Citation Information :
Doshi B, Mehendale MA, Nayak AH, Bhosale AA, Koria R. Study of Anxiety, Fear and Depression Associated with Breastfeeding in COVID-positive Mothers. J South Asian Feder Obs Gynae 2021; 13 (5):292-296.
Aim and objective: To study anxiety, fear and depression associated with breastfeeding in coronavirus disease (COVID)-positive mothers.
Materials and methods: The following three standard scales were used to measure fear anxiety, and depression namely fear of coronavirus disease-2019 (COVID-19) scale (FCV-19S), corona disease anxiety scale (CDAS), and Edinburgh postnatal depression scale (EPDS) among postpartum women along with a self-made breastfeeding questionnaire by the author to assess the association with breastfeeding.
Results: Among the total of 62 respondents, a mean of 17 was obtained on the EPDS which is more than the cutoff value. FCV-19S and CDAS did not show extreme results except for few cases. The breastfeeding questionnaire suggested that most women are afraid of transmitting the infection to their newborns and they lack the knowledge about the importance of breast milk in warding off other infections. Also, women found it difficult to take care of their newborns on their own.
Conclusion: With this study, we could determine the effects of this pandemic on anxiety levels, depression, and fear of COVID infection in postpartum women. In the current scenario with the possibility of the next pandemic wave in India, there is an urgent need to provide emotional and psychosocial support to this group of the population during the crisis. Otherwise, the adverse outcome is possible involving both mother and newborn.
Clinical significance: The COVID-19 outbreak that began in China has turned into a pandemic that affects global health, thereby prompting the concentration of studies and clinical routines on treating and preventing the disease with measures like vaccination. Still, the clinical data regarding psychological manifestations of the ongoing pandemic among the general public, especially postpartum women and breastfeeding mothers, are inadequate. In this study, we analyzed experiences of breastfeeding mothers during the COVID-19 pandemic, specifically concerning how COVID-positive status affected their infant\'s feeding decisions. It clearly showed that being COVID positive created, affected, and exacerbated mental health issues for mothers.
John Hopkins University and Medicine, coronavirus.jhu.edu [Internet], Coronavirus Resource Center. 2021. Available from: https://coronavirus.jhu.edu/data/mortality.
Mackenzie JS, Smith DW. COVID-19: a novel zoonotic disease caused by a coronavirus from China: what we know and what we don't. Microbiol Aust 2020:MA20013. DOI: 10.1071/MA20013.
Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed 2020;91(1):157–160. DOI: 10.23750/abm.v91i1.9397.
Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/2020-07-24-coronavirus-covid-19-infection-in-pregnancy.pdf.
Zhao X, Jiang Y, Zhao Y, et al. Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. Eur J Clin Microbiol Infect Dis 2020:1–12. DOI: 10.1007/s10096-020-03897-6.
Schwartz A, Yogev Y, Zilberman A, et al. Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vaginal swabs of women with acute SARS-CoV-2 infection: a prospective study. BJOG 2021;128(1):97–100. DOI: 10.1111/1471-0528.16556.
World Health Organization. Breastfeeding and COVID-19: scientific brief (23 June 2020). Geneva, Switzerland: World Health Organization; 2020.
Chawla D, Chirla DI, Dalwai S, et al. Perinatal-neonatal management of COVID-19 infection-guidelines of the Federation of Obstetric and Gynecological Societies of India (FOGSI), National Neonatology Forum of India (NNF), and Indian Academy of Pediatrics (IAP). Indian Pediatr 2020;57(6):536–548. DOI: 10.1007/s13312-020-1852-4.
Poon LC, Yang H, Kapur A, et al. Global interim guidance on coronavirus disease 2019 (COVID-19) during pregnancy and puerperium from FIGO and allied partners: information for healthcare professionals. Int J Gynecol Obstet 2020;149(3):273–286. DOI: 10.1002/ijgo.13156.
Hanson LA. Breastfeeding provides passive and likely long-lasting active immunity. Ann Allergy Asthma Immunol 1998;81(6):523–537. DOI: 10.1016/S1081-1206(10)62704-4.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150(6):782–786. DOI: 10.1192/bjp.150.6.782.
Ahorsu DK, Lin CY, Imani V, et al. The fear of COVID-19 scale: development and initial validation. Int J Mental Health Addict 2020:1–9. DOI: 10.1007/s11469-020-00270-8.
