibilizado pelo JBI(¹⁷17. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editores. JBI Manual for Evidence Synthesis. JBI; 2020. DOI: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12... ). As informações selecionadas foram: autoria; ano de publicação; título; revista; volume; edição; páginas; país; idioma; contexto; participantes (idade e número); objetivo(s); metodologia/métodos; principais resultados; e conclusões.

Análise e Tratamento dos Dados

A análise dos dados ocorreu por meio da categorização dos estudos, reunindo temas em comum, envolvendo a codificação dos dados, com a seleção das unidades de registro (UR), correspondendo aos recortes de conteúdos textuais significativos e representativos para a análise, originando, assim, os temas. Após isso, ocorrem a enumeração das UR e, então, a classificação e agregação dos dados na forma de categorias, consistindo no agrupamento dos temas em comum(²⁰20. Bardin L. Análise de conteúdo. 1ª ed. São Paulo: Edições 70; 2016.).

RESULTADOS

A busca resultou em 297 estudos. Após remoção das duplicatas, leitura de título e resumo e leitura na íntegra, a amostra final foi composta por 25 estudos, como mostra a Figura 1.

Figura 1.
Fluxograma da estrutura da scoping review. Curitiba, PR, Brasil, 2021.

Dos estudos incluídos (Tabela 1), observou-se predominância do idioma inglês (n = 22,88%), seguido do espanhol (n = 2,8%) e português (n = 1,4%). Os Estados Unidos da América foram o país com maior número de publicação (n = 9,36%), seguido da Espanha, Itália (n = 3,12%), Brasil (n = 2,8%), China, Vietnã, Bélgica, Índia, Nepal, Irã e Áustria (n = 1,4%), além de um estudo na Rede SIBEN da América Latina e Guiné Equatorial (n = 1,4%). Predominaram artigos publicados no ano de 2020 (n = 15,60%), sendo 10 (40%) em 2021.

Thumbnail

Tabela 1.
Estudos incluídos na scoping review – Curitiba, PR, Brasil, 2021.

Dos 25 estudos, 4 (16%) se caracterizaram como pesquisas transversais, 2 (8%), como estudos retrospectivos, 1 (4%), como ambispectivo e prospectivo, 6 (24%), como relatos de experiência/caso, 5 (20%), como artigos de revisão, 2 (8%), como comentários, 1 (4%), como relatório de pesquisa, comunicação curta, estudo de caso-controle e estudo descritivo. De 21 estudos, 16 (76%) foram em hospitais, 4 (19%), na comunidade e 1 (5%), na atenção primária. Os participantes dos estudos foram puérperas (n = 11,44%), gestantes e puérperas (n = 4,16%), profissionais da instituição hospitalar (n = 4,16%), parturientes (n = 2,8%), gestantes e lactantes, lactantes, gestantes e RN de mães testadas para COVID-19 (n = 1,4%).

A partir da análise categorial, emergiram temas comuns que respondem à questão de pesquisa, organizados em cinco categorias: Influência da pandemia na rotina de cuidados ao aleitamento materno; Influência da pandemia nas taxas do aleitamento materno; Influência da pandemia na rede de apoio para a prática do aleitamento materno; Influência da pandemia nas emoções das puérperas; Influência da pandemia no uso da tecnologia para apoio ao aleitamento materno.

Influência da Pandemia na Rotina de Cuidados ao Aleitamento Materno

Estudos apontaram medidas preventivas adotadas contra a COVID-19(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
https://doi.org/10.1590/1806-9304202100S... ,²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ,²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
https://doi.org/10.1111/apa.15837... –³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.–⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
https://doi.org/10.1111/1471-0528.16278... ). Destacaram a recomendação do uso de máscara ao amamentar(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
https://doi.org/10.1590/1806-9304202100S... ,²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ,²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
https://doi.org/10.1111/apa.15837... ,²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ,³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
https://doi.org/10.1111/1471-0528.16278... ), a higienização das mãos antes de tocar no bebê(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
https://doi.org/10.1590/1806-9304202100S... ,²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
https://doi.org/10.1111/apa.15837... ,²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ,³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ) e ao manusear a bomba de leite(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
https://doi.org/10.1590/1806-9304202100S... ,²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ) e a adoção dos testes para COVID-19 na admissão hospitalar(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ,²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ).

Em relação à mudança na rotina hospitalar, foi mencionada manutenção do alojamento conjunto com distanciamento de, pelo menos, 1 metro entre o berço e o leito materno(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
https://doi.org/10.1590/1806-9304202100S... ,²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
https://doi.org/10.1111/apa.15837... ,²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ,²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... ,³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ). Destacaram-se casos em que o alojamento conjunto não foi permitido ou foi desencorajado(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ,²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... –³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ). A preocupação com a exposição ao vírus, junto às medidas de prevenção adotadas, como a separação do binômio, podem prejudicar o aleitamento materno(³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
https://doi.org/10.1111/mcn.13033... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ).

Observou-se que o aleitamento materno foi mantido e apoiado com a discussão entre a mãe e a equipe de saúde sobre os riscos e benefícios(²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
https://doi.org/10.1111/1471-0528.16278... ). No entanto, foi descrito que a amamentação não foi possível, devido ao binômio estar separado(³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ).

Sobre a presença do acompanhante, descreveram-se a permissão do acompanhamento durante o pós-parto(²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ), a não permissão(⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ) e o não recebimento de visitas na internação(³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ). Em relação às visitas dos pais ao bebê internado, registrou-se que a mãe teve autorização para visitar seu filho após 16 dias de internação(³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ) e que visitas não eram permitidas(⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ).

A pandemia de COVID-19 influenciou no atendimento à lactação e hospitais passaram a ofertar consultas de amamentação virtuais(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ). Cancelaram-se aulas sobre amamentação, assim como as puérperas procuraram amigos ao invés de profissionais da saúde(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ).

Observou-se fragilidade das informações relacionadas à COVID-19, gestação e puerpério(²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.–³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
https://doi.org/10.1111/mcn.13033... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ,⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ), afetando negativamente manejo do parto, puerpério e amamentação em mulheres positivas para COVID-19(²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... ), saúde mental(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.), cuidado humanizado(⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ) e desafio de se tomar uma decisão em relação ao aleitamento materno devido à falta de informação(³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ).

Por outro lado, o conhecimento sobre a COVID-19, demonstrado pelas puérperas(³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ), ajudou-as a manter seus filhos protegidos do vírus SARS-CoV-2(³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... ), e os benefícios da amamentação encorajaram para a manutenção dessa prática(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ). Um estudo apresentou que a não realização da amamentação, devido à separação do binômio, pode trazer desfechos negativos às puérperas, como aumento do risco de hemorragia pós-parto, anemia materna, partos espaçados, risco aumentado de câncer de mama entre outros, além de danos à saúde do bebê(³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
https://doi.org/10.1111/mcn.13033... ). Por fim, destacou-se que a prática do alojamento conjunto e do aleitamento materno permitiu oportunidade de aprendizado às puérperas sobre as medidas de prevenção contra a COVID-19 e a amamentação ou extração do leite seguras, reduzindo os riscos de transmissão do vírus(³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ).

Influência da Pandemia Nas Taxas do Aleitamento Materno

Nessa categoria, descreveu-se(²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ) o uso da alimentação com fórmula, devido ao RN estar na UTIN durante o isolamento(²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ) ou os pais estarem em quarentena(⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ). Apresentou-se que mães positivas para COVID-19 tiveram taxas maiores de alimentação com fórmula, sendo 56,8% (n = 71), seguido do leite materno ordenhado, de 36% (n = 45)(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ) e 63% (n = 49) optaram pela fórmula, em comparação com 24% (n = 19), que mantiveram o aleitamento materno, e 13% (n = 10), leite materno ordenhado(⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ).

A alimentação por leite materno ordenhado foi realizada na internação pós-parto de mães com COVID-19(²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ) durante a internação do RN na UTIN(²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ) e até que a puérpera fosse assintomática, podendo, assim, estabelecer a amamentação(³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ). O aleitamento materno durante a hospitalização no pós-parto foi relatado(²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
https://doi.org/10.1111/apa.15837... –²⁷27. Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286
https://doi.org/10.1016/j.earlhumdev.202... ,³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ,³⁴34. Mejía Jiménez I, Salvador López R, García Rosas E, Rodriguez de la Torre I, Montes García J, Cruz Conty M, et al. Umbilical cord clamping and skin-to-skin contact in deliveries from women positive for SARS-CoV-2: a prospective observational study. BJOG. 2020;128(5):908-15. DOI: https://doi.org/10.1111/1471-0528.16597
https://doi.org/10.1111/1471-0528.16597... ,⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
https://doi.org/10.1111/1471-0528.16278... ). Na Itália(²⁷27. Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286
https://doi.org/10.1016/j.earlhumdev.202... ), a taxa do aleitamento materno exclusivo foi menor (n = 107, 70,39%) nas puérperas que deram à luz durante a pandemia de COVID-19, em relação às puérperas que deram à luz em 2019 (n = 123, 86,39%). Observou-se que, de 1.343 hospitais, a taxa de aleitamento materno exclusivo diminuiu em 12,2% deles(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ).

Em um estudo, 94% (n = 31) dos RN que estavam junto com suas mães foram amamentados na primeira hora de vida(³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ). A taxa de amamentação em um grupo que teve o CTC foi maior em comparação com o grupo de clampeamento precoce do cordão (77,3% contra 50,2%)(³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ). Um estudo(⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
https://doi.org/10.1111/1471-0528.16278... ) apontou que 26,2% (n = 11) das puérperas com COVID-19 amamentaram no período de internação pós-parto.

Relatou-se aleitamento materno exclusivo, leite no seio materno e leite materno ordenhado(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ). Estudo observou que, de 97% em aleitamento materno, 53% dos bebês estavam em aleitamento materno exclusivo em casa(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ). Identificou-se que 55% das mães forneceram leite materno exclusivamente durante reuniões do grupo de apoio sobre amamentação, além do aumento da taxa de amamentação de 43%, em 2017, para 55%, em 2020(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
https://doi.org/10.1089/bfm.2020.0323... ).

Houve registro de taxas mais baixas de aleitamento materno exclusivo de mães que amamentavam durante a pandemia, adotando mais práticas de alimentação complementar, assim como mudança de leite em fórmula para aleitamento materno por falta de fórmula, custo, medo de contaminação da fórmula ou por acreditar que o leite era a melhor opção para proteção do filho. As mães mencionaram um impacto positivo da pandemia na amamentação(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ).

Também foram mencionados os planos de alimentação infantil, havendo plano alimentar de um ano combinando leite materno no peito e bombeado(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ). Apontou-se que a dieta do bebê não mudou devido à pandemia e que 97% das mães não consideraram parar de oferecer leite materno, assim como as mulheres com experiência anterior de aleitamento materno relataram que o SARS-CoV-2 não teve influência sobre como elas lidaram com a amamentação(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ).

A proteção que o leite materno pode oferecer contra o SARS-CoV-2 também foi citada, demonstrando que, de quatro amostras, três deram positivas para IgM ou IgG contra SARS-CoV-2(²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ). Destaca-se que a diminuição da amamentação poderia limitar a proteção contra o vírus(³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
https://doi.org/10.1111/mcn.13033... ).

Estudos mencionaram aumento da frequência do aleitamento(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ), demonstrando crescimento comparado a antes da pandemia, sendo um dos motivos ficar mais tempo em casa devido ao lockdown e o desejo de oferecer proteção contra o vírus através do leite materno, considerando prolongar o tempo de amamentação devido ao coronavírus(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ). Relatou-se o aumento da duração da licença-maternidade, como influência positiva na jornada para amamentar, assim como o medo por falta de leite em fórmula, sendo um incentivo a continuar a amamentar(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ).

Além disso, foi descrita diminuição da frequência(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ). As puérperas mencionaram que o declínio ou interrupção da amamentação se deu por consequências do bloqueio, como trabalhar em casa juntamente com outras responsabilidades de puericultura, uma maior carga de trabalho ou uma redução na produção de leite devido às preocupações com o coronavírus(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ).

Houve registro sobre a recusa de puérperas (n = 3, 23,1%) em amamentar, mesmo desejando fazê-lo, após saber o resultado positivo para COVID-19(²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... ) e que, em algum momento, houve interrupção da amamentação(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ) e mudança da alimentação para leite em fórmula(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ).

