by Jenny Buck
Leader with LLL Hong Kong - English Group
The timing and severity of the crisis have varied widely across our region. Many parts of China experienced a severe lockdown from mid-January to mid-March. Hong Kong and Taiwan started dealing with the crisis in late January and have been largely successful in keeping the situation under control, with only limited restrictions required. More recently, from mid-March onwards, other countries started taking action and have implemented moderate to severe restrictions, either as preventive measures or in response to an escalating public health crisis.
But even in countries which have implemented “mild” restrictions, there can be a serious impact on the situation for families welcoming a new baby into the world and/or caring for young children. Hong Kong can be counted among countries which have been lucky enough to not suffer lockdown, yet a restriction on visitors to public hospitals has resulted in many giving birth without their partners, and feeling isolated in their homes because they don’t feel it’s safe to take their vulnerable newborns outside or to receive visitors. It has been especially challenging for families who have been trying to help a newborn learn to breastfeed while simultaneously entertaining an older child who can’t engage in their usual activities outside the home.
There have also been some unfortunate incidents of separation of breastfeeding babies from their mothers. In March, we learned about one mother in Hong Kong who had tested positive for COVID-19 and was sent to a quarantine centre without her four-month-old breastfeeding baby, leaving the father holding the baby who turned out to be allergic to infant formula milk. The community rallied around to find informal milk donors to help provide breast milk for this baby. La Leche League’s code of conduct does not allow Leaders to facilitate informal milk sharing due to its health risks, but we have provided support to the mother concerned, who is now back home with her baby and trying to ramp up her milk production.
We also heard that in some countries there has been some routine separation from newborn babies in hospitals because some doctors have unfounded concerns that mothers could infect their babies via physical contact and/or their milk. La Leche League International has been busy compiling and translating information intended to counter misinformation in this regard. Multilingual information can be found here – feel free to share widely.
In-person meetings of LLL Groups have also been curtailed by the pandemic. Many LLL Groups around our region have been holding live online meetings. Some groups have been holding video-call meetings, such as via Zoom or other live video platforms, which run much like a regular LLL meeting.
This question prompted some interesting responses, such as the fact that reduced visitors after the birth can be a benefit as well as a drawback. There may be less help from outside the home but also less unwanted interference. Being home and left to breastfeed without much interruption has resulted in better breastfeeding outcomes for some.
continue to knit the fabric of the group together, continue to nurture mothers and possible friendships between them, and to continue to offer a safe space for mothers who were already feeling isolated in motherhood and more so now. Spontaneous conversation is a bit more difficult on Zoom than during in-person meetings, which is both a plus and a minus. Sometimes, a little bit more facilitation from me is required (e.g. “Would anyone like to respond to Anna? Has anyone else experienced this?” etc.) but on the other hand there are fewer side conversations so it’s easier to stay focused on a topic. Plus a nice bonus: I don’t have to clean my house or my bathroom! Our first meeting topic was "Breastfeeding and Mothering in lockdown", and the second one was 'Connection in Isolation - Building Your Network' where we explored support networks for breastfeeding families and how support differs in a time of social distancing. Since there have been security concerns about Zoom, I have been careful not to publish the meeting details online and to specify that the group do not share the meeting dial-in details with anyone else.”
Whilst the meetings in Hong Kong and Australia have reported attendance similar to their usual in-person meetings, LLL Lebanon has experienced huge turnouts. Leader Nadiya Dragan reports: “Our first online LLL Lebanon meeting on 6 May was a huge success - we had over 60 attendants at some points during the session and the discussion continued for over four hours! This is one of the longest LLL meetings we have ever had in Lebanon and it is definitely one of the biggest too. So we created a new WhatsApp group for all attendants of that online session to keep in touch with them. This group will be moderated by all LLL Leaders of Lebanon, where we will be adding new online attendants of the future sessions too. Two of our four Leaders are outside of Lebanon at the moment but were able to join the meeting from Canada and Spain – it was so cool that in spite of being separated geographically, we were still all able to hold the meeting together!”
That the timing of the early days of the crisis was relatively good in China because it started during the Chinese New Year holiday, when many people were taking a break from work and visiting their home villages, so they simply decided to stay longer. There was little need for “panic buying” because most people had already stocked up on food that they needed for the holiday feasting. Many new mothers in China go through the practice of “confinement” for a month after childbirth anyway, so the lockdown was merely an extension of something they were well used to.
Meanwhile, Muslim families have been experiencing a very different Ramadan (between 23 April and 23 May) in many countries in our Area this year. Ramadan is a time for fasting during the daytime, with feasting and heavy socialising after sunset. Some families with young children or babies have found social distancing or lockdown to be a balm for them to enjoy a quiet month, especially in the hotter countries. The three-day celebration of Eid ul Fitr, which marks the end of Ramadan, promises to be a more somber occasion than usual, with families being unable to mingle, but this will probably make unrestricted breastfeeding easier, without the stress of needing to cook for large gatherings.
While some families have benefited from more time alone together with fewer distractions, on the other hand, many new parents have suffered from isolation and/or a lack of support. In Australia, many midwife consultations are being done online rather than in person. In Pakistan, LLL Leader Aida Tasneem Zafar reports that in remote areas without internet access, mothers can be isolated from their usual breastfeeding support networks and, if they seem unwell, will face pressure from older family members to separate from their baby for the baby’s protection.
More encouragingly, in Hong Kong, we have heard reports that the duration of breastfeeding has been extended beyond what parents had originally planned, partly because they know that breast milk gives immunological benefits and partly because it’s very convenient, whereas restricting breastfeeding can be difficult when stuck indoors with limited distractions available.
Particularly in countries experiencing lockdown, parents are vulnerable to feeling overwhelmed when stuck indoors with young children without much support, so it is important that all avenues of online support are explored and that social connections are maintained or new ones formed. Physical distancing doesn’t need to mean social isolation. The internet is a very useful source of ideas about how to entertain toddlers and preschoolers at the moment.
Lastly, we need to remember that the needs of breastfeeding babies remain the same during all circumstances, and that all their needs will continue to be met by breastfeeding during a pandemic. All they need is warmth, food and love, all of which can be provided at the breast. Common breastfeeding difficulties will arise as normal, and parents will overcome those difficulties as normal, with the right information and support, which does not necessarily need to be provided in person.
“LLLI supports the World Health Organization (WHO) recommendation for breastfeeding immediately after birth even when a positive COVID-19 test has been obtained. Breastfeeding is important for an infant who is born to anyone who tests positive for COVID-19 or who has a close family member who has tested positive. It is critical that all newborns be supported in breastfeeding within one hour after birth so they can benefit from the immunological components that colostrum provides.
If someone who is breastfeeding becomes ill, it is important not to interrupt breastfeeding unless it becomes medically necessary. When any member of the family has been exposed, the infant has been exposed. Any interruption of breastfeeding may actually increase the infant’s risk of becoming ill and even of becoming severely ill.
Mothers who become too ill to breastfeed should be supported in expressing or pumping so that the baby can still be given the milk. If that is not possible, donor milk is recommended by the WHO as the next best feeding option, as donor milk will contain immunological components not available in human milk substitutes. Information about relactation should be offered, along with support to help get the baby back to the breast when health improves." - LLLI press release 16 April 2020 -
Close to the Heart Vol. 21, No. 1 (Early- & Mid-Year 2020)
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