Impact of COVID-19 Pandemic-Related Workflow Changes on a Clinically-Integrated Breastfeeding Peer Counselor Program

To evaluate whether Covid-19 related workflow changes to a clinically-integrated breastfeeding peer counseling (ci-BPC) program were associated with poorer breastfeeding outcomes for Medicaid-enrolled patients.

This retrospective chart review included patients who received ci-BPC care during January 2017-March 2020 (“Pre-Pandemic,” N = 318); March 2020-September 2020 (“During-Peak,” N = 53); and September 2020-May 2021 (“Post-Peak,” N = 97). ANOVA evaluated differences in encounter type frequencies for each time point, as well as differences in breastfeeding initiation, exclusivity during inpatient admission, and continuation of breastfeeding at least 6 weeks post-delivery.

In-person prenatal counseling significantly decreased from Pre-Pandemic to During-Peak (43.9–8.2%, p < 0.05). Breastfeeding at 6 weeks postpartum significantly increased from the Pre-Pandemic cohort to the During-Peak cohort (67–85%, p < 0.05), and returned to baseline for the Post-Peak cohort (74%).

Covid-19 related workflow changes for the peer counselor did not decrease breastfeeding outcomes as anticipated.