Influência da Pandemia na Rede de Apoio Para a Prática do Aleitamento Materno

Os temas relacionados a essa categoria correspondem ao suporte recebido pelas puérperas tanto dos profissionais da saúde quanto de grupos de apoio, família, amigos e colegas de trabalho(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
https://doi.org/10.1089/bfm.2020.0323... ,²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ,³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ,³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ). A rede de apoio envolvendo a família e amigos(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ) e colegas de trabalho(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ) foi citada. Os cuidados dos profissionais de saúde compreenderam o auxílio e orientação nos cuidados com a amamentação e com consulta sobre lactação(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ). Em um hospital, observou-se a realização de videoconferências com as famílias que não podiam ir às visitas(³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ). Relatou-se a influência positiva de um grupo de apoio à amamentação(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
https://doi.org/10.1089/bfm.2020.0323... ), porém houve o cancelamento de grupos de apoio devido à pandemia(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ).

A falta de assistência pelos serviços de saúde foi observada(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ,³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ). Houve redução do acesso ao suporte à lactação presencial(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ). Puérperas relataram insatisfação com a assistência que receberam, além da redução do apoio à lactação no ambiente hospitalar(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ). Essas sentiram o impacto no aconselhamento médico, relataram que receberam menos assistência profissional em comparação à antes da pandemia. As mães que amamentaram por menos de 6 semanas relataram que a pandemia afetou sua assistência e menos de 10% das puérperas relataram ter recebido mais assistência profissional(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ).

A falta de apoio familiar foi relatada durante a internação da puérpera com COVID-19(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.). Houve relato do desejo de ter recebido mais apoio de creches e da família que, devido à pandemia, não puderam ficar próximos(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ). De 39% das puérperas que relataram ter recebido menos apoio social na amamentação, 87% relataram ser de família e amigos(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ).

Influência da Pandemia Nas Emoções Das Puérperas

Os estudos reunidos nessa categoria apresentaram os sentimentos expressados pelas puérperas. Preocupações devido à pandemia foram descritas(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ), atribuídas ao retorno ao trabalho devido a novas políticas que dificultam para retirar o leite materno no trabalho, relacionadas à manutenção da lactação(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ) no que se refere tanto à ordenha manual do leite materno quanto à extração por bombas extratoras, por não poder realizar as funções maternas por estar longe do filho na internação, com julgamentos pela sua doença(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.), com o encargo financeiro para comprar fórmula infantil e sua disponibilidade nas lojas, bem como se o estresse afetaria a oferta de leite(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ) e com a transmissão do vírus através da amamentação(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ).

Um estudo identificou que 23,03% (n = 35) das puérperas que deram à luz durante a pandemia de COVID-19 tiveram o escore da Edinburgh Postnatal Depression Scale (EPDS) para risco de sintomas depressivos >12, em comparação com 11,56% (n = 17) das puérperas que deram à luz em 2019, como também apresentaram escores maiores na subescala de anedonia e depressão. Observaram-se também que as puérperas que estavam em aleitamento materno exclusivo apresentaram, nessas subescalas, pontuações significativamente mais baixas do que aquelas que estabeleceram práticas complementares e alimentação artificial(²⁷27. Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286
https://doi.org/10.1016/j.earlhumdev.202... ).

Relatou-se perda de apetite e interesse pelas atividades diárias durante a internação(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.) e de sintomas depressivos em puérperas amamentando(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ). Por outra perspectiva, puérperas em aleitamento materno exclusivo apresentaram pontuações mais baixas na EPDS, comparado a outros métodos de alimentação(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ).

O estresse(²⁴24. Mayopoulos GA, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, et al. COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. J Affect Disord. 2021;282:122-5. DOI: https://doi.org/10.1016/j.jad.2020.12.101
https://doi.org/10.1016/j.jad.2020.12.10... ,³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ) foi relacionado à jornada de amamentação pela falta de apoio e como a pandemia poderia influenciar a puérpera e seu filho(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ), também devido aos deveres maternos não cumpridos(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.). A frustração(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ) foi descrita como um desapontamento com as medidas do distanciamento social, por ter planejado a participação de sua família e amigos em seu parto, e, devido à pandemia, apenas o marido pôde estar presente(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ). O estresse esteve, também, relacionada às expectativas da maternidade não atendidas e com a sensação de oportunidade perdida de amamentar o filho(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ).

O medo foi relatado pela possibilidade de infecção a partir da hospitalização ou pela amamentação(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.) e do diagnóstico e das consequências que isso pode causar(³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ). Houve relato de ansiedade devido às preocupações(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ), ao medo(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.), ao sentimento de isolamento(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.), à culpa(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ), à tristeza por não receber visita de familiares e amigos durante a internação(³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ) e por não participar de grupos de apoio devido ao distanciamento social(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ).

Os desafios descritos se relacionaram à tomada de decisões em relação à amamentação com informações limitadas sobre a COVID-19(³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ) e ao fato de que, se a pandemia tivesse ocorrido na primeira experiência das puérperas, os desafios teriam sido maiores(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ). Outro aspecto apontado foi que o vínculo mãe-filho pode acabar sofrendo impacto com as medidas de prevenção adotadas para combater a COVID-19, além do medo e da ansiedade por parte da mãe que podem acabar afetando a construção desse vínculo(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
https://doi.org/10.1590/1806-9304202100S... ). Relatou-se, também, o momento gratificante da puérpera ao ter contato com seu filho após ficar dias sem poder visitá-lo, podendo, assim iniciar os cuidados maternos(³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ).

Influência da Pandemia No Uso da Tecnologia Para Apoio ao Aleitamento Materno

Aqui estão incluídos estudos que relataram as experiências das puérperas com o uso da tecnologia(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
https://doi.org/10.1089/bfm.2020.0323... ,³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ,³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... ,³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ). As fontes de informação descritas foram o meio online(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ), tais como redes sociais(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... ), televisão e rádio(³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... ). Em relação aos atendimentos online, após a alta hospitalar, houve 100% de adesão às televisitas(³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ) e atendimento pós-parto facilitado através da telessaúde, incluindo visitas de lactação(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ). Entretanto, houve dificuldade e preocupação de obter uma boa assistência relacionada à pega na amamentação através da telessaúde(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ).

A utilização de chamadas de vídeos em um hospital foi citada, sendo realizadas por profissionais entre a puérpera e o RN, que estava internado em outra unidade, possibilitando o envio de fotos e atualizações sobre o bebê até que a puérpera pudesse visitá-lo. As visitas virtuais ajudaram para que a mãe conseguisse extrair o seu leite para enviar ao seu filho(³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ). Destaca-se, também, aumento da frequência de reuniões de um grupo de apoio à amamentação após o início da pandemia, no formato online. A mídia social foi uma boa alternativa para envolver os participantes, considerando continuar com a opção virtual das reuniões, visto que, nesse formato, é possível a participação de mães que têm dificuldade de comparecer pessoalmente(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
https://doi.org/10.1089/bfm.2020.0323... ).

DISCUSSÃO

As mudanças nas práticas de amamentação demonstradas(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
https://doi.org/10.1590/1806-9304202100S... ,²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ,²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
https://doi.org/10.1111/apa.15837... ,²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ,³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
https://doi.org/10.1111/1471-0528.16278... ) vão ao encontro das recomendações da OMS(⁴⁶46. World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected [Internet]. WHO; 2020 [cited 2021 July 13]. Available from: https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf
https://www.who.int/docs/default-source/... ), Centers for Disease Control and Prevention (CDC)(⁴⁷47. Centers for Disease Control and Prevention. Care for Breastfeeding People [Internet]. COVID-19; 2021 [cited 2021 July 13]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/care-for-breastfeeding-women.html
https://www.cdc.gov/coronavirus/2019-nco... ) e do MS(⁴⁸48. Brasil. Ministério da Saúde. Nota técnica Nº 7/2020-DAPES/SAPS/MS [Internet]. Brasília; 2020 [cited 21 July 13]. Available from: http://www.saude.sp.gov.br/resources/instituto-de-saude/homepage/pdfs/sei_ms-0014033399-notatecnicaaleitamentoecovid.pdf
http://www.saude.sp.gov.br/resources/ins... ), a fim de evitar a transmissão do vírus para o bebê. A manutenção do alojamento conjunto(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
https://doi.org/10.1590/1806-9304202100S... ,²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
https://doi.org/10.1111/apa.15837... ,²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ,²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... ,³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ) e ao aleitamento materno(²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
https://doi.org/10.1016/j.semperi.2020.1... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
https://doi.org/10.1111/1471-0528.16278... ) corroboram com as recomendações da OMS(¹¹11. World Health Organization. Breastfeeding and COVID-19 [Internet]. WHO; 2020 [cited 2021 Jan 13]. Available from: https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19
https://www.who.int/news-room/commentari... ). O binômio deve permanecer junto, e a amamentação deve continuar, independente da suspeita ou confirmação de COVID-19.

O CDC(⁴⁹49. Centers for Disease Control and Prevention. Breastfeeding and Caring for Newborns [Internet]. COVID-19; 2021 [cited 2021 July 13]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html
https://www.cdc.gov/coronavirus/2019-nco... ) orienta que a decisão do alojamento conjunto seja tomada em consenso entre mãe e equipe, após ter conhecimento dos riscos e benefícios, visto que essa prática auxilia no desenvolvimento do vínculo do binômio mãe-bebê e no aleitamento materno. Como mencionado em um estudo(⁵⁰50. Popofsky S, Noor A, Leavens-Maurer J, Quintos-Alagheband ML, Mock A, Vinci A, et al Impact of Maternal Severe Acute Respiratory Syndrome Coronavirus 2 Detection on Breastfeeding Due to Infant Separation at Birth. J Pediatr. 2020;226:64-70. DOI: https://doi.org/10.1016/j.jpeds.2020.08.004
https://doi.org/10.1016/j.jpeds.2020.08.... ), apenas 12% das puérperas que foram separadas dos filhos durante a internação na pandemia de COVID-19 amamentaram em casa, em comparação a 27,8% das mães que não foram separadas, demonstrando que a separação tem um impacto negativo na amamentação, como observado nos achados(²⁷27. Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286
https://doi.org/10.1016/j.earlhumdev.202... ,³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
https://doi.org/10.1111/mcn.13033... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... –⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ).

A OMS recomenda a presença de acompanhante durante o trabalho de parto e parto(⁵¹51. World Health Organization. WHO recommendations Intrapartum care for a positive childbirth experience [Internet]. WHO; 2018 [cited 2021 July 25]. Available from: http://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf;jsessionid=EAF86236F2A8E00D4EFB98BF409FDF7D?sequence=1
http://apps.who.int/iris/bitstream/handl... ). No Brasil, as parturientes têm direito a um acompanhante de escolha durante o trabalho de parto, parto e pós-parto imediato, regulamentado por lei(⁵²52. Brasil. Lei nº 11.108, de 7 de abril de 2005. Altera a Lei nº 8.080, de 19 de setembro de 1990, para garantir às parturientes o direito à presença de acompanhante durante o trabalho de parto, parto e pós-parto imediato, no âmbito do Sistema Único de Saúde – SUS [Internet]. Brasília; 2005 [cited 2021 July 24]. Available from: http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2005/lei/l11108.htm
http://www.planalto.gov.br/ccivil_03/_at... ), no entanto, em dois estudos desta revisão, as puérperas não tiveram essa permissão(⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... ,⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ). A presença do acompanhante, além de transmitir segurança às puérperas, foi associado à boas práticas assistenciais, como aleitamento materno na primeira hora de vida, escolha da posição do parto, não ser amarrada, submissão a manobras não farmacológicas e analgesia para alívio da dor(⁵³53. Tomasi YT, Saraiva S dos S, Boing AC, Delziovo CR, Wagner KJP, Boing AF. From prenatal care to childbirth: a cross-sectional study on the influence of a companion on good obstetric practices in the Brazilian National Health System in Santa Catarina State, 2019. Epidemiol Serv Saude. 2021;30(1):e2020383. DOI: https://doi.org/10.1590/S1679-49742021000100014
https://doi.org/10.1590/S1679-4974202100... ), destacando a importância dos acompanhantes nesse processo.

