{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T10:24:23Z","timestamp":1758709463630,"version":"3.41.2"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>At the onset of the COVID-19 pandemic, support for breastfeeding was disrupted in many countries. Italy was severely impacted by the pandemic and is known to have the lowest exclusive breastfeeding rate of all European countries. Considering the inverse association between anxiety and breastfeeding, maternal concerns about the COVID-19 emergency could reduce breastfeeding rates. The aim of the study is to explore the association between infant feeding practices and maternal COVID-19 concerns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This paper is a secondary analysis of the cross-sectional study COVID-ASSESS conducted in Italy in 2020. The original survey was administered in two phases: during the first lockdown and during the reopening. The survey included five sections: socio-demographic, medical history, concerns about the COVID-19 pandemic, infant feeding practices and psychometric evaluation. Participants were considered eligible for the <jats:italic>post-hoc<\/jats:italic> analyses if they were exclusively breastfeeding or they were feeding with infant formula (either alone or with breastfeeding) at the time of the interview.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between phase 1 and phase 2 there was a decrease in anxiety and concerns about the danger of COVID-19 to general health, except for concerns about their baby's health. Women using formula were more concerned about all the health topics investigated. Moreover, they showed higher levels of stress, state anxiety, somatization and PTSD symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Breastfeeding during the first pandemic lockdown in Italy seems to have been an independent factor associated with lower anxiety about COVID-19, fewer psychopathological symptoms, and a positive experience of infant feeding.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.965306","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T06:56:45Z","timestamp":1661237805000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Exclusive breastfeeding and women's psychological well-being during the first wave of COVID-19 pandemic in Italy"],"prefix":"10.3389","volume":"10","author":[{"given":"Claudia","family":"Ravaldi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Mosconi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyce N.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa H.","family":"Amir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Bonaiuti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valdo","family":"Ricca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Vannacci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"633700","DOI":"10.3389\/fped.2020.633700","article-title":"Promoting and protecting human milk and breastfeeding in a COVID-19 world","volume":"8","author":"Spatz","year":"2021","journal-title":"Front Pediatr."},{"key":"B2","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/S0140-6736(15)01024-7","article-title":"Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect","volume":"387","author":"Victora","year":"2016","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"112769","DOI":"10.1016\/j.psychres.2020.112769","article-title":"Postpartum stress and infant outcome: a review of current literature","volume":"284","author":"Oyetunji","year":"2020","journal-title":"Psychiatry Res."},{"key":"B4","unstructured":""},{"key":"B5","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1097\/MPG.0000000000002234","article-title":"Breastfeeding rates and programs in europe: a survey of 11 national breastfeeding committees and representatives","volume":"68","author":"Theurich","year":"2019","journal-title":"J Pediatr Gastroenterol Nutr."},{"key":"B6","unstructured":"Allattamento al seno-Aspetti epidemiologici2021"},{"key":"B7","doi-asserted-by":"publisher","first-page":"457","DOI":"10.4415\/ANN_16_03_18","article-title":"Prevalence of breastfeeding in Italy: a population based follow-up study","volume":"52","author":"Lauria","year":"2016","journal-title":"Ann Ist Super Sanita."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.3346\/jkms.2017.32.10.1717","article-title":"MERS-CoV infection in a pregnant woman in Korea","volume":"32","author":"Jeong","year":"2017","journal-title":"J Korean Med Sci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"345","DOI":"10.3201\/eid1002.030736","article-title":"SARS and pregnancy: a case report","volume":"10","author":"Robertson","year":"2004","journal-title":"Emerg Infect Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"194","DOI":"10.3390\/v12020194","article-title":"Potential maternal and infant outcomes from coronavirus 2019-nCoV (SARS-CoV-2) infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections","volume":"12","author":"Schwartz","year":"2020","journal-title":"Viruses."},{"key":"B11","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/s13006-022-00478-5","volume":"17","author":"Turner","year":"2022","journal-title":"A review of the disruption of breastfeeding supports in response to the COVID-19 pandemic in five Western countries and applications for clinical practice. Int Breastfeed J."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13006-021-00382-4","article-title":"Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers","volume":"16","author":"Latorre","year":"2021","journal-title":"Int Breastfeed J."},{"key":"B13","unstructured":"2014"},{"key":"B14","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1002\/ijgo.13295","article-title":"Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic: a call for action","volume":"151","author":"Ceulemans","year":"2020","journal-title":"Int J Gynecol Obstet."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1111\/aogs.14092","article-title":"Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic\u2014a multinational cross-sectional study","volume":"100","author":"Ceulemans","year":"2021","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fgwh.2020.00001","article-title":"Moms are not OK: COVID-19 and maternal mental health","volume":"1","author":"Davenport","year":"2020","journal-title":"Front Glob Women's Heal."