TABLE 3.
Infant feeding‐related changes experienced by participating caregivers of infants aged < 6 months due to COVID‐19 State of Emergency in Nova Scotia
| N a | Changed since State of Emergency | Change caused by … | Illustrative quote(s): examples of usual (• illustrative of the majority of respondents) and unusual (▪ illustrates ‘cases’ or minority viewpoints) responses | |||
|---|---|---|---|---|---|---|
| COVID‐19 (e.g., food availability and income) | Other factor (e.g., infant age) | Reason unknown | ||||
| Food provided to infant | ||||||
| Breast milk from breast | 333 | 50 (15%) | 3 (6%) | 18 (36%) | 29 (58%) |
• ‘I could not keep my milk supply up with my baby's needs’ • ‘Baby needed more than I produced, so we changed to formula’ • ‘Breast couldn't produce enough milk’ ▪ ‘We spend most of our days topless and skin to skin so she has fed a lot more unrestricted than if we were permitted to go places or have visitors’. ▪ ‘Less bottle feeding since I am apart from baby less’ ▪ ‘Had to breast feed more to try to make up for lack of calories due to running out of formula’ |
| Breast milk from a bottle | 319 | 63 (20%) | 10 (16%) | 26 (41%) | 27 (43%) | |
| Infant formula | 326 | 62 (19%) | 8 (13%) | 24 (39%) | 30 (48%) | |
| Water | 320 | 16 (5%) | 0 (0%) | 12 (75%) | 4 (25%) | • ‘Baby turned 6 months’ |
| Introduced solid foods during COVID‐19 | 335 | 48 (14%) | 4 (8%) | 12 (25%) | 32 (67%) |
• ‘Started showing signs he was ready [for complementary foods]’ • ‘Was going to wait until 6 months but he was very interested so I started a few purees around 5.5 months’ ▪ ‘More time at home has led to increased meals at the table for our family; baby showed interest in food. Also was “something different” to stimulate my baby in the absence of community programs, baby groups, scenery changes, etc.’ ▪ ‘Started one week early for baby to have more things to do to pass the time in the day’ |
| Introduced solids earlier than expected | 16 (33%) | 4 (25%) | 12 (75%) | ‐ | ||
| Feeding habits | ||||||
| Frequency | 335 | 11 (3%) | 5 (45%) | 6 (55%) | ‐ |
• ‘Baby is bored from being home more so I found that my baby would feed a lot more’ ▪ ‘We went with more of a schedule now doing around 7 bottles a day’ |
| Amount | 335 | 7 (2%) | 1 (14%) | 6 (86%) | ‐ |
• ‘We decreased my babies food intake an ounce or 2 due to him spitting up a lot’. ▪ ‘Ran out of formula at one point and store didn't have any in stock …’ |
| Food safety | 327 | 20 (6%) | 20 (6%) | 0 (0%) | ‐ |
• ‘I'm more careful about regular sanitizing as opposed to just thorough cleaning’. ▪ ‘Use dishwasher, don't have time to handwash and sanitize as much’ |
| Feeding style altered to limit potential spread of COVID‐19 | 333 | 40 (12%) | 40 (100%) | 0 (0%) | ‐ |
• ‘More hand washing’ ▪ ‘I pumped before COVID‐19, stopped because of all of the sanitizing’. |
| Primary caregiver no longer shops in‐store or does not shop in‐store as frequently | 282 | 242 (86%) | ‐ | ‐ | ‐ | ▪ ‘I still shop in‐store but I don't bring my kids unless my mother is absolutely unavailable and I have no other option and it cannot wait’ |
| Breastfeeding | ||||||
| Challenges | 264 | 71 (27%) | 6 (8%) | 62 (87%) | 3 (4%) |
• ‘Engorgement, nipple blanching, decreased milk supply’ ▪ ‘… with my other children being home from school and trying to enforce homeschooling while breastfeeding a newborn. I prefer to feed on demand, and let baby nurse until they are done even if it's purely for comfort. That had been affected as there is more demand for my time and attention now’. |
| Different access to breastfeeding support | 71 | 47 (66%) | 42 (59%) | 5 (7%) | ‐ |
• ‘We had to give up on breastfeeding directly because the public health nurse who was trying to help us wasn't allowed to do home visits and it's impossible to trouble shoot breastfeeding over the phone when the child isn't latching or feeding from the breast no matter how perfect the technique. Now I have to pump 100%’ ▪ ‘I would have reached out to other mothers online’ |
| Positive experiences | 264 | 50 (19%) | 33 (66%) | 16 (32%) | 1 (2%) |
• ‘Breastfeeding was hard for us. We had to get lactation consultant and tongue tie fix in month 2‐3. We were just settling into feeding when pandemic started. Because I have nowhere to go now I spend a lot more time relaxing with baby and doing comfort nursing. I would have felt pressure to be on the go with baby but pandemic has allowed me to relax with baby and focus on breastfeeding’ ▪ ‘Gradually getting the hang of things with less pain’ |
| Now pump milk more often | 174 | 42 (24%) | 26 (62%) | 14 (33%) | 1 (2%) |
• ‘Wanted to ensure I have milk stored in case I was to get sick my partner would have EBM to use’ ▪ ‘Baby's preference to bottle has increased’ |
| Now pump milk less often | 174 | 51 (29%) | 36 (71%) | 12 (24%) | 3 (6%) |
• ‘… I won't be away from him because of the pandemic. So, I don't feel a need to store breastmilk in the freezer for bottles since I won't be going out’ ▪ ‘Prescribed Domperidone’ |
| Formula feeding | ||||||
| Formula form | 133 | 28 (21%) | 15 (54%) | 12 (43%) | 1(3%) |
• ‘Needed to use both stage 1 and stage 2 formula because there wasn't enough stage one available at stores’. ▪ ‘We ran out of the ready‐made and were naturally ready to switch to powder’. |
Data presented as n (%). Percentages may not add to 100% due to rounding.
Abbreviation: EBM, expressed breast milk.
N differs due to participants skipping some questions.