Observa-se o impacto da desinformação relacionada a COVID-19(³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
https://doi.org/10.1038/s41372-020-0695-... ,³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
https://doi.org/10.3126/kumj.v18i2.32938... –³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
https://doi.org/10.1111/mcn.13033... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ,⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ) em puérperas que pararam de amamentar, nas quais houve maior probabilidade de serem informadas por profissionais de saúde ou familiares e amigos de que amamentar não seria seguro ou não poderiam fazê-la caso estivessem com sintomas da doença(⁶6. Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
https://doi.org/10.1111/mcn.13088... ). É possível perceber a importância de transmitir informações atualizadas sobre a COVID-19, visto que as evidências sobre o vírus causador dessa doença mudam rapidamente. Dessa forma, os profissionais de saúde devem orientar e tomar as decisões, de modo compartilhado, com a família, respeitando a vontade dos pais(¹1. DiLorenzo MA, O’Connor SK, Ezekwesili C, Sampath S, Zhao M, Yarrington C, et al. COVID-19 guidelines for pregnant women and new mothers: A systematic evidence review. Int J Gynaecol Obstet. 2021;153(3):373-82. DOI: https://doi.org/10.1002/ijgo.13668
https://doi.org/10.1002/ijgo.13668... ). Nesse sentindo, observou-se estratégia de suporte à lactantes com embasamento científico por consultoras de lactação, no qual promoveram-se encontros online em tempo real com profissionais de várias áreas da saúde, a fim de sanar dúvidas das famílias e para que as puérperas se mantivessem incentivadas a manter a amamentação, reforçando para as puérperas a importância de consultar informações sobre a COVID-19 e amamentação em fontes seguras e confiáveis(⁵⁴54. Lima ACMACC, Chaves AFL, Oliveira MG de, Lima SAFCC, Machado MMT, Oriá MOB. Breastfeeding consultancy during the COVID-19 pandemic: experience report. Escola Anna Nery. 2020;24(Spe):e20200350. DOI: https://doi.org/10.1590/2177-9465-EAN-2020-0350
https://doi.org/10.1590/2177-9465-EAN-20... ).

Sobre a alimentação por fórmula infantil, um estudo encontrou dado semelhante aos achados(²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ,⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
https://doi.org/10.3233/NPM-200478... –⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
https://doi.org/10.26633/RPSP.2020.47... ), demonstrando que este tipo de alimentação predominou no grupo de díades mãe-bebê que foram separadas na internação, sendo 81,6% em comparação a 27,8% das díades que não foram separadas. A taxa de amamentação foi menor entre as díades separadas (0%), em comparação com as não separadas (22%)(⁵⁰50. Popofsky S, Noor A, Leavens-Maurer J, Quintos-Alagheband ML, Mock A, Vinci A, et al Impact of Maternal Severe Acute Respiratory Syndrome Coronavirus 2 Detection on Breastfeeding Due to Infant Separation at Birth. J Pediatr. 2020;226:64-70. DOI: https://doi.org/10.1016/j.jpeds.2020.08.004
https://doi.org/10.1016/j.jpeds.2020.08.... ). Os resultados encontrados sobre o aleitamento materno exclusivo(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
https://doi.org/10.1089/bfm.2020.0323... ,²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ,²⁷27. Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286
https://doi.org/10.1016/j.earlhumdev.202... ,³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ) são corroborados por estudos, em que 58,6% das participantes amamentaram exclusivamente em casa durante a pandemia(⁶6. Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
https://doi.org/10.1111/mcn.13088... ), em que 40% de 316 mães que deram à luz durante o isolamento social estavam em aleitamento materno exclusivo no domicílio(¹⁵15. Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
https://doi.org/10.1016/j.appet.2020.104... ), e que identificaram que, no momento da alta, 69,4% dos bebês estavam em aleitamento materno exclusivo, em comparação a 97,7% dos bebês em 2018(⁵⁵55. Latorre G, Martinelli D, Guida P, Masi E, De Benedictis R, Maggio L. Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers. Int Breastfeed J. 2021;16(1):36. DOI: https://doi.org/10.1186/s13006-021-00382-4
https://doi.org/10.1186/s13006-021-00382... ).

Observou-se nos achados desta revisão que a maioria dos planos de alimentação não foram influenciados negativamente pela pandemia(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ). Na literatura, 219 (14,2%) pais relataram mudanças na alimentação devido à pandemia, com 95% realizando o desmame mais tarde do que o planejado(⁵⁶56. Palmquist AE, Fox C, Chung S, Tomori C, Quinn EA. Infant Feeding during the COVID-19 Pandemic in the U.S. – 90th Annual Meeting of the American Association of Physical Anthropologists. Am J Phys Anthropol. 2021;174 Suppl 71:81. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajpa.24262
https://onlinelibrary.wiley.com/doi/epdf... ). Contudo, em um estudo, 35,3% das mães mudaram seus planos de alimentação devido à COVID-19, considerando a separação e, consequentemente, à dificuldade de pega na mama como motivos(⁵⁰50. Popofsky S, Noor A, Leavens-Maurer J, Quintos-Alagheband ML, Mock A, Vinci A, et al Impact of Maternal Severe Acute Respiratory Syndrome Coronavirus 2 Detection on Breastfeeding Due to Infant Separation at Birth. J Pediatr. 2020;226:64-70. DOI: https://doi.org/10.1016/j.jpeds.2020.08.004
https://doi.org/10.1016/j.jpeds.2020.08.... ). Mães que deram à luz durante o lockdown relataram que os planos de alimentação mudaram por falta de apoio para amamentar (6,6%), principalmente no auxílio presencial, com problemas práticos, como pega na mama, que resultou na retirada do leite materno e introdução de fórmula ou interrupção da amamentação(¹⁵15. Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
https://doi.org/10.1016/j.appet.2020.104... ).

Há registro da presença de anticorpos IgM ou IgG contra SARS-CoV-2 no leite materno(²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
https://doi.org/10.1016/j.nmni.2020.1007... ). Na revisão, houve duas evidências da presença de anticorpos IgG contra o mesmo vírus no leite materno, porém não foram identificados anticorpos IgM(⁷7. Caparros-Gonzalez RA, Pérez-Morente MA, Hueso-Montoro C, Álvarez-Serrano MA, de la Torre-Luque A. Congenital, Intrapartum and Postnatal Maternal-Fetal-Neonatal SARS-CoV-2 Infections: A Narrative Review. Nutrients. 2020;12(11):3570. DOI: https://doi.org/10.3390/nu12113570
https://doi.org/10.3390/nu12113570... ). Esses achados indicam uma possível proteção aos bebês contra SARS-CoV-2, e a diminuição da amamentação poderia limitar a proteção contra o vírus(³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
https://doi.org/10.1111/mcn.13033... ).

O aumento da frequência do aleitamento materno(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ) está de acordo com dados obtidos no Reino Unido e EUA, em que um dos motivos para este aumento entre as puérperas foi estar em casa mais tempo na pandemia(¹⁵15. Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
https://doi.org/10.1016/j.appet.2020.104... ,⁵⁶56. Palmquist AE, Fox C, Chung S, Tomori C, Quinn EA. Infant Feeding during the COVID-19 Pandemic in the U.S. – 90th Annual Meeting of the American Association of Physical Anthropologists. Am J Phys Anthropol. 2021;174 Suppl 71:81. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajpa.24262
https://onlinelibrary.wiley.com/doi/epdf... ). Apesar disso, houve relatos de declínio, interrupção ou desistência da amamentação(²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... ,³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ). Esses resultados são consistentes com outro achado, no qual o suporte profissional insuficiente, a dificuldade de pega, o cansaço, o leite insuficiente e a dor foram atribuídos a parar de amamentar no Reino Unido na atual pandemia(⁶6. Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
https://doi.org/10.1111/mcn.13088... ).

Ainda no mesmo estudo, 67% das participantes relataram sentir menos suporte à amamentação durante o lockdown(⁶6. Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
https://doi.org/10.1111/mcn.13088... ), outro dado semelhante ao desta revisão(²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
https://doi.org/10.1016/j.enfcli.2021.01... ,³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ). Notou-se, em estudo realizado antes da atual pandemia, que o apoio adequado à amamentação tem papel fundamental no sucesso do aleitamento materno percebido, em que a ausência de dificuldades para amamentar e receber apoio, em caso de dificuldades, foi associada a um menor risco de amamentação não exclusiva(⁵⁷57. Gianni ML, Bettinelli ME, Manfra P, Sorrentino G, Bezze E, Plevani L, et al. Breastfeeding Difficulties and Risk for Early Breastfeeding Cessation. Nutrients. 2019;11(10):2266. DOI: https://doi.org/10.3390/nu11102266
https://doi.org/10.3390/nu11102266... ). Mulheres que buscaram ajuda profissional por dificuldades na amamentação apresentaram maiores chances de interromper o aleitamento materno exclusivo(⁵⁸58. Moraes BA, Strada JKR, Gasparin VA, Espirito-Santo LC do, Gouveia HG, Gonçalves AC. Breastfeeding in the first six months of life for babies seen by Lactation Consulting. Rev Lat Am Enfermagem. 2021;29:e3412. DOI: https://doi.org/10.1590/1518-8345.3538.3412
https://doi.org/10.1590/1518-8345.3538.3... ). Também, algumas puérperas, durante a pandemia de COVID-19, pararam de amamentar mais cedo do que desejavam por falta de apoio no hospital e em casa(⁵⁹59. Rice K, Williams S. Women’s postpartum experiences in Canada during the COVID-19 pandemic: a qualitative study. CMAJ Open. 2021;9(2):E556-62. DOI: https://doi.org/10.9778/cmajo.20210008
https://doi.org/10.9778/cmajo.20210008... ).

A respeito da rede de apoio(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
https://doi.org/10.3390/ijerph17186766... ,³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.), há estudo que registrou que o apoio à alimentação infantil diminuiu desde o bloqueio em 57% das mulheres que deram à luz antes do lockdown, assim como o apoio de creches diminuiu para 69% das participantes(¹⁵15. Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
https://doi.org/10.1016/j.appet.2020.104... ). Ademais, a falta de apoio social e emocional na pandemia impactou negativamente a experiência na amamentação entre puérperas no Reino Unido(⁶6. Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
https://doi.org/10.1111/mcn.13088... ), reforçando a importância do suporte social às lactantes, observado na influência positiva do grupo de apoio na amamentação(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
https://doi.org/10.1089/bfm.2020.0323... ). O suporte social possui forte proteção contra depressão pós-parto (DPP), e ter uma rede de apoio adequada é fundamental para reduzir os sintomas de DPP(⁶⁰60. Pao C, Guintivano J, Santos H, Meltzer-Brody S. Postpartum depression and social support in a racially and ethnically diverse population of women. Arch Womens Ment Health. 2018;22(1):105-14. DOI: https://doi.org/10.1007/s00737-018-0882-6
https://doi.org/10.1007/s00737-018-0882-... ).

No tocante à influência nas emoções(²⁷27. Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286
https://doi.org/10.1016/j.earlhumdev.202... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ), fatores psicofisiológicos como o estresse e sono podem afetar a produção láctea(⁶¹61. Bryant J, Thistle J. Anatomy, Colostrum [Internet]. 2021 [cited 2022 Jan 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513256/
https://www.ncbi.nlm.nih.gov/books/NBK51... ). Em pesquisa na Bélgica, de 5.866 mulheres, sendo 2.421 grávidas e 3.445 lactantes, quase metade da amostra apresentou sintomas depressivos ou ansiosos. Os dados obtidos foram consideravelmente superiores às estimativas obtidas antes da pandemia de COVID-19(⁶²62. Ceulemans M, Hompes T, Foulon V. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic: A call for action. Int J Gynaecol Obstet. 2020;151(1):146-7. DOI: https://doi.org/10.1002/ijgo.13295
https://doi.org/10.1002/ijgo.13295... ). Outro estudo realizado antes da pandemia identificou uma associação entre satisfação materna com amamentação e sintomas de DPP, em que houve maior prevalência de satisfação com a amamentação entre puérperas sem sintomas de DPP(⁶³63. Avilla JC de, Giugliani C, Bizon AMBL, Martins ACM, Senna AFK de, Giugliani ERJ. Association between maternal satisfaction with breastfeeding and postpartum depression symptoms. PloS One. 2020;15(11):e0242333. DOI: https://doi.org/10.1371/journal.pone.0242333
https://doi.org/10.1371/journal.pone.024... ).

