Breastfeeding mothers with COVID-19 infection: a case series.

BACKGROUND: The first reports of the Chinese experience in the management of newborns of mothers with SARS-CoV 2 infection did not recommend mother-baby contact or breastfeeding. At present, the most important International Societies, such as WHO and UNICEF, promote breastfeeding and mother-baby contact as long as adequate measures to control COVID-19 infection are followed. In cases where maternal general health conditions impede direct breastfeeding or in cases of separation between mother and baby, health organizations encourage and support expressing milk and safely providing it to the infants. METHODS: A series of 22 case studies of newborns to mothers with COVID-19 infection from March 14th to April 14th, 2020 was conducted. Mothers and newborns were followed for a median period of 1.8 consecutive months. RESULTS: Out of 22 mothers, 20 (90.9%) chose to breastfeed their babies during hospital admission. Timely initiation and skin to skin contact at delivery room was performed in 54.5 and 59.1%, respectively. Eighty two percent of newborns to mothers with COVID-19 were fed with breast milk after 1 month, decreasing to 77% at 1.8 months. Six of 22 (37.5%) mothers with COVID-19 required transitory complementary feeding until exclusive breastfeeding was achieved. During follow-up period, there were no major complications, and no neonates were infected during breastfeeding. CONCLUSIONS: Our experience shows that breastfeeding in newborns of mothers with COVID-19 is safe with the adequate infection control measures to avoid mother-baby contagion. Supplementing feeding with pasteurized donor human milk or infant formula may be effective, until exclusive breastfeeding is achieved.

Demand Analysis of a Psychiatric Emergency Room and an Adolescent Acute Inpatient Unit in the Context of the COVID-19 Pandemic in Madrid, Spain.

Introduction: COVID-19 represents a serious threat to mental health worldwide. The aim of this study is to identify changes in adolescent psychiatry treatment demand in a tertiary hospital in Madrid during the first month (March 11 to April 11) after the pandemic declaration by the World Health Organization (WHO). We hypothesized that fear of contagion within COVID-19 may deter people from asking for psychiatric care. Method: The current study is retrospective, observational, and transversal. We reviewed the clinical records of 89 adolescents who went to the Emergency Room (ER) or were hospitalized at the Acute Inpatient Unit (AIU) at the Puerta de Hierro University Hospital-Majadahonda (PHUH-M) between March 11 and April 11. Socio-demographic, clinical, and demand variables were included in the study. Chi-square or Fisher exact tests were performed to compare categorical variables. We used the U Mann-Whitney test to compare quantitative variables. The level of statistical significance was set at p< 0.05. Analyses were conducted using SPSS v11.0. Results: The number of adolescents demanding psychiatric care at the ER dropped from 64 adolescents in 2019 to 25 in 2020. Similarly, psychiatric demand collapsed from 31 to 18 patients when comparing 2019 and 2020. Furthermore, the average hospital stay in 2020 trended toward a decrease when compared to 2019 (8.94 ± 4.87 vs. 14.32 ±10.23, p = 0.08). Self-injurious thoughts and behaviors were the most predominant reasons for consultation at both ER and AIU. Conclusion: The demand for adolescent psychiatric care decreased in the first month after the declaration of the pandemic. Our findings may be explained by (1) the fear of contagion, (2) the strict confinement measures, and (3) the initial shock as an adaptive reaction described in other disasters. Further studies are needed.