Breastfeeding Self-efficacy in COVID-19 Positive Postpartum Mothers in a Community Maternal Facility in South India: A Case Control Study

Background: Breastfeeding experiences have altered during the COVID-19 pandemic. Breastfeeding self-efficacy is a strong determinant of the breastfeeding behaviour of women. We aimed to study breastfeeding self-efficacy and assess the perceived factors for breastfeeding hindrance in COVID-19 positive mothers in the postpartum period. Method: A facility based case-control study was conducted with 63 COVID-19 positive (cases) and 63 COVID-19 negative postnatal mothers (controls). A breastfeeding self-efficacy short form (BFSE SF) instrument measured Breastfeeding self-efficacy 24 to 48 hours post-delivery. Mothers who tested positive for COVID-19 were interviewed about perceived factors for breastfeeding hindrance. Data was analyzed by SPSS version 25. Descriptive statistics were used for maternal parameters. BFSE SF scores were compared by a t test. Results: The mean BFSE SF score of COVID-19 positive mothers was 53.14 which was significantly lower than the mean BFSE SF score of 56.52 of COVID-19 negative mothers (p=0.013). Mothers who had received postpartum breastfeeding advice had significantly higher BFSE SF mean scores (p= 0.031). Sixty-seven percentage of COVID-19 positive mothers reported fear of transmission of illness to the neonate as a hindering factor. Conclusions: Breastfeeding self-efficacy scores were significantly lower in COVID- 19 positive mothers. Higher breastfeeding self-efficacy scores were observed in mothers who had received postpartum breastfeeding advice. The fear of transmission of the COVID-19 illness to the neonate was perceived as a breastfeeding hindering factor in most of the mothers. These observations imply the need for professional lactation support programs.