O isolamento social, diminuição do suporte social, problemas financeiros estão relacionados com aumento do risco para desenvolver ansiedade e transtornos de humor(⁶⁴64. Goyal D, Selix NW. Impact of COVID-19 on Maternal Mental Health. MCN Am J Matern Child Nurs. 2021;46(2):103-9. DOI: https://doi.org/10.1097/NMC.0000000000000692
https://doi.org/10.1097/NMC.000000000000... ), tal fato foi evidenciado em nossos achados(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
https://doi.org/10.1089/bfm.2020.0200... ,³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.,³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
https://doi.org/10.1590/1806-9282.66.4.5... ,³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ,⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
https://doi.org/10.1055/a-1207-0702... ,⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
https://doi.org/10.3390/bs11030034... ). Foram identificadas preocupação e culpa, evidenciadas em um estudo nos EUA, devido ao suprimento limitado do leite materno, em consequência do aumento do estresse pelas puérperas devido à pandemia(⁶⁵65. Shuman CJ, Morgan ME, Chiangong J, Pareddy N, Veliz P, Peahl AF, et al. “Mourning the Experience of What Should Have Been”: Experiences of Peripartum Women During the COVID-19 Pandemic. Matern Child Health J. 2022;26(1):102-9. DOI: https://doi.org/10.1007/s10995-021-03344-8
https://doi.org/10.1007/s10995-021-03344... ). As mudanças decorrentes da pandemia, como o distanciamento social, podem afetar negativamente as experiências das puérperas e seu estado emocional, aumentando os riscos de desenvolver problemas de saúde mental(¹²12. Almeida M, Shrestha AD, Stojanac D, Miller LJ. The impact of the COVID-19 pandemic on women’s mental health. Arch Womens Ment Health. 2020;23(6):741-8. DOI: https://doi.org/10.1007/s00737-020-01092-2
https://doi.org/10.1007/s00737-020-01092... ,¹⁵15. Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
https://doi.org/10.1016/j.appet.2020.104... ).

Como visto em estudos realizados durante a pandemia, na Sérvia, 14,8% das puérperas demonstraram risco para transtornos de ansiedade e humor pós-parto não psicóticos, relacionados ao distanciamento social, problemas emocionais e ausência de apoio social(⁶⁶66. Stojanov J, Stankovic M, Zikic O, Stankovic M, Stojanov A. The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic. Int J Psychiatry Med. 2021;56(4):228-39. DOI: https://doi.org/10.1177/0091217420981533
https://doi.org/10.1177/0091217420981533... ). A pesquisa realizada em cinco países europeus com 9.041 mulheres, sendo 5.134 lactantes, identificou sintomas depressivos em 13% das lactantes e taxas de sintomas de ansiedade generalizada moderada a grave em 10% das lactantes(⁶⁷67. Ceulemans M, Foulon V, Ngo E, Panchaud A, Winterfeld U, Pomar L, et al. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic—A multinational cross-sectional study. Acta Obstet Gynecol Scand. 2021;100(7):1219-29. DOI: https://doi.org/10.1111/aogs.14092
https://doi.org/10.1111/aogs.14092... ).

Além dos efeitos negativos de não amamentar sob a saúde da mulher descrito em um dos estudos(³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
https://doi.org/10.1111/mcn.13033... ), mães que amamentam apresentam níveis menores de ansiedade, humor negativo, estresse, bem como padrões de sono prolongados e melhores chances de vínculo seguro entre mãe-filho(⁶⁸68. Krol KM, Grossmann T. Psychological effects of breastfeeding on children and mothers. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018;61(8):977-85. DOI: https://doi.org/10.1007/s00103-018-2769-0
https://doi.org/10.1007/s00103-018-2769-... ). A literatura também evidencia que o vínculo entre o binômio e, consequentemente, a amamentação, podem sofrer impacto com as medidas de distanciamento social devido à pandemia de COVID-19, como a separação da díade mãe-filho(⁶⁹69. Tscherning C, Sizun J, Kuhn P. Promoting attachment between parents and neonates despite the COVID-19 pandemic. Acta Paediatr. 2020;109(10):1937-43. DOI: https://doi.org/10.1111/apa.15455
https://doi.org/10.1111/apa.15455... ).

O uso da tecnologia, como o atendimento online, tornou-se essencial atualmente, a fim de limitar a exposição ao SARS-CoV-2, podendo assim garantir acesso contínuo aos cuidados de saúde(⁶⁴64. Goyal D, Selix NW. Impact of COVID-19 on Maternal Mental Health. MCN Am J Matern Child Nurs. 2021;46(2):103-9. DOI: https://doi.org/10.1097/NMC.0000000000000692
https://doi.org/10.1097/NMC.000000000000... ). Além disso, o atendimento remoto viabiliza promoção do aleitamento materno e facilita acesso aos serviços de saúde em localidades distantes(⁷⁰70. Santos LF dos, Borges RF, Azambuja DA de. Telehealth and Breastfeeding: An Integrative Review. Telemed J E Health. 2020;26(7)837-46. DOI: https://doi.org/10.1089/tmj.2019.0073
https://doi.org/10.1089/tmj.2019.0073... ). Isso também está de acordo com observações relacionadas à tecnologia(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
https://doi.org/10.1089/bfm.2020.0323... ,²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
https://www.cdc.gov/mmwr/volumes/69/wr/p... ,³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
https://doi.org/10.1038/s41372-020-0765-... ,³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
https://doi.org/10.7759/cureus.13699... ,⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
https://doi.org/10.1097/NMC.000000000000... ). Contudo, a telelactação exige planejamento e participação tanto do profissional quanto dos pais, para que o atendimento seja adequado(⁷¹71. Singh AP, Kumar VHS, Panda S. Supporting Breastfeeding in 2021 and Beyond—Lessons from the Pandemic. Pediatr Rep. 2021;13(2):289-301. DOI: https://doi.org/10.3390/pediatric13020037
https://doi.org/10.3390/pediatric1302003... ).

Antes da pandemia de COVID-19, a telelactação era praticada, tendo sido registrada boa aceitação de videoconferência para atendimentos à lactação entre puérperas(⁷²72. Habibi MF, Springer CM, Spence ML, Hansen-Petrik MB, Kavanagh KF. Use of Videoconferencing for Lactation Consultation: An Online Cross-Sectional Survey of Mothers’ Acceptance in the United States. J Hum Lact. 2017;34(2):313-21. DOI: https://doi.org/10.1177/0890334417711385
https://doi.org/10.1177/0890334417711385... ). Consultadoras de amamentação, em que 73% do atendimento foi realizado de forma online na atual pandemia, relataram ser notória a satisfação das lactantes pelo serviço prestado, principalmente por estarem com a rede de apoio reduzida, possibilitando a promoção do aleitamento materno e saúde mental das lactantes(⁵⁴54. Lima ACMACC, Chaves AFL, Oliveira MG de, Lima SAFCC, Machado MMT, Oriá MOB. Breastfeeding consultancy during the COVID-19 pandemic: experience report. Escola Anna Nery. 2020;24(Spe):e20200350. DOI: https://doi.org/10.1590/2177-9465-EAN-2020-0350
https://doi.org/10.1590/2177-9465-EAN-20... ).

As limitações para esta scoping review consistem em não ter sido publicado um protocolo prospectivo, a não realização de busca manual nos principais periódicos ou em outras fontes de informação, e a restrição aos idiomas espanhol, inglês e português.

CONCLUSÃO

Os artigos analisados neste estudo apontaram que a influência da pandemia de COVID-19 na prática do aleitamento materno pode ser muito heterogênea, pois, para algumas puérperas, pode-se dizer que a pandemia influenciou positivamente, possibilitando maior tempo para amamentação, enquanto que, para outras, demonstrou-se o contrário, interrompendo a amamentação devido à maior sobrecarga ou menor suporte social. Compreendeu-se que a informação segura, o apoio social, a saúde emocional e meios novos de atendimento à lactação são fatores a serem considerados no cuidado em relação ao aleitamento materno. Assim, a rede de apoio das puérperas durante a pandemia de COVID-19 se tornou uma questão importante para pesquisas futuras.

Esta revisão apontou também que a telessaúde pode ser uma boa alternativa de suporte nesse período, permitindo a transmissão de orientações seguras, podendo também identificar outros problemas não relacionados à amamentação. Espera-se que este estudo traga novos conhecimentos para as puérperas e sociedade em geral e para os profissionais de saúde, de modo a contribuir para uma assistência com maior assertividade diante dessa nova situação, promovendo um atendimento que supra as novas necessidades em relação ao aleitamento materno.