Alipour A, Ghadami A, Alipour Z, et al. Preliminary validation of the Corona disease anxiety scale (CDAS) in the Iranian sample. Health Psychol J 2020;8(32):163–175. DOI: 10.30473/HPJ.2020.52023.4756.
Xiang YT, Yang Y, Li W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry 2020;7(3): 228–229. DOI: 10.1016/S2215-0366(20)30046-8.
Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. IJERPH 2020;17(5):1729. DOI: 10.3390/ijerph17051729.
Li Z, Ge J, Yang M, et al. Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain Behav Immun 2020;88:916–919. DOI: 10.1016/j.bbi.2020.03.007. PII: S0889-1591(20)30309-3.
Capanna F, Haydar A, McCarey C, et al. Preparing an obstetric unit in the heart of the epidemic strike of COVID-19: quick reorganization tips. J Matern Neonatal Med 2020:1–7. DOI: 10.1080/14767058.2020.1749258.
Mirzadeh M, Khedmat L. Pregnant women in the exposure to COVID-19 infection outbreak: the unseen risk factors and preventive healthcare patterns. J Matern Neonatal Med 2020:1–2. DOI: 10.1080/14767058.2020.1749257.
Salehi L, Rahimzadeh M, Molaei E, et al. The relationship among fear and anxiety of COVID-19, pregnancy experience, and mental health disorder in pregnant women: a structural equation model. Brain Behav 2020;10(11):e01835. DOI: 10.1002/brb3.1835.
World Health Organisation. www.who.int [internet], maternal-mental-health. 2021. Available from: https://www.who.int/teams/mental-health-and-substance-use/maternal-mental-health.
Kale DP, Nadkarni TK, Pawar AP, et al. A prospective observational study of the effects of COVID-19 pandemic on mental health status of COVID-positive pregnant women in a COVID Care Center. J South Asian Fede Obst Gynae 2021. DOI: 10.5005/jp-journals-10006- 1904.
Tomori C, Gribble K, Palmquist AE, et al. When separation is not the answer: breastfeeding mothers and infants affected by COVID-19. Maternal Child Nutr 2020;16(4):e13033. DOI: 10.1111/mcn.13033.
Bartick MC, Schwarz EB, Green BD, et al. Suboptimal breastfeeding in the United States: maternal and pediatric health outcomes and costs. Matern Child Nutr 2017;13(1):e12366. DOI: 10.1111/mcn.12366.
Singh P, Singh S, Sohal M, et al. Psychological fear and anxiety caused by COVID-19: insights from Twitter analytics. Asian J Psychiatr 2020;54:102280. DOI: 10.1016/j.ajp.2020.102280.
Pérez-Escamilla R, Hall Moran V. Scaling up breastfeeding programmes in a complex adaptive world. Matern Child Nutr 2016;12(3):375–380. DOI: 10.1111/mcn.12335.
Ahn SY, Ko SY, Kim KA, et al. The effect of rooming-in care on the emotional stability of newborn infants. Korean J Pediatr 2008;51(12):1315–1319. DOI: 10.3345/kjp.2008.51.12.1315.
Lokken EM, Walker CL, Delaney S, et al. Clinical characteristics of 46 pregnant women with a severe acute respiratory syndrome coronavirus 2 infection in Washington State. Am J Obstet Gynecol 2020;223(6):911.e1. DOI: 10.1016/j.ajog.2020.05.031.
Kapadia SN, Mehta A, Mehta CR, et al. Study of pregnancy with COVID-19 and its clinical outcomes in a tertiary care teaching hospital in Western India. J South Asian Feder Obs Gynae 2021;13(2):125–130. DOI: 10.5005/jp-journals-10006-1886.
Lowe B, Bopp B. COVID-19 vaginal delivery–a case report. Aust N Z J Obstet Gynaecol 2020;60(3):465–466. DOI: 10.1111/ajo.13173.
Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016;387(10017):475–490. DOI: 10.1016/S0140-6736(15)01024-7.
Garofalo RP, Goldman AS. Expression of functional immunomodulatory and anti-inflammatory factors in human milk. Clin Perinatol 1999;26(2):361–377. DOI: 10.1016/s0095-5108(18)30057-5.
Brown A, Shenker N. Experiences of breastfeeding during COVID-19: lessons for future practical and emotional support. Matern Child Nutr 2021;17(1):e13088. DOI: 10.1111/mcn.13088.