Breastfeeding Rates in the Military Are Unchanged Before and After the Onset of the COVID-19 Pandemic

Introduction: The COVID-19 pandemic brought changes in clinical operations and raised concerns about breastfeeding safety. We investigated the change in breastfeeding rates within a military population, a model of universal health care coverage, and elucidated factors that enhance or deter breastfeeding. Methods: A retrospective analysis was performed on mothers delivering infants ≥35 weeks' gestation at a military treatment facility (MTF) before (PRE) and during (PERI) the pandemic. Demographic data and feeding methods (exclusive, any, and no breastfeeding) from birth to 6 months of life were obtained. The primary outcome compared the breastfeeding rates between PRE and PERI. Logistic regressions identified factors associated with breastfeeding. Results: Of the 372 dyads, 189 (51%) were in PRE and 183 (49%) were in PERI. Exclusive breastfeeding rates in the nursery (77% versus 78%, p = 0.7), at 1 month (70% versus 65%, p = 0.3), at 2 months (65% versus 62%, p = 0.6), 4 months (49% versus 56%, p = 0.2), and 6 months of life (42% versus 47%, p = 0.5) were similar between PRE and PERI. Trends for any breastfeeding were also unchanged. Interactions with a lactation consultant were most strongly associated with exclusive breastfeeding in the nursery (odds ratio 21.88, confidence interval 5.84-82.00, p < 0.001). Discussion: Breastfeeding rates from birth to 6 months of life in infants receiving care at a single MTF were unchanged before and during the pandemic. Access to lactation consultants appears to be a significant contributing factor, and universal health care coverage may have improved access to this resource. Accessibility to breastfeeding resources and education is essential to support and strengthen breastfeeding within the military community.