EDITOR ASSOCIADO

Ivone Evangelista Cabral

REFERENCES

^1.
DiLorenzo MA, O’Connor SK, Ezekwesili C, Sampath S, Zhao M, Yarrington C, et al. COVID-19 guidelines for pregnant women and new mothers: A systematic evidence review. Int J Gynaecol Obstet. 2021;153(3):373-82. DOI: https://doi.org/10.1002/ijgo.13668
» https://doi.org/10.1002/ijgo.13668
^2.
Brasil. Ministério da Saúde. Nota Informativa Nº 13/2020 – SE/GAB/SE/MS. Manual de Recomendações para a Assistência à Gestante e Puérpera frente à Pandemia de COVID-19 [Internet]. Brasília; 2020 [cited 2021 Jan 07]. Available from: https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2020/09/Manual-de-Recomenda-es-para-Gestante-1.pdf
» https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2020/09/Manual-de-Recomenda-es-para-Gestante-1.pdf
^3.
World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. Geneva: WHO; 2021 [cited 2021 July 26]. Available from: https://covid19.who.int/
» https://covid19.who.int/
^4.
Brasil. Ministério da Saúde. 72 – Boletim epidemiológico especial: Doença pelo Coronavírus COVID-19 [Internet]. Brasília; 2021 [cited July 26]. Available from: https://www.gov.br/saude/pt-br/media/pdf/2021/julho/23/boletim_epidemiologico_covid_72_final23jul21-c-1.pdf
» https://www.gov.br/saude/pt-br/media/pdf/2021/julho/23/boletim_epidemiologico_covid_72_final23jul21-c-1.pdf
^5.
Fiocruz. Ministério da Saúde. Boletim observatório Covid-19 [Internet]. Rio de Janeiro: Fundação Oswaldo Cruz; 2021 [cited 2021 July 16]. Available from: https://agencia.fiocruz.br/sites/agencia.fiocruz.br/files/u34/boletim_covid_2021-semanas_20-21-red.pdf
» https://agencia.fiocruz.br/sites/agencia.fiocruz.br/files/u34/boletim_covid_2021-semanas_20-21-red.pdf
^6.
Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
» https://doi.org/10.1111/mcn.13088
^7.
Caparros-Gonzalez RA, Pérez-Morente MA, Hueso-Montoro C, Álvarez-Serrano MA, de la Torre-Luque A. Congenital, Intrapartum and Postnatal Maternal-Fetal-Neonatal SARS-CoV-2 Infections: A Narrative Review. Nutrients. 2020;12(11):3570. DOI: https://doi.org/10.3390/nu12113570
» https://doi.org/10.3390/nu12113570
^8.
Federação Brasileira das Associações de Ginecologia e Obstetrícia. Infecção pelo Coronavírus SARS-CoV-2 em obstetrícia. Enfrentando o desconhecido! [Internet]. São Paulo: FEBRASGO; 2020 [cited 2022 Jan 21]. Available from: https://www.febrasgo.org.br/pt/noticias/item/948-infeccao-pelo-coronavirus-sars-cov-2-em-obstetricia-enfrentando-o-desconhecido?highlight=WyJhbGVpdGFtZW50byJd
» https://www.febrasgo.org.br/pt/noticias/item/948-infeccao-pelo-coronavirus-sars-cov-2-em-obstetricia-enfrentando-o-desconhecido?highlight=WyJhbGVpdGFtZW50byJd
^9.
Federação Brasileira das Associações de Ginecologia e Obstetrícia. Nótula complementar sobre COVID-19 e Aleitamento Materno [Internet]. São Paulo: FEBRASGO; 2020 [cited 2022 Jan 21]. Available from: https://www.febrasgo.org.br/pt/noticias/item/949-notula-complementar-sobre-covid-19-e-aleitamento-materno?highlight=WyJhbGVpdGFtZW50byJd
» https://www.febrasgo.org.br/pt/noticias/item/949-notula-complementar-sobre-covid-19-e-aleitamento-materno?highlight=WyJhbGVpdGFtZW50byJd
^10.
Sociedade Brasileira de Pediatria. O Aleitamento Materno nos Tempos de COVID-19! [Internet]. SBP; 2020 [cited 2022 Jan 21]. Available from: https://www.sbp.com.br/fileadmin/user_upload/22393c-Nota_de_Alerta_sobe_Aleitam_Materno_nos_Tempos_COVID-19.pdf
» https://www.sbp.com.br/fileadmin/user_upload/22393c-Nota_de_Alerta_sobe_Aleitam_Materno_nos_Tempos_COVID-19.pdf
^11.
World Health Organization. Breastfeeding and COVID-19 [Internet]. WHO; 2020 [cited 2021 Jan 13]. Available from: https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19
» https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19
^12.
Almeida M, Shrestha AD, Stojanac D, Miller LJ. The impact of the COVID-19 pandemic on women’s mental health. Arch Womens Ment Health. 2020;23(6):741-8. DOI: https://doi.org/10.1007/s00737-020-01092-2
» https://doi.org/10.1007/s00737-020-01092-2
^13.
Mitoulas LR, Schärer-Hernández NG, Liabat S. Breastfeeding, Human Milk and COVID-19—What Does the Evidence Say? Front Pediatr. 2020;8:613339. DOI: https://doi.org/10.3389/fped.2020.613339
» https://doi.org/10.3389/fped.2020.613339
^14.
Del Ciampo LA, Del Ciampo IRL. Breastfeeding and the Benefits of Lactation for Women’s Health. Rev Bras Ginecol Obstet. 2018;40(6):354-9. DOI: https://doi.org/10.1055/s-0038-1657766
» https://doi.org/10.1055/s-0038-1657766
^15.
Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
» https://doi.org/10.1016/j.appet.2020.104985
^16.
Ahlers-Schmidt CR, Hervey AM, Neil T, Kuhlmann S, Kuhlmann Z. Concerns of women regarding pregnancy and childbirth during the COVID-19 pandemic. Patient Educ Couns. 2020;103(12):2578-82. DOI: https://doi.org/10.1016/j.pec.2020.09.031
» https://doi.org/10.1016/j.pec.2020.09.031
^17.
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editores. JBI Manual for Evidence Synthesis. JBI; 2020. DOI: https://doi.org/10.46658/JBIMES-20-12
» https://doi.org/10.46658/JBIMES-20-12
^18.
Mendes KDS, Silveira RC de CP, Galvão CM. Use of the bibliographic reference manager in the selection of primary studies in integrative reviews. Texto & Contexto Enfermagem. 2019;28:e20170204. DOI: https://doi.org/10.1590/1980-265X-TCE-2017-0204
» https://doi.org/10.1590/1980-265X-TCE-2017-0204
^19.
Ouzzani, M, Hammady, H, Fedorowicz, Z, Elmagarmid A. Rayyan – a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. DOI: https://doi.org/10.1186/s13643-016-0384-4
» https://doi.org/10.1186/s13643-016-0384-4
^20.
Bardin L. Análise de conteúdo. 1ª ed. São Paulo: Edições 70; 2016.
^21.
Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
» https://doi.org/10.1089/bfm.2020.0323
^22.
Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
» https://doi.org/10.1590/1806-9304202100S100012
^23.
Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
» https://doi.org/10.1016/j.nmni.2020.100752
^24.
Mayopoulos GA, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, et al. COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. J Affect Disord. 2021;282:122-5. DOI: https://doi.org/10.1016/j.jad.2020.12.101
» https://doi.org/10.1016/j.jad.2020.12.101
^25.
Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
» https://doi.org/10.1111/apa.15837
^26.
Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
» https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
^27.
Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286
» https://doi.org/10.1016/j.earlhumdev.2020.105286
^28.
Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
» https://doi.org/10.1016/j.semperi.2020.151320
^29.
Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
» https://doi.org/10.1016/j.enfcli.2021.01.006
^30.
Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
» https://doi.org/10.1038/s41372-020-0695-0
^31.
Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
» https://doi.org/10.1038/s41372-020-0765-3
^32.
Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
» https://doi.org/10.3390/ijerph17186766
^33.
Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
» https://doi.org/10.1089/bfm.2020.0200
^34.
Mejía Jiménez I, Salvador López R, García Rosas E, Rodriguez de la Torre I, Montes García J, Cruz Conty M, et al. Umbilical cord clamping and skin-to-skin contact in deliveries from women positive for SARS-CoV-2: a prospective observational study. BJOG. 2020;128(5):908-15. DOI: https://doi.org/10.1111/1471-0528.16597
» https://doi.org/10.1111/1471-0528.16597
^35.
Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.
^36.
Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
» https://doi.org/10.3126/kumj.v18i2.32938
^37.
Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
» https://doi.org/10.1590/1806-9282.66.4.541
^38.
Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
» https://doi.org/10.7759/cureus.13699
^39.
Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
» https://doi.org/10.1111/mcn.13033
^40.
Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
» https://doi.org/10.1097/NMC.0000000000000672
^41.
Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
» https://doi.org/10.1055/a-1207-0702
^42.
Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
» https://doi.org/10.3233/NPM-200478
^43.
Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
» https://doi.org/10.3390/bs11030034
^44.
Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
» https://doi.org/10.26633/RPSP.2020.47
^45.
Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
» https://doi.org/10.1111/1471-0528.16278
^46.
World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected [Internet]. WHO; 2020 [cited 2021 July 13]. Available from: https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf
» https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf
^47.
Centers for Disease Control and Prevention. Care for Breastfeeding People [Internet]. COVID-19; 2021 [cited 2021 July 13]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/care-for-breastfeeding-women.html
» https://www.cdc.gov/coronavirus/2019-ncov/hcp/care-for-breastfeeding-women.html
^48.
Brasil. Ministério da Saúde. Nota técnica Nº 7/2020-DAPES/SAPS/MS [Internet]. Brasília; 2020 [cited 21 July 13]. Available from: http://www.saude.sp.gov.br/resources/instituto-de-saude/homepage/pdfs/sei_ms-0014033399-notatecnicaaleitamentoecovid.pdf
» http://www.saude.sp.gov.br/resources/instituto-de-saude/homepage/pdfs/sei_ms-0014033399-notatecnicaaleitamentoecovid.pdf
^49.
Centers for Disease Control and Prevention. Breastfeeding and Caring for Newborns [Internet]. COVID-19; 2021 [cited 2021 July 13]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html
» https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html
^50.
Popofsky S, Noor A, Leavens-Maurer J, Quintos-Alagheband ML, Mock A, Vinci A, et al Impact of Maternal Severe Acute Respiratory Syndrome Coronavirus 2 Detection on Breastfeeding Due to Infant Separation at Birth. J Pediatr. 2020;226:64-70. DOI: https://doi.org/10.1016/j.jpeds.2020.08.004
» https://doi.org/10.1016/j.jpeds.2020.08.004
^51.
World Health Organization. WHO recommendations Intrapartum care for a positive childbirth experience [Internet]. WHO; 2018 [cited 2021 July 25]. Available from: http://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf;jsessionid=EAF86236F2A8E00D4EFB98BF409FDF7D?sequence=1
» http://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf;jsessionid=EAF86236F2A8E00D4EFB98BF409FDF7D?sequence=1
^52.
Brasil. Lei nº 11.108, de 7 de abril de 2005. Altera a Lei nº 8.080, de 19 de setembro de 1990, para garantir às parturientes o direito à presença de acompanhante durante o trabalho de parto, parto e pós-parto imediato, no âmbito do Sistema Único de Saúde – SUS [Internet]. Brasília; 2005 [cited 2021 July 24]. Available from: http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2005/lei/l11108.htm
» http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2005/lei/l11108.htm
^53.
Tomasi YT, Saraiva S dos S, Boing AC, Delziovo CR, Wagner KJP, Boing AF. From prenatal care to childbirth: a cross-sectional study on the influence of a companion on good obstetric practices in the Brazilian National Health System in Santa Catarina State, 2019. Epidemiol Serv Saude. 2021;30(1):e2020383. DOI: https://doi.org/10.1590/S1679-49742021000100014
» https://doi.org/10.1590/S1679-49742021000100014
^54.
Lima ACMACC, Chaves AFL, Oliveira MG de, Lima SAFCC, Machado MMT, Oriá MOB. Breastfeeding consultancy during the COVID-19 pandemic: experience report. Escola Anna Nery. 2020;24(Spe):e20200350. DOI: https://doi.org/10.1590/2177-9465-EAN-2020-0350
» https://doi.org/10.1590/2177-9465-EAN-2020-0350
^55.
Latorre G, Martinelli D, Guida P, Masi E, De Benedictis R, Maggio L. Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers. Int Breastfeed J. 2021;16(1):36. DOI: https://doi.org/10.1186/s13006-021-00382-4
» https://doi.org/10.1186/s13006-021-00382-4
^56.
Palmquist AE, Fox C, Chung S, Tomori C, Quinn EA. Infant Feeding during the COVID-19 Pandemic in the U.S. – 90th Annual Meeting of the American Association of Physical Anthropologists. Am J Phys Anthropol. 2021;174 Suppl 71:81. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajpa.24262
» https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajpa.24262
^57.
Gianni ML, Bettinelli ME, Manfra P, Sorrentino G, Bezze E, Plevani L, et al. Breastfeeding Difficulties and Risk for Early Breastfeeding Cessation. Nutrients. 2019;11(10):2266. DOI: https://doi.org/10.3390/nu11102266
» https://doi.org/10.3390/nu11102266
^58.
Moraes BA, Strada JKR, Gasparin VA, Espirito-Santo LC do, Gouveia HG, Gonçalves AC. Breastfeeding in the first six months of life for babies seen by Lactation Consulting. Rev Lat Am Enfermagem. 2021;29:e3412. DOI: https://doi.org/10.1590/1518-8345.3538.3412
» https://doi.org/10.1590/1518-8345.3538.3412
^59.
Rice K, Williams S. Women’s postpartum experiences in Canada during the COVID-19 pandemic: a qualitative study. CMAJ Open. 2021;9(2):E556-62. DOI: https://doi.org/10.9778/cmajo.20210008
» https://doi.org/10.9778/cmajo.20210008
^60.
Pao C, Guintivano J, Santos H, Meltzer-Brody S. Postpartum depression and social support in a racially and ethnically diverse population of women. Arch Womens Ment Health. 2018;22(1):105-14. DOI: https://doi.org/10.1007/s00737-018-0882-6
» https://doi.org/10.1007/s00737-018-0882-6
^61.
Bryant J, Thistle J. Anatomy, Colostrum [Internet]. 2021 [cited 2022 Jan 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513256/
» https://www.ncbi.nlm.nih.gov/books/NBK513256/
^62.
Ceulemans M, Hompes T, Foulon V. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic: A call for action. Int J Gynaecol Obstet. 2020;151(1):146-7. DOI: https://doi.org/10.1002/ijgo.13295
» https://doi.org/10.1002/ijgo.13295
^63.
Avilla JC de, Giugliani C, Bizon AMBL, Martins ACM, Senna AFK de, Giugliani ERJ. Association between maternal satisfaction with breastfeeding and postpartum depression symptoms. PloS One. 2020;15(11):e0242333. DOI: https://doi.org/10.1371/journal.pone.0242333
» https://doi.org/10.1371/journal.pone.0242333
^64.
Goyal D, Selix NW. Impact of COVID-19 on Maternal Mental Health. MCN Am J Matern Child Nurs. 2021;46(2):103-9. DOI: https://doi.org/10.1097/NMC.0000000000000692
» https://doi.org/10.1097/NMC.0000000000000692
^65.
Shuman CJ, Morgan ME, Chiangong J, Pareddy N, Veliz P, Peahl AF, et al. “Mourning the Experience of What Should Have Been”: Experiences of Peripartum Women During the COVID-19 Pandemic. Matern Child Health J. 2022;26(1):102-9. DOI: https://doi.org/10.1007/s10995-021-03344-8
» https://doi.org/10.1007/s10995-021-03344-8
^66.
Stojanov J, Stankovic M, Zikic O, Stankovic M, Stojanov A. The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic. Int J Psychiatry Med. 2021;56(4):228-39. DOI: https://doi.org/10.1177/0091217420981533
» https://doi.org/10.1177/0091217420981533
^67.
Ceulemans M, Foulon V, Ngo E, Panchaud A, Winterfeld U, Pomar L, et al. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic—A multinational cross-sectional study. Acta Obstet Gynecol Scand. 2021;100(7):1219-29. DOI: https://doi.org/10.1111/aogs.14092
» https://doi.org/10.1111/aogs.14092
^68.
Krol KM, Grossmann T. Psychological effects of breastfeeding on children and mothers. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018;61(8):977-85. DOI: https://doi.org/10.1007/s00103-018-2769-0
» https://doi.org/10.1007/s00103-018-2769-0
^69.
Tscherning C, Sizun J, Kuhn P. Promoting attachment between parents and neonates despite the COVID-19 pandemic. Acta Paediatr. 2020;109(10):1937-43. DOI: https://doi.org/10.1111/apa.15455
» https://doi.org/10.1111/apa.15455
^70.
Santos LF dos, Borges RF, Azambuja DA de. Telehealth and Breastfeeding: An Integrative Review. Telemed J E Health. 2020;26(7)837-46. DOI: https://doi.org/10.1089/tmj.2019.0073
» https://doi.org/10.1089/tmj.2019.0073
^71.
Singh AP, Kumar VHS, Panda S. Supporting Breastfeeding in 2021 and Beyond—Lessons from the Pandemic. Pediatr Rep. 2021;13(2):289-301. DOI: https://doi.org/10.3390/pediatric13020037
» https://doi.org/10.3390/pediatric13020037
^72.
Habibi MF, Springer CM, Spence ML, Hansen-Petrik MB, Kavanagh KF. Use of Videoconferencing for Lactation Consultation: An Online Cross-Sectional Survey of Mothers’ Acceptance in the United States. J Hum Lact. 2017;34(2):313-21. DOI: https://doi.org/10.1177/0890334417711385
» https://doi.org/10.1177/0890334417711385