},{"key":"B17","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1111\/j.1753-4887.2004.tb00050.x","article-title":"Breastfeeding and maternal stress response and health","volume":"62","author":"Mezzacappa","year":"2004","journal-title":"Nutr Rev."},{"key":"B18","doi-asserted-by":"publisher","first-page":"106440","DOI":"10.1016\/j.dib.2020.106440","article-title":"The COVID-ASSESS dataset-COVID19 related anxiety and stress in prEgnancy, poSt-partum and breaStfeeding during lockdown in Italy","volume":"33","author":"Ravaldi","year":"2020","journal-title":"Data Br."},{"key":"B19","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.wombi.2020.07.002","article-title":"Pregnant women voice their concerns and birth expectations during the COVID-19 pandemic in Italy","volume":"34","author":"Ravaldi","year":"2021","journal-title":"Women Birth."},{"key":"B20","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1007\/s00737-020-01086-0","article-title":"Previous psychopathology predicted severe COVID-19 concern, anxiety, and PTSD symptoms in pregnant women during \u201clockdown\u201d in Italy","volume":"23","author":"Ravaldi","year":"2020","journal-title":"Arch Womens Ment Health."},{"key":"B21","doi-asserted-by":"publisher","first-page":"703214","DOI":"10.3389\/fpsyg.2021.703214","article-title":"A 6-month follow-up study on worry and its impact on well-being during the first wave of covid-19 pandemic in an Italian sample","volume":"12","author":"Ongaro","year":"2021","journal-title":"Front Psychol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1093\/advances\/nmy132","article-title":"Impact of maternal anxiety on breastfeeding outcomes: a systematic review","volume":"10","author":"Hoff","year":"2019","journal-title":"Adv Nutr."},{"key":"B23","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1111\/j.1365-2648.2008.04722.x","article-title":"The influence of psychological factors on breastfeeding duration","volume":"63","author":"O'Brien","year":"2008","journal-title":"J Adv Nurs."},{"key":"B24","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1111\/aogs.14324","article-title":"Perinatal antidepressant use and breastfeeding outcomes: findings from the Norwegian mother, father and child cohort study","volume":"101","author":"Grzeskowiak","year":"2022","journal-title":"Acta Obstet Gynecol Scand."},{"key":"B25","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s00737-017-0805-y","article-title":"Physical health, breastfeeding problems and maternal mood in the early postpartum: a prospective cohort study","volume":"21","author":"Cooklin","year":"2018","journal-title":"Arch Womens Ment Health."},{"key":"B26","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1079\/PHN2001147","article-title":"Breastfeeding in countries of the European Union and EFTA: current and proposed recommendations, rationale, prevalence, duration and trends","volume":"4","author":"Yngve","year":"2001","journal-title":"Public Health Nutr"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1111\/j.1365-2702.2007.02239.x","article-title":"A systematic review of professional support interventions for breastfeeding","volume":"17","author":"Hannula","year":"2008","journal-title":"J Clin Nurs."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1943","DOI":"10.1111\/j.1365-2702.2012.04071.x","article-title":"A systematic review of peer support interventions for breastfeeding","volume":"21","author":"Kaunonen","year":"2012","journal-title":"J Clin Nurs."},{"key":"B29","doi-asserted-by":"publisher","first-page":"e0235806","DOI":"10.1371\/journal.pone.0235806","article-title":"Maternal plasma levels of oxytocin during breastfeeding\u2014a systematic review","volume":"15","author":"Uvnas-Moberg","year":"2020","journal-title":"PLoS ONE."},{"key":"B30","doi-asserted-by":"publisher","first-page":"413","DOI":"10.3390\/ijerph17020413","article-title":"Breastfeeding in the community-how can partners\/fathers help? a systematic review","volume":"17","author":"Ogbo","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"B31","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.midw.2017.12.001","article-title":"The role of fathers during breastfeeding","volume":"58","author":"deMontigny","year":"2018","journal-title":"Midwifery."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e13147","DOI":"10.1111\/mcn.13147","article-title":"Relationships between paternal attitudes, paternal involvement, and infant-feeding outcomes: mixed-methods findings from a global on-line survey of English-speaking fathers","volume":"17","author":"Atkinson","year":"2021","journal-title":"Matern Child Nutr"},{"key":"B33","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s13006-022-00484-7","article-title":"A mixed-methods study on the association of six-month predominant breastfeeding with socioecological factors and COVID-19 among experienced breastfeeding women in Hong Kong","volume":"17","author":"Kwan","year":"2022","journal-title":"Int Breastfeed J."},{"key":"B34","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1089\/bfm.2020.0353","article-title":"Maternal and infant outcomes associated with maternity practices related to COVID-19: the COVID mothers study","volume":"16","author":"Bartick","year":"2021","journal-title":"Breastfeed Med."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.965306\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T06:56:52Z","timestamp":1661237812000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.965306\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,23]]},"references-count":34,"alternative-id":["10.3389\/fpubh.2022.965306"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.965306","relation":{},"ISSN":["2296-2565"],"issn-type":[{"type":"electronic","value":"2296-2565"}],"subject":[],"published":{"date-parts":[[2022,8,23]]},"article-number":"965306"}}