Objective Changes to parental presence and engagement in neonatal intensive care units (NICUs) during the COVID-19 pandemic were associated with marked reductions in direct breastfeeding among premature infants. Whether these rates have recovered following the removal of pandemic-related restrictions remains unclear. This study examined direct breastfeeding rates 1 year after the pandemic among premature infants admitted to a NICU. Methods A retrospective cohort study was conducted in a level II-III NICU. Sixty-four infants born at ≤34 weeks’ gestation whose mothers intended to breastfeed were included. Infants were grouped as pre-pandemic ( n = 28), in-pandemic ( n = 12), or post-pandemic ( n = 24). The occurrence of direct breastfeeding at the first oral feeding attempt and at hospital discharge was evaluated. Results There was a statistically significant difference in the proportion of infants receiving direct breastfeeds at hospital discharge across the three groups: 20/28 (71%) pre-pandemic, 1/14 (8%) in-pandemic, and 2/24 (8%) post-pandemic ( p = .001). Conclusion Direct breastfeeding rates among premature infants have not returned to pre-pandemic levels despite the removal of visitation restrictions. These findings underscore the continued need for targeted parental engagement and lactation support strategies within NICUs.
Lopes et al. (2026) studied this question.