Datas de Publicação

Publicação nesta coleção
15 Jun 2022
Data do Fascículo
2022

Histórico

Recebido
03 Dez 2021
Aceito
18 Abr 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

[1] ^1.
DiLorenzo MA, O’Connor SK, Ezekwesili C, Sampath S, Zhao M, Yarrington C, et al. COVID-19 guidelines for pregnant women and new mothers: A systematic evidence review. Int J Gynaecol Obstet. 2021;153(3):373-82. DOI: https://doi.org/10.1002/ijgo.13668
» https://doi.org/10.1002/ijgo.13668

[2] ^2.
Brasil. Ministério da Saúde. Nota Informativa Nº 13/2020 – SE/GAB/SE/MS. Manual de Recomendações para a Assistência à Gestante e Puérpera frente à Pandemia de COVID-19 [Internet]. Brasília; 2020 [cited 2021 Jan 07]. Available from: https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2020/09/Manual-de-Recomenda-es-para-Gestante-1.pdf
» https://portaldeboaspraticas.iff.fiocruz.br/wp-content/uploads/2020/09/Manual-de-Recomenda-es-para-Gestante-1.pdf

[3] ^3.
World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. Geneva: WHO; 2021 [cited 2021 July 26]. Available from: https://covid19.who.int/
» https://covid19.who.int/

[4] ^4.
Brasil. Ministério da Saúde. 72 – Boletim epidemiológico especial: Doença pelo Coronavírus COVID-19 [Internet]. Brasília; 2021 [cited July 26]. Available from: https://www.gov.br/saude/pt-br/media/pdf/2021/julho/23/boletim_epidemiologico_covid_72_final23jul21-c-1.pdf
» https://www.gov.br/saude/pt-br/media/pdf/2021/julho/23/boletim_epidemiologico_covid_72_final23jul21-c-1.pdf

[5] ^5.
Fiocruz. Ministério da Saúde. Boletim observatório Covid-19 [Internet]. Rio de Janeiro: Fundação Oswaldo Cruz; 2021 [cited 2021 July 16]. Available from: https://agencia.fiocruz.br/sites/agencia.fiocruz.br/files/u34/boletim_covid_2021-semanas_20-21-red.pdf
» https://agencia.fiocruz.br/sites/agencia.fiocruz.br/files/u34/boletim_covid_2021-semanas_20-21-red.pdf

[6] ^6.
Brown A, Shenker N. Experiences of breastfeeding during COVID-19: Lessons for future practical and emotional support. Matern Child Nutr. 2020;17(1):e13088. DOI: https://doi.org/10.1111/mcn.13088
» https://doi.org/10.1111/mcn.13088

[7] ^7.
Caparros-Gonzalez RA, Pérez-Morente MA, Hueso-Montoro C, Álvarez-Serrano MA, de la Torre-Luque A. Congenital, Intrapartum and Postnatal Maternal-Fetal-Neonatal SARS-CoV-2 Infections: A Narrative Review. Nutrients. 2020;12(11):3570. DOI: https://doi.org/10.3390/nu12113570
» https://doi.org/10.3390/nu12113570

[8] ^8.
Federação Brasileira das Associações de Ginecologia e Obstetrícia. Infecção pelo Coronavírus SARS-CoV-2 em obstetrícia. Enfrentando o desconhecido! [Internet]. São Paulo: FEBRASGO; 2020 [cited 2022 Jan 21]. Available from: https://www.febrasgo.org.br/pt/noticias/item/948-infeccao-pelo-coronavirus-sars-cov-2-em-obstetricia-enfrentando-o-desconhecido?highlight=WyJhbGVpdGFtZW50byJd
» https://www.febrasgo.org.br/pt/noticias/item/948-infeccao-pelo-coronavirus-sars-cov-2-em-obstetricia-enfrentando-o-desconhecido?highlight=WyJhbGVpdGFtZW50byJd

[9] ^9.
Federação Brasileira das Associações de Ginecologia e Obstetrícia. Nótula complementar sobre COVID-19 e Aleitamento Materno [Internet]. São Paulo: FEBRASGO; 2020 [cited 2022 Jan 21]. Available from: https://www.febrasgo.org.br/pt/noticias/item/949-notula-complementar-sobre-covid-19-e-aleitamento-materno?highlight=WyJhbGVpdGFtZW50byJd
» https://www.febrasgo.org.br/pt/noticias/item/949-notula-complementar-sobre-covid-19-e-aleitamento-materno?highlight=WyJhbGVpdGFtZW50byJd

[10] ^10.
Sociedade Brasileira de Pediatria. O Aleitamento Materno nos Tempos de COVID-19! [Internet]. SBP; 2020 [cited 2022 Jan 21]. Available from: https://www.sbp.com.br/fileadmin/user_upload/22393c-Nota_de_Alerta_sobe_Aleitam_Materno_nos_Tempos_COVID-19.pdf
» https://www.sbp.com.br/fileadmin/user_upload/22393c-Nota_de_Alerta_sobe_Aleitam_Materno_nos_Tempos_COVID-19.pdf

[11] ^11.
World Health Organization. Breastfeeding and COVID-19 [Internet]. WHO; 2020 [cited 2021 Jan 13]. Available from: https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19
» https://www.who.int/news-room/commentaries/detail/breastfeeding-and-covid-19

[12] ^12.
Almeida M, Shrestha AD, Stojanac D, Miller LJ. The impact of the COVID-19 pandemic on women’s mental health. Arch Womens Ment Health. 2020;23(6):741-8. DOI: https://doi.org/10.1007/s00737-020-01092-2
» https://doi.org/10.1007/s00737-020-01092-2

[13] ^13.
Mitoulas LR, Schärer-Hernández NG, Liabat S. Breastfeeding, Human Milk and COVID-19—What Does the Evidence Say? Front Pediatr. 2020;8:613339. DOI: https://doi.org/10.3389/fped.2020.613339
» https://doi.org/10.3389/fped.2020.613339

[14] ^14.
Del Ciampo LA, Del Ciampo IRL. Breastfeeding and the Benefits of Lactation for Women’s Health. Rev Bras Ginecol Obstet. 2018;40(6):354-9. DOI: https://doi.org/10.1055/s-0038-1657766
» https://doi.org/10.1055/s-0038-1657766

[15] ^15.
Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;156:104985. DOI: https://doi.org/10.1016/j.appet.2020.104985
» https://doi.org/10.1016/j.appet.2020.104985

[16] ^16.
Ahlers-Schmidt CR, Hervey AM, Neil T, Kuhlmann S, Kuhlmann Z. Concerns of women regarding pregnancy and childbirth during the COVID-19 pandemic. Patient Educ Couns. 2020;103(12):2578-82. DOI: https://doi.org/10.1016/j.pec.2020.09.031
» https://doi.org/10.1016/j.pec.2020.09.031

[17] ^17.
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editores. JBI Manual for Evidence Synthesis. JBI; 2020. DOI: https://doi.org/10.46658/JBIMES-20-12
» https://doi.org/10.46658/JBIMES-20-12

[18] ^18.
Mendes KDS, Silveira RC de CP, Galvão CM. Use of the bibliographic reference manager in the selection of primary studies in integrative reviews. Texto & Contexto Enfermagem. 2019;28:e20170204. DOI: https://doi.org/10.1590/1980-265X-TCE-2017-0204
» https://doi.org/10.1590/1980-265X-TCE-2017-0204

[19] ^19.
Ouzzani, M, Hammady, H, Fedorowicz, Z, Elmagarmid A. Rayyan – a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. DOI: https://doi.org/10.1186/s13643-016-0384-4
» https://doi.org/10.1186/s13643-016-0384-4

[20] ^20.
Bardin L. Análise de conteúdo. 1ª ed. São Paulo: Edições 70; 2016.

[21] ^21.
Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323
» https://doi.org/10.1089/bfm.2020.0323

[22] ^22.
Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012
» https://doi.org/10.1590/1806-9304202100S100012

[23] ^23.
Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752
» https://doi.org/10.1016/j.nmni.2020.100752

[24] ^24.
Mayopoulos GA, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, et al. COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. J Affect Disord. 2021;282:122-5. DOI: https://doi.org/10.1016/j.jad.2020.12.101
» https://doi.org/10.1016/j.jad.2020.12.101

[25] ^25.
Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837
» https://doi.org/10.1111/apa.15837

[26] ^26.
Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf
» https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf

[27] ^27.
Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286
» https://doi.org/10.1016/j.earlhumdev.2020.105286

[28] ^28.
Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320
» https://doi.org/10.1016/j.semperi.2020.151320

[29] ^29.
Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006
» https://doi.org/10.1016/j.enfcli.2021.01.006

[30] ^30.
Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0
» https://doi.org/10.1038/s41372-020-0695-0

[31] ^31.
Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3
» https://doi.org/10.1038/s41372-020-0765-3

[32] ^32.
Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766
» https://doi.org/10.3390/ijerph17186766

[33] ^33.
Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200
» https://doi.org/10.1089/bfm.2020.0200

[34] ^34.
Mejía Jiménez I, Salvador López R, García Rosas E, Rodriguez de la Torre I, Montes García J, Cruz Conty M, et al. Umbilical cord clamping and skin-to-skin contact in deliveries from women positive for SARS-CoV-2: a prospective observational study. BJOG. 2020;128(5):908-15. DOI: https://doi.org/10.1111/1471-0528.16597
» https://doi.org/10.1111/1471-0528.16597

[35] ^35.
Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.

