{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:13:19Z","timestamp":1760058799196,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Objectives: The hospital organizational model can have an impact on people\u2019s health. A critical lesson can be drawn from the pandemic. The possible negative sequelae of the practice of separation of maternal\u2013infant dyads adopted during an infant\u2019s first SARS-CoV-2 pandemic infection on infants have not been considered. Our purpose was to investigate the short- and long-term effects on neonates born to SARS-CoV-2 infected mothers of two different mother\u2013infant dyad management strategies after birth (Separation vs. Rooming-In). Methods: This prospective cohort study enrolled 60 pregnant women who tested positive for SARS-CoV-2 infection and their newborns. We identified two cohorts of study based on mother\u2013infant dyad management after delivery: Cohort A (Separation) and Cohort B (Rooming-In). Inclusion criteria were neonates born from mothers infected with SARS-CoV-2 during the pregnancy undergoing or not undergoing separation. Main Outcome: Rate of exclusive breastfeeding at 6 months of age was the primary outcome. The rate of mother\u2013infant transmission of SARS-CoV-2 infection, growth, incidence of acute infections and neurodevelopment up to 12 months of life were also evaluated. Results: In total, 60 mother\u2013infant dyads (maternal age 30.6 vs. 33.8 years, p = 0.335; gestational age 39.0 vs. 38.9 weeks, p = 0.451) were enrolled at delivery, and 53 dyads completed the study at the 6-month follow-up. Baseline clinical characteristics were similar between the two cohorts. At 6-month follow-up, the rate of breastfeeding was significantly decreased in Cohort A compared with Cohort B (4% vs. 46%, p &lt; 0.001). The rate of SARS-CoV-2 infection was similar between the two cohorts of the study. Weight gain at 6 months of life was significantly higher in Cohort A compared to Cohort B (8129 g, 95% CI, 7562 to 8695; vs. 7393 g, 95% CI, 6912 to 7874; p = 0.005). No differences were detected in terms of rate of acute neonatal infections and neurodevelopment outcomes. Conclusions: The separation practice led to a reduction in the rate of breastfeeding after discharge and to a consequently increased implementation of formula milk, which might justify the alarming increased weight gain of newborns who did not undergo the Rooming-In practice. Given the potential of recurrent outbreaks of other viral pandemics, our results suggest more caution early in life towards the disruption of consolidated procedures that may have long-term consequences. However, the COVID-19 pandemic offered a unique context to observe the effects of temporary mother\u2013infant separation; clinicians should be reassured that the temporary separation practice did not affect neurodevelopment and be aware that it could be considered an option, at least if Rooming-In cannot be carried out due to severe reasons such as lack of staff or adequate space.<\/jats:p>","DOI":"10.3390\/children12050592","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T08:28:11Z","timestamp":1746174491000},"page":"592","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pandemic as an Organizational Paradigm for Neonatal Care: Long-Term Impact of Mother\u2013Infant Separation Practice During COVID-19"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1947-6247","authenticated-orcid":false,"given":"Maria","family":"Di Chiara","sequence":"first","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"De Santis","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Gloria","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2513-9899","authenticated-orcid":false,"given":"Fabio","family":"Natale","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annarita","family":"Ferazzoli","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-2870","authenticated-orcid":false,"given":"Gianluigi","family":"Laccetta","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Marciano","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Brunelli","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3541-2876","authenticated-orcid":false,"given":"Gianluca","family":"Terrin","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Health, Policlinico Umberto I, University \u201cLa Sapienza\u201d, Viale del Policlinico 155, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"The Lancet (2023). 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