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A new study from Saint Louis University (SLU) sheds light on how COVID-19 stay-at-home orders influenced breastfeeding practices across diverse communities in the United States. Published in the Maternal and Child Health Journal, the research offers valuable insights into the challenges and opportunities presented by the pandemic, particularly for historically marginalized populations.
The study found that for many mothers, stay-at-home orders during the pandemic proved to be beneficial for breastfeeding. Thirty-four percent of mothers reported that the home environment allowed for easier breastfeeding, facilitated stronger mother-child bonding, and contributed to longer breastfeeding durations. However, the pandemic also exacerbated barriers, including limited access to lactation support and increased maternal stress.
“COVID-19 highlighted both the strengths and the gaps in our support systems for breastfeeding mothers,” said María José Romo-Palafox, Ph.D., senior author of the paper and assistant professor of nutrition and dietetics at SLU. “While some mothers benefited from the opportunity to breastfeed more easily at home, others struggled without the right resources and support, especially those from marginalized backgrounds.”
Romo-Palafox, a Mexican immigrant and registered dietitian, focuses her research on maternal and child health in communities that often face systemic challenges. She pointed out that the findings underscored the urgent need for policies that address the broader needs of mothers, including mental health and financial stability.
The study also highlights the disparity between past research on breastfeeding, which often relied on samples from White, non-Hispanic, well-educated, partnered, and employed mothers, and the current findings, which involved a more diverse group of respondents in terms of race, ethnicity, and socio-economic background.
Breastfeeding and the Role of Policy
Breastfeeding is widely recognized as a key factor in a child’s long-term health, with the World Health Organization recommending exclusive breastfeeding for the first six months of life. Yet, only 26% of infants in the U.S. met this guideline in 2020. One significant barrier to breastfeeding success in the U.S. is the return to work. Many mothers face difficulties in continuing breastfeeding when they go back to work, particularly when there is insufficient support from their employers, such as a lack of designated lactation spaces or adequate time to pump.
Recent legislation like the PUMP for Nursing Mothers Act and the Pregnant Workers Fairness Act, passed by the U.S. Senate in 2022, aims to address some of these issues. However, Romo-Palafox and her team argue that these measures may not fully meet the needs of low-income, racially diverse mothers, who often return to work early due to financial constraints.
“The pandemic demonstrated that working from home allowed many mothers to breastfeed longer and bond more closely with their infants,” Romo-Palafox explained. “This experience highlighted that existing policies do not go far enough to support mothers, particularly those from historically marginalized backgrounds.”
The Call for More Comprehensive Policies
To better support breastfeeding mothers, Romo-Palafox and her colleagues propose policies that go beyond current mandates. These would include more flexible work options, expanded financial support, and integrated mental health resources. One crucial element, they argue, is the continued availability of telehealth lactation services, which were widely used during the pandemic but have since seen reduced access.
“Telehealth lactation support, especially through programs like WIC (Women, Infants, and Children), was a lifeline during the pandemic,” said Romo-Palafox. “It allowed mothers to access expert advice without leaving home, helping them navigate challenges and stress. Reinstating and standardizing these services would make a significant difference, particularly for low-income and racially diverse populations.”
Other authors of the study include Valerie Graham, Haley Pritz, and Zoe Henkes, all from the Department of Nutrition and Dietetics at Saint Louis University.
As the U.S. continues to address the challenges of maternal and child health, this research underscores the need for a holistic approach that recognizes the diverse realities faced by mothers, particularly those from historically marginalized communities. By expanding breastfeeding support systems and policies, the country can ensure healthier outcomes for both mothers and their children.