[36] ^36.
Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938
» https://doi.org/10.3126/kumj.v18i2.32938

[37] ^37.
Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541
» https://doi.org/10.1590/1806-9282.66.4.541

[38] ^38.
Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699
» https://doi.org/10.7759/cureus.13699

[39] ^39.
Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033
» https://doi.org/10.1111/mcn.13033

[40] ^40.
Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672
» https://doi.org/10.1097/NMC.0000000000000672

[41] ^41.
Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702
» https://doi.org/10.1055/a-1207-0702

[42] ^42.
Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478
» https://doi.org/10.3233/NPM-200478

[43] ^43.
Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034
» https://doi.org/10.3390/bs11030034

[44] ^44.
Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47
» https://doi.org/10.26633/RPSP.2020.47

[45] ^45.
Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278
» https://doi.org/10.1111/1471-0528.16278

[46] ^46.
World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected [Internet]. WHO; 2020 [cited 2021 July 13]. Available from: https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf
» https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf

[47] ^47.
Centers for Disease Control and Prevention. Care for Breastfeeding People [Internet]. COVID-19; 2021 [cited 2021 July 13]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/care-for-breastfeeding-women.html
» https://www.cdc.gov/coronavirus/2019-ncov/hcp/care-for-breastfeeding-women.html

[48] ^48.
Brasil. Ministério da Saúde. Nota técnica Nº 7/2020-DAPES/SAPS/MS [Internet]. Brasília; 2020 [cited 21 July 13]. Available from: http://www.saude.sp.gov.br/resources/instituto-de-saude/homepage/pdfs/sei_ms-0014033399-notatecnicaaleitamentoecovid.pdf
» http://www.saude.sp.gov.br/resources/instituto-de-saude/homepage/pdfs/sei_ms-0014033399-notatecnicaaleitamentoecovid.pdf

[49] ^49.
Centers for Disease Control and Prevention. Breastfeeding and Caring for Newborns [Internet]. COVID-19; 2021 [cited 2021 July 13]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html
» https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

[50] ^50.
Popofsky S, Noor A, Leavens-Maurer J, Quintos-Alagheband ML, Mock A, Vinci A, et al Impact of Maternal Severe Acute Respiratory Syndrome Coronavirus 2 Detection on Breastfeeding Due to Infant Separation at Birth. J Pediatr. 2020;226:64-70. DOI: https://doi.org/10.1016/j.jpeds.2020.08.004
» https://doi.org/10.1016/j.jpeds.2020.08.004

[51] ^51.
World Health Organization. WHO recommendations Intrapartum care for a positive childbirth experience [Internet]. WHO; 2018 [cited 2021 July 25]. Available from: http://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf;jsessionid=EAF86236F2A8E00D4EFB98BF409FDF7D?sequence=1
» http://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf;jsessionid=EAF86236F2A8E00D4EFB98BF409FDF7D?sequence=1

[52] ^52.
Brasil. Lei nº 11.108, de 7 de abril de 2005. Altera a Lei nº 8.080, de 19 de setembro de 1990, para garantir às parturientes o direito à presença de acompanhante durante o trabalho de parto, parto e pós-parto imediato, no âmbito do Sistema Único de Saúde – SUS [Internet]. Brasília; 2005 [cited 2021 July 24]. Available from: http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2005/lei/l11108.htm
» http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2005/lei/l11108.htm

[53] ^53.
Tomasi YT, Saraiva S dos S, Boing AC, Delziovo CR, Wagner KJP, Boing AF. From prenatal care to childbirth: a cross-sectional study on the influence of a companion on good obstetric practices in the Brazilian National Health System in Santa Catarina State, 2019. Epidemiol Serv Saude. 2021;30(1):e2020383. DOI: https://doi.org/10.1590/S1679-49742021000100014
» https://doi.org/10.1590/S1679-49742021000100014

[54] ^54.
Lima ACMACC, Chaves AFL, Oliveira MG de, Lima SAFCC, Machado MMT, Oriá MOB. Breastfeeding consultancy during the COVID-19 pandemic: experience report. Escola Anna Nery. 2020;24(Spe):e20200350. DOI: https://doi.org/10.1590/2177-9465-EAN-2020-0350
» https://doi.org/10.1590/2177-9465-EAN-2020-0350

[55] ^55.
Latorre G, Martinelli D, Guida P, Masi E, De Benedictis R, Maggio L. Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers. Int Breastfeed J. 2021;16(1):36. DOI: https://doi.org/10.1186/s13006-021-00382-4
» https://doi.org/10.1186/s13006-021-00382-4

[56] ^56.
Palmquist AE, Fox C, Chung S, Tomori C, Quinn EA. Infant Feeding during the COVID-19 Pandemic in the U.S. – 90th Annual Meeting of the American Association of Physical Anthropologists. Am J Phys Anthropol. 2021;174 Suppl 71:81. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajpa.24262
» https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajpa.24262

[57] ^57.
Gianni ML, Bettinelli ME, Manfra P, Sorrentino G, Bezze E, Plevani L, et al. Breastfeeding Difficulties and Risk for Early Breastfeeding Cessation. Nutrients. 2019;11(10):2266. DOI: https://doi.org/10.3390/nu11102266
» https://doi.org/10.3390/nu11102266

[58] ^58.
Moraes BA, Strada JKR, Gasparin VA, Espirito-Santo LC do, Gouveia HG, Gonçalves AC. Breastfeeding in the first six months of life for babies seen by Lactation Consulting. Rev Lat Am Enfermagem. 2021;29:e3412. DOI: https://doi.org/10.1590/1518-8345.3538.3412
» https://doi.org/10.1590/1518-8345.3538.3412

[59] ^59.
Rice K, Williams S. Women’s postpartum experiences in Canada during the COVID-19 pandemic: a qualitative study. CMAJ Open. 2021;9(2):E556-62. DOI: https://doi.org/10.9778/cmajo.20210008
» https://doi.org/10.9778/cmajo.20210008

[60] ^60.
Pao C, Guintivano J, Santos H, Meltzer-Brody S. Postpartum depression and social support in a racially and ethnically diverse population of women. Arch Womens Ment Health. 2018;22(1):105-14. DOI: https://doi.org/10.1007/s00737-018-0882-6
» https://doi.org/10.1007/s00737-018-0882-6

[61] ^61.
Bryant J, Thistle J. Anatomy, Colostrum [Internet]. 2021 [cited 2022 Jan 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513256/
» https://www.ncbi.nlm.nih.gov/books/NBK513256/

[62] ^62.
Ceulemans M, Hompes T, Foulon V. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic: A call for action. Int J Gynaecol Obstet. 2020;151(1):146-7. DOI: https://doi.org/10.1002/ijgo.13295
» https://doi.org/10.1002/ijgo.13295

[63] ^63.
Avilla JC de, Giugliani C, Bizon AMBL, Martins ACM, Senna AFK de, Giugliani ERJ. Association between maternal satisfaction with breastfeeding and postpartum depression symptoms. PloS One. 2020;15(11):e0242333. DOI: https://doi.org/10.1371/journal.pone.0242333
» https://doi.org/10.1371/journal.pone.0242333

[64] ^64.
Goyal D, Selix NW. Impact of COVID-19 on Maternal Mental Health. MCN Am J Matern Child Nurs. 2021;46(2):103-9. DOI: https://doi.org/10.1097/NMC.0000000000000692
» https://doi.org/10.1097/NMC.0000000000000692

[65] ^65.
Shuman CJ, Morgan ME, Chiangong J, Pareddy N, Veliz P, Peahl AF, et al. “Mourning the Experience of What Should Have Been”: Experiences of Peripartum Women During the COVID-19 Pandemic. Matern Child Health J. 2022;26(1):102-9. DOI: https://doi.org/10.1007/s10995-021-03344-8
» https://doi.org/10.1007/s10995-021-03344-8

[66] ^66.
Stojanov J, Stankovic M, Zikic O, Stankovic M, Stojanov A. The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic. Int J Psychiatry Med. 2021;56(4):228-39. DOI: https://doi.org/10.1177/0091217420981533
» https://doi.org/10.1177/0091217420981533

[67] ^67.
Ceulemans M, Foulon V, Ngo E, Panchaud A, Winterfeld U, Pomar L, et al. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic—A multinational cross-sectional study. Acta Obstet Gynecol Scand. 2021;100(7):1219-29. DOI: https://doi.org/10.1111/aogs.14092
» https://doi.org/10.1111/aogs.14092

[68] ^68.
Krol KM, Grossmann T. Psychological effects of breastfeeding on children and mothers. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018;61(8):977-85. DOI: https://doi.org/10.1007/s00103-018-2769-0
» https://doi.org/10.1007/s00103-018-2769-0

[69] ^69.
Tscherning C, Sizun J, Kuhn P. Promoting attachment between parents and neonates despite the COVID-19 pandemic. Acta Paediatr. 2020;109(10):1937-43. DOI: https://doi.org/10.1111/apa.15455
» https://doi.org/10.1111/apa.15455

[70] ^70.
Santos LF dos, Borges RF, Azambuja DA de. Telehealth and Breastfeeding: An Integrative Review. Telemed J E Health. 2020;26(7)837-46. DOI: https://doi.org/10.1089/tmj.2019.0073
» https://doi.org/10.1089/tmj.2019.0073

[71] ^71.
Singh AP, Kumar VHS, Panda S. Supporting Breastfeeding in 2021 and Beyond—Lessons from the Pandemic. Pediatr Rep. 2021;13(2):289-301. DOI: https://doi.org/10.3390/pediatric13020037
» https://doi.org/10.3390/pediatric13020037

[72] ^72.
Habibi MF, Springer CM, Spence ML, Hansen-Petrik MB, Kavanagh KF. Use of Videoconferencing for Lactation Consultation: An Online Cross-Sectional Survey of Mothers’ Acceptance in the United States. J Hum Lact. 2017;34(2):313-21. DOI: https://doi.org/10.1177/0890334417711385
» https://doi.org/10.1177/0890334417711385

