Study: COVID-19 Stay-at-Home Orders Boosted Breastfeeding but Exposed Gaps in Support
SLU study finds COVID-19 stay-at-home orders helped many U.S. mothers breastfeed longer and bond, but exposed gaps in lactation support, stress, and policy needs.
A new Saint Louis University study examining COVID-19 stay-at-home orders and breastfeeding finds that many mothers reported prolonged breastfeeding and closer mother infant bonding during lockdowns, while also facing reduced access to professional lactation support and greater stress. The research, published in the Maternal and Child Health Journal, surveyed a large and demographically diverse sample of U.S. mothers and highlights uneven benefits across income and racial groups. The study’s results underscore how pandemic-era changes to work and family life altered breastfeeding practices and exposed policy shortfalls that may hinder long term progress.
Study scope and methodology
The paper analyzed responses from a broad cross section of U.S. mothers representing multiple regions, income brackets, and racial and ethnic backgrounds. That diversity marks a departure from earlier breastfeeding research that often relied on samples dominated by White, non Hispanic, well educated and employed respondents. Saint Louis University