Women’s Perceptions of Breastfeeding Rights During the COVID-19 Pandemic: A Qualitative Study in Quito, Ecuador
This qualitative study in Quito, Ecuador, reveals that the COVID-19 pandemic disrupted breastfeeding rights and support through practices like mother-infant separation and inconsistent guidance, highlighting the urgent need for evidence-based emergency protocols that uphold bioethical principles and protect maternal-infant wellbeing.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Breastfeeding is more than just feeding a baby; it is a biological partnership that provides a newborn with perfect nutrition and a shield against illness. For decades, health organizations have agreed that this practice is a fundamental right for both mother and child, supported by laws and medical standards that encourage hospitals to keep mothers and babies together immediately after birth. This approach, known as skin-to-skin contact, helps the baby learn to feed and gives the mother confidence in her ability to nourish her child. However, when a global health crisis strikes, the rules of care can change rapidly. In times of emergency, health systems must balance the need to stop the spread of disease with the need to protect the delicate bond between a mother and her newborn. The question becomes whether the measures taken to keep people safe might accidentally harm the very things they are trying to protect.
In Quito, Ecuador, a team of researchers set out to understand how this balance played out during the early years of the COVID-19 pandemic. They focused on the experiences of ten women who gave birth between April 2020 and June 2021 in both public and private hospitals. The researchers listened to these women's stories to see how the pandemic affected their rights and their ability to breastfeed. They looked at the situation through a lens of basic ethical principles: whether the women were treated with respect and given clear information to make their own choices, whether the care provided helped them and their babies, whether it caused any unnecessary harm, and whether the support was fair and available to everyone.
The women in the study described a confusing and often difficult time. Many reported that they were separated from their newborns for hours after birth, or that they were not allowed to hold their babies close in the hospital bed. One mother recalled waiting several hours after a cesarean section just to see her baby, with no opportunity for the immediate skin-to-skin contact that usually helps start breastfeeding. Another woman explained that she was not allowed to keep her baby near her, which made it very hard to feed, especially while she was still recovering from surgery. These delays and separations, which were put in place as safety measures against the virus, often meant that breastfeeding started much later than usual, leaving mothers feeling anxious and unsure of what to do.
The confusion was made worse by mixed messages from the people meant to help them. Some women said that doctors encouraged them to breastfeed, while nurses told them to use formula to keep the baby quiet. One participant described the frustration of hearing different advice from different staff members, with no one explaining the benefits of breastfeeding or showing her how to start properly. This lack of clear, consistent information left the mothers feeling powerless to make decisions about their own children's feeding. Instead of receiving support, many women found themselves being given commercial baby formula. Some received bottles and cans of formula as they left the hospital, or were told their milk supply was low even though no one had properly checked how they were feeding. These actions made the women doubt their ability to breastfeed and created a sense that the hospital was pushing them toward formula rather than helping them succeed with breastfeeding.
The researchers found that these experiences were not just about logistics; they touched on deep ethical concerns. The women felt that their right to make informed choices was ignored because the information they received was contradictory. They felt that the care they received did not always act in their best interest, as the separation from their babies and the push toward formula disrupted the natural process of bonding and feeding. There was also a sense of unfairness in how the system worked. Women with more money could hire private lactation consultants to help them, while others had to rely on the public system, which often lacked trained staff or clear guidance. The study suggests that during the rush to manage the pandemic, the established rules that protect breastfeeding were not always followed, and the specific needs of mothers and babies were sometimes overlooked in favor of infection control.
Ultimately, the study highlights that protecting breastfeeding during a health emergency requires more than just good intentions. It needs clear, evidence-based plans that keep mothers and babies together whenever it is safe to do so, and healthcare workers who are trained to support breastfeeding without confusion. The women in Quito emphasized that governments and hospitals must prepare for future crises by ensuring that the right to breastfeed is protected, that information is reliable, and that support is available to every mother, regardless of her background. Their stories serve as a reminder that in times of fear and uncertainty, the most vulnerable needs—like a mother's ability to feed her child—must remain a central part of the plan.
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