País/ano	Objetivo	População
EUA/2021(²¹21. Ware JL, Love D, Ladipo J, Paddy K, Starr M, Gilliam J, et al. African American Breastfeeding Peer Support: All Moms Empowered to Nurse. Breastfeed Med. 2021;16(2):156-64. DOI: https://doi.org/10.1089/bfm.2020.0323 https://doi.org/10.1089/bfm.2020.0323... )	Construir apoio e promoção da amamentação na comunidade, mudar o comportamento de saúde por meio do apoio entre pares e abordar os determinantes sociais e econômicos da saúde como um meio de abordar a amamentação como um imperativo de saúde pública.	Gestantes e puérperas (n = 110)
Brasil/2021(²²22. Paz MMS da, Almeida M de O, Cabral NO, Assis TJCF de, Mendes CKTT. Barriers imposed in the relationship between puerperal mothers and newborns in the pandemic scenario of COVID-19. Revista Brasileira de Saúde Materno Infantil. 2021;21 Supl 1:229-32. DOI: https://doi.org/10.1590/1806-9304202100S100012 https://doi.org/10.1590/1806-9304202100S... )	Analisar as condições clínicas para o aleitamento materno, que é uma oportunidade crucial para as puérperas e seus filhos, além das orientações preexistentes acerca desse tema. O estudo observou ainda os impactos da pandemia de SARS-CoV-2 no vínculo afetivo do binômio mãe-feto.	Puérperas
China/2020(²³23. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, et al. Clinical and immunologic features among COVID-19-affected mother-infant pairs: antibodies to SARS-CoV-2 detected in breast milk. New Microbes New Infect. 2020;37:100752. DOI: https://doi.org/10.1016/j.nmni.2020.100752 https://doi.org/10.1016/j.nmni.2020.1007... )	Avaliar as características clínicas e imunológicas dos pares mãe-bebê afetados por COVID-19, leite materno testado especificamente para patógenos, anticorpos neutralizantes de SARS-CoV-2 e componentes imunológicos. Explorar a viabilidade da amamentação e as possibilidades de transmissão relacionadas.	Gestantes e puérperas (n = 14)
EUA/2021(²⁴24. Mayopoulos GA, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, et al. COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. J Affect Disord. 2021;282:122-5. DOI: https://doi.org/10.1016/j.jad.2020.12.101 https://doi.org/10.1016/j.jad.2020.12.10... )	Estudar uma grande amostra de mulheres que deram à luz durante os primeiros picos de COVID-19 e as comparar com mulheres que deram à luz antes da pandemia. Perguntar se a COVID-19 está associada ao parto estressante e se o estresse agudo no parto medeia a associação entre a presença da COVID-19 nas comunidades e o estresse pós-traumático duradouro e problemas de vínculo materno.	Puérperas (n = 1274)
Vietnã/2021(²⁵25. Tran HT, Huynh LT, Le CHM, Nguyen VD, Nguyen PTT, Hoang DT, et al. Early Essential Newborn Care can still be used with mothers who have COVID-19 if effective infection control measures are applied. Acta Paediatr. 2021;110(7):1991-4. DOI: https://doi.org/10.1111/apa.15837 https://doi.org/10.1111/apa.15837... )	Descrever o uso dos primeiros Cuidados Essenciais ao Recém-Nascido (CERN) para o primeiro parto de COVID-19 no Vietnã, no Hoa Vang Medical Center, um hospital distrital de 170 leitos na cidade de Da Nang designado para gerenciar casos de COVID-19.	Puérpera (n = 1)
EUA/2020(²⁶26. Perrine CG, Chiang KV, Anstey EH, Grossniklaus DA, Boundy EO, Sauber-Schatz EK, et al. Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 — United States, July 15–August 20, 2020. Morbidity and Mortality Weekly Report [Internet]. 2020 [cited 2021 June 30];69(47);1767-70. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6947a3-H.pdf https://www.cdc.gov/mmwr/volumes/69/wr/p... )	Perguntar sobre as práticas hospitalares atuais.	Profissionais da instituição hospitalar
Itália/2021(²⁷27. Zanardo V, Tortora D, Guerrini P, Garani G, Severino L, Soldera G, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. DOI: https://doi.org/10.1016/j.earlhumdev.2020.105286 https://doi.org/10.1016/j.earlhumdev.202... )	Explorar o sofrimento psicoemocional, testado pela Edinburg Postnatal Depression Scale (EPDS) no pós-parto precoce e práticas de iniciação da amamentação, definidas de acordo com a OMS entre mulheres em quarentena que deram à luz em um “hotspot” COVID-19 no nordeste da Itália.	Puérperas (n = 299)
EUA/2020(²⁸28. Saiman L, Acker KP, Dumitru D, Messina M, Johnson C, Zachariah P, et al. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320. DOI: https://doi.org/10.1016/j.semperi.2020.151320 https://doi.org/10.1016/j.semperi.2020.1... )	Descrever as políticas e práticas de Prevenção e Controle de Infecção (PCI) para mulheres em trabalho de parto, parto e pós-parto e para recém-nascidos (RN) de mães SARS-CoV-2 positivas que foram atendidas no Well Baby Nurseries (WBN) e Unidades de Terapia Intensiva Neonatal (UTIN) e após a alta hospitalar, que foram implementadas durante as primeiras semanas da primeira onda da pandemia de COVID-19 em Nova Iorque, ou seja, de meados de março a meados de maio.	Profissionais da instituição hospitalar
Espanha/2021(²⁹29. Vila-Candel R, Mena-Tudela D, Gómez-Seguí A, Asensio-Tomás N, Cervera-Gasch A, Herraiz-Solerd Y. Management of labour, puerperium, and lactation in SARS-CoV-2 positive women. Multicentric study in the Valencian Community. Enferm Clin. 2021;31(3):184-8. DOI: https://doi.org/10.1016/j.enfcli.2021.01.006 https://doi.org/10.1016/j.enfcli.2021.01... )	Determinar as repercussões maternas e perinatais de gestantes infectadas pelo SARS-CoV-2 durante o parto e puerpério clínico em vários centros da Comunidade Valenciana. Os objetivos secundários foram determinar a ausência ou existência da transmissão vertical e descrever os cuidados maternos fornecidos durante a epidemia e o tipo de aleitamento realizado.	Gestantes e puérperas (n = 13)
EUA/2020(³⁰30. Amatya S, Corr TE, Gandhi CK, Glass KM, Kresch MJ, Mujsce DJ, et al. Management of newborns exposed to mothers with confirmed or suspected COVID-19. J Perinatol. 2020;40(7):987-96. DOI: https://doi.org/10.1038/s41372-020-0695-0 https://doi.org/10.1038/s41372-020-0695-... )	Discutir várias práticas de cuidado que mudaram na era COVID-19, incluindo o uso de esteroides pré-natais, clampeamento tardio do cordão (CTC), separação mãe-RN e amamentação.	Profissionais da instituição hospitalar
EUA/2020(³¹31. Patil UP, Maru S, Krishnan P, Carroll-Bennett R, Sanchez J, Noble L, et al. Newborns of COVID-19 mothers: short-term outcomes of aúdeating and breastfeeding from the pandemic’s epicenter. J Perinatol. 2020;40(10):1455-8. DOI: https://doi.org/10.1038/s41372-020-0765-3 https://doi.org/10.1038/s41372-020-0765-... )	Descrever a experiência única do Hospital Amigo da Criança no epicentro da pandemia de COVID-19.	RN de mães testadas para COVID-19 (n = 118)
Bélgica/2020(³²32. Ceulemans M, Verbakel JY, Calsteren KV, Eerdekens A, Allegaert K, Foulon V. SARS-CoV-2 Infections and Impact of the COVID-19 Pandemic in Pregnancy and Breastfeeding: Results from an Observational Study in Primary Care in Belgium. Int J Environ Res Public Health. 2020;17(18):6766. DOI: https://doi.org/10.3390/ijerph17186766 https://doi.org/10.3390/ijerph17186766... )	Fornecer estimativas de infecções por SARS-CoV-2 entre mulheres grávidas e lactantes, bem como avaliar o impacto percebido pelas mulheres da pandemia em suas práticas de amamentação, aconselhamento médico e apoio social durante a gravidez e lactação.	Gestantes (n = 2.647) e lactantes (n = 3.823)
EUA/2021(³³33. Snyder K, Worlton G. Social Support During COVID-19: Perspectives of Breastfeeding Mothers. Breastfeed Med. 2021;16(1):39-45. DOI: https://doi.org/10.1089/bfm.2020.0200 https://doi.org/10.1089/bfm.2020.0200... )	Explorar as percepções de apoio social entre mães que amamentam durante a pandemia da COVID-19.	Lactantes (n = 29)
Espanha/2020(³⁴34. Mejía Jiménez I, Salvador López R, García Rosas E, Rodriguez de la Torre I, Montes García J, Cruz Conty M, et al. Umbilical cord clamping and skin-to-skin contact in deliveries from women positive for SARS-CoV-2: a prospective observational study. BJOG. 2020;128(5):908-15. DOI: https://doi.org/10.1111/1471-0528.16597 https://doi.org/10.1111/1471-0528.16597... )	Demonstrar que o CTC é seguro em mães com infecção confirmada para SARS-CoV-2.	Gestantes (n = 403)
Índia/2020(³⁵35. Kumar S, Rathore P, Shweta, Krishnapriya V, Haokip N, Thankachan A, et al. Why I Can’t Breastfeed My New-born Baby? Psychosocial Dilemma of a COVID-Positive Post-LSCS Mother. Indian J Palliat Care. 2020;26 Suppl 1:S150-2.)	Apresentar o caso de uma mãe pós-parto COVID positiva de 26 anos, separada de seu bebê prematuro de 28 semanas de gestação, que estava internado na UTIN. Neste caso, o estudo irá destacar as preocupações físicas, psicossociais, espirituais e o estigma que ela teve que enfrentar durante o período de quarentena.	Puérpera (n = 1)
Nepal/2020(³⁶36. Adhikari SP, Pariyar J, Sapkota K, Gurung TK, Adhikari SR. Evaluation of Knowledge, Attitude, Practice and Hospital Experience Regarding COVID-19 among Post-partum Mothers at a Tertiary Care Center: A Cross-sectional Study. Kathmandu Univ Med J (KUMJ). 2020;18(2):10-4. DOI: https://doi.org/10.3126/kumj.v18i2.32938 https://doi.org/10.3126/kumj.v18i2.32938... )	Avaliar o conhecimento, atitude e prática (CAP) em relação à COVID-19 entre as puérperas que deram à luz em um centro de atenção terciária em Bharatpur, Chitwan, e descrever sua experiência durante a admissão hospitalar.	Puérperas (n = 203)
Brasil/2020(³⁷37. Calil VMLT, Krebs VLJ, Carvalho WB de. Guidance on breastfeeding during the Covid-19 pandemic. Rev Assoc Med Bras (1992). 2020;66(4):541-6. DOI: https://doi.org/10.1590/1806-9282.66.4.541 https://doi.org/10.1590/1806-9282.66.4.5... )	Orientar o aleitamento materno de mães com suspeita ou confirmada para COVID-19.	Puérperas
Irã/2021(³⁸38. Farhadi R, Mehrpisheh S, Philip RK. Mobile-Assisted Virtual Bonding Enables Breast Milk Supply in Critically Ill Mothers With COVID-19: A Reflection on the Feasibility of Telelactation. Cureus. 2021;13(3):e13699. DOI: https://doi.org/10.7759/cureus.13699 https://doi.org/10.7759/cureus.13699... )	Descrever a experiência relativa a três pares de mães-bebês que receberam a oferta de vínculo virtual durante a pandemia de COVID-19 no norte do Irã.	Puérperas (n = 3)
EUA/2020(³⁹39. Tomori C, Gribble K, Palmquist AEL, Ververs MT, Gross MS. When separation is not the answer: Breastfeeding mothers and infants affected by COVID-19. Matern Child Nutr. 2020;16(4):e13033. DOI: https://doi.org/10.1111/mcn.13033 https://doi.org/10.1111/mcn.13033... )	Fornecer uma síntese das consequências não intencionais das políticas de separação e dos impactos danosos/nocivos da separação sobre o aleitamento materno.	Puérperas
EUA/2021(⁴⁰40. Spatz DL, Froh EB. Birth and Breastfeeding in the Hospital Setting during the COVID-19 Pandemic. MCN Am J Matern Child Nurs. 2021;46(1):30-5. DOI: https://doi.org/10.1097/NMC.0000000000000672 https://doi.org/10.1097/NMC.000000000000... )	Apresentar a experiência de três mães, pela primeira vez, saudáveis e seus bebês, quando deram à luz no hospital e amamentaram durante o início da pandemia na Filadélfia, PA.	Puérperas (n = 3)
Áustria/2020(⁴¹41. Klaritsch P, Ciresa-König A, Pristauz-Telsnigg G; board of the OEGGG. COVID-19 During Pregnancy and Puerperium – A Review by the Austrian Society of Gynaecology and Obstetrics (OEGGG). Geburtshilfe Frauenheilkd. 2020;80(8):813-9. DOI: https://doi.org/10.1055/a-1207-0702 https://doi.org/10.1055/a-1207-0702... )	Avaliar a literatura científica disponível até 1º de maio de 2020 e discutir questões comuns sobre a COVID-19 no contexto da gravidez e no período pós-parto.	Puérperas e gestantes
Itália/2020(⁴²42. Pietrasanta C, Pugni L, Ronchi A, Schena F, Davanzo R, Gargantini G, et al. Management of the mother-infant dyad with suspected or confirmed SARS-CoV-2 infection in a highly epidemic context. J Neonatal Perinatal Med. 2020;13(3):307-11. DOI: https://doi.org/10.3233/NPM-200478 https://doi.org/10.3233/NPM-200478... )	Apresentar uma visão geral de como a assistência foi organizada e como estamos atualmente gerenciando mães e bebês com suspeita ou comprovação de infecção por SARS-CoV-2 antes e depois do nascimento.	Profissionais da instituição hospitalar
Espanha/2021(⁴³43. Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel). 2021;11(3):34. DOI: https://doi.org/10.3390/bs11030034 https://doi.org/10.3390/bs11030034... )	Revisar como a pandemia de COVID-19 tem impactado as práticas/planos de amamentação e as expectativas das mães e investigar o efeito que as expectativas de amamentação não atendidas têm na saúde mental das mulheres.	Puérperas
Rede SIBEN da América Latina e Guiné Equatorial/2020(⁴⁴44. Sola A, Rodríguez S, Cardett M, Dávila C. COVID-19 perinatal en América Latina. Rev Panam Salud Publica. 2020;44:e47. DOI: https://doi.org/10.26633/RPSP.2020.47 https://doi.org/10.26633/RPSP.2020.47... )	Avaliar e relatar as características clínicas e os resultados da infecção por SARS-CoV-2 em gestantes e seus RN na América Latina.	Parturientes (n = 86)
Itália/2020(⁴⁵45. Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116-21. DOI: https://doi.org/10.1111/1471-0528.16278 https://doi.org/10.1111/1471-0528.16278... )	Relatar o tipo de parto e o resultado neonatal imediato em mulheres infectadas com SARS-CoV-2, observadas na fase inicial da epidemia na Lombardia.	Parturientes (n = 42)

Brasil

Brasil

Aleitamento materno em tempos de COVID-19: uma scoping review

RESUMO

Objetivo:

Método:

Resultados:

Conclusão:

ABSTRACT

Objective:

Method:

Results:

Conclusion:

RESUMEN

Objetivo:

Método:

Resultados:

Conclusión:

INTRODUÇÃO

MÉTODO

Tipo do Estudo

Critérios de Seleção

Coleta de Dados

Análise e Tratamento dos Dados

RESULTADOS

Influência da Pandemia na Rotina de Cuidados ao Aleitamento Materno

Influência da Pandemia Nas Taxas do Aleitamento Materno

Influência da Pandemia na Rede de Apoio Para a Prática do Aleitamento Materno

Influência da Pandemia Nas Emoções Das Puérperas

Influência da Pandemia No Uso da Tecnologia Para Apoio ao Aleitamento Materno

DISCUSSÃO

CONCLUSÃO

EDITOR ASSOCIADO

REFERENCES

Datas de Publicação

Histórico