Keywords
Breastfeeding
Maternal Health
Neonatal Immunity
Prenatal Period
How to Cite
Abstract
INTRODUCTION: The COVID-19 pandemic, declared by the World Health Organization (WHO) in March 2020, brought numerous challenges to global health, particularly in prenatal and neon'atal care. Pregnant women, due to immunological and physiological changes, showed increased susceptibility to severe respiratory infections, including SARS-CoV-2-associated pneumonia. This context raised concerns about vertical transmission of the virus, childbirth practices, the use of breast milk, and associated risks to neonatal health. Initial studies indicated high cesarean rates and disruptions in breastfeeding practices, which contradict the known immunological benefits of human milk. Additionally, the pandemic's psychological and social impact hindered adherence to breastfeeding and COVID-19 vaccination among pregnant and lactating women. OBJECTIVES: To explore the impacts of SARS-CoV-2 in the prenatal and perinatal periods, emphasizing the role of breastfeeding in neonatal immunity and the challenges faced by mothers during the pandemic. METHODOLOGY: A literature review was conducted in October 2024, with searches in the PubMed database using the descriptors Milk AND SARS-CoV-2. Inclusion criteria comprised articles published between 2020 and 2024 in Portuguese, English, Spanish, and French, focusing on review and meta-analysis studies. Sixteen articles were selected after applying the inclusion criteria. RESULTS: SARS-CoV-2 significantly impacted maternal and neonatal health. Studies showed that breast milk contains specific antibodies against SARS-CoV-2, reinforcing its importance even in the context of maternal infection. However, the pandemic reduced breastfeeding rates due to fear of viral transmission and hospital policies separating mothers and newborns. Complications such as preterm birth, preeclampsia, and low birth weight were more frequent in infected pregnant women. Breastfeeding was found to be safe and essential, highlighting the presence of IgA antibodies and bioactive factors in milk that promote neonatal immunity. CONCLUSION: The pandemic underscored the importance of breastfeeding as an essential strategy for neonatal health, even in adverse scenarios. Providing clear, evidence-based information is crucial to support mothers in maintaining breastfeeding and adhering to COVID-19 vaccination, aiming to mitigate the negative impacts on maternal and child health.References
CENTENO‐TABLANTE, Elizabeth et al. Transmission of SARS‐CoV‐2 through breast milk and breastfeeding: a living systematic review. Annals of the New York Academy of Sciences, v. 1484, n. 1, p. 32-54, 2021.
DHIR, Shashi Kant et al. Clinical features and outcome of SARS-CoV-2 infection in neonates: a systematic review. Journal of tropical pediatrics, v. 67, n. 3, p. fmaa059, 2021.
JUAN, Juan et al. Effect of coronavirus disease 2019 (COVID‐19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound in Obstetrics & Gynecology, v. 56, n. 1, p. 15-27, 2020.
MUSTAFA, Naira M.; SELIM, Laila A. Characterisation of COVID-19 pandemic in paediatric age group: a systematic review and meta-analysis. Journal of Clinical Virology, v. 128, p. 104395, 2020.
NICOLAIDOU, Vicky et al. Detection of SARS-CoV-2–Specific Antibodies in Human Breast Milk and Their Neutralizing Capacity after COVID-19 Vaccination: A Systematic Review. International Journal of Molecular Sciences, v. 24, n. 3, p. 2957, 2023.
ONCEL, Mehmet Yekta et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. European journal of pediatrics, v. 180, p. 733-742, 2021.
RODRIGUES, Carina et al. Pregnancy and breastfeeding during COVID-19 pandemic: a systematic review of published pregnancy cases. Frontiers in public health, v. 8, p. 558144, 2020.
VASSILOPOULOU, Emilia et al. Breastfeeding and COVID-19: from nutrition to immunity. Frontiers in immunology, v. 12, p. 661806, 2021.
WALKER, Kate F. et al. Maternal transmission of SARS‐COV‐2 to the neonate, and possible routes for such transmission: a systematic review and critical analysis. BJOG: An International Journal of Obstetrics & Gynaecology, v. 127, n. 11, p. 1324-1336, 2020.
WESOŁOWSKA, Aleksandra et al. Protecting breastfeeding during the COVID-19 pandemic: a scoping review of perinatal care recommendations in the context of maternal and child well-being. International Journal of Environmental Research and Public Health, v. 19, n. 6, p. 3347, 2022.
Binns, C., Lee, M., & Low, W. Y. (2023). Breastfeeding in the time of COVID-19. Journal of Human Lactation, 39(1), 12-20.
Carvalho, R. B., Santos, P. R., & Almeida, C. A. (2022). Socioeconomic challenges to breastfeeding during the COVID-19 pandemic. International Breastfeeding Journal, 17(1), 45-53.
Collier, A. Y., McMahan, K., & Yu, J. (2022). Immunogenicity of COVID-19 mRNA vaccines in pregnant and lactating women. JAMA, 327(15), 1478-1480.
López-Maestro, M., Calvo, C., & Pérez-González, M. C. (2021). Maternal mental health and breastfeeding during the COVID-19 pandemic. Maternal and Child Health Journal, 25(10), 1531-1540.
Pacheco, F., Sobral, M., & Guiomar, R. (2021). Impact of maternal COVID-19 infection on breastfeeding. Clinical Pediatrics, 60(4), 198-205.
Perl, S. H., Uzan-Yulzari, A., & Klainer, H. (2021). SARS-CoV-2–specific antibodies in breast milk after COVID-19 vaccination. Journal of the American Medical Association, 326(1), 28-29.
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Copyright (c) 2024 Victor Salarolli Lorencini, Amanda Grillo Vetorazi, Thalya Mendes Barbosa, Mateus Bertolini Da Rós , Kimberly Dos Santos Rosa, Anna Paula Cosenza Paixão Sousa
