Table 3.
Recommendations in home environment for the management of the mother-infant dyad exposed to SARS-CoV-2
| Recommendation | Brazilian hospital guidelines existence (n = 24) | Available recommendations in Brazilian and international literature [15–27] | |
|---|---|---|---|
| Yes (%) | No (RA/NR-%) | ||
| Breastfeeding | 24 (100) | 0 (0)/RA |
UENPS, WHO and UNICEF clearly stand in favor; rBLH, SBP, ABM, RCOG and CDC recommend if the mother desires. |
| Feeding on demand | 24 (100) | 0 (0)/NR | WHO, RCOG, ABM, SBP, CDC, UNICEF and UENPS do not specify. |
| Comforting techniques | 11 (45.8) | 13 (54.1)/NR | WHO, UNICEF, CDC, RCOG, ABM, SBP and UENPS do not specify. |
| Other person’s neonatal care (not mother’s care) | 16 (66.6) | 8 (33.3)/NR |
CDC, ABM and SPB recommend; RCOG, WHO, UNICEF and UENPS do not specify. |
| Infant formula | 6 (25) | 18 (75)/RA |
RCOG, ABM, SBP and CDC do not specify; UENPS clearly discourages and recommends expressed fresh mother’s milk; WHO, UNICEF suggests infant formula if breast milk is not possible. |
| Hygiene measures | 24 (100) | 0 (0)/RA | WHO, UNICEF, CDC, RCOG, ABM, UENPS, SBP and rBLH allow alcohol gel before handling. |
| 2 m distance | 24 (100) | 0 (00)/RA |
ABM, UENPS, SBP and CDC recommend; RCOG, WHO and UNICEF do not specify. |
| Separate rooms | 4 (16.6) | 20 (83.3)/NR |
Recommendation not specified for home environment; UENPS, SBP, RCOG, WHO and UNICEF do not specify; ABM recommends as an option; CDC recommends. |
| Distance between siblings | 15 (62.5) | 9 (37.5)/NR | WHO, UNICEF, CDC, RCOG, SBP, ABM and UENPS do not specify. |
| Actions to support breastfeeding | 11 (45.8) | 13 (54.1)/NR |
WHO, UNICEF, UENPS, ABM and SBP do not specify; rBLH recommends suspending educational groups on breastfeeding; RCOG and CDC recommend. |
| Home visit | 4 (16.6) | 20 (83.3)/RA |
RCOG, ABM, SBP, CDC, WHO and UNICEF do not specify; UENPS discourages. |
| Telemedicine | 11 (45.8) | 13 (54.1)/NR |
WHO, RCOG, CDC and UENPS encourage; ABM does not specify; rBLH recommends for breastfeeding support and encouragement; UNICEF do not specify. |
| Reference center to medical evaluation | 5 (20.8) | 19 (79.1)/NR |
UENPS recommends return with 7 days, 14 days and 28 days after discharge; WHO, UNICEF, CDC, RCOG, ABM and SBP do not specify. |
| Newborn screening in the hospital | 11 (45.8) | 13 (54.1)/NR | WHO, CDC, RCOG, ABM, SBP, UNICEF and UENPS do not specify. |
| Psychological call center | 9 (37.5) | 15 (62.5)/NR |
ABM, WHO, UNICEF SBP and UENPS do not specify; CDC and RCOG recommend. |
RA Recommended against, NR There was no description of the recommendation in guidelines, ABM Academy of Breastfeeding Medicine, rBLH Brazilian Network of Human Milk Banks, SBP Brazilian Society of Pediatrics CDC Centers for Disease Control and Prevention, PPE Personal Protective Equipment, RCOG Royal College of Obstetricians and Gynaecologists, UENPS Union of European Neonatal and Perinatal Societies, UNICEF United Nations Children’s Fund, WHO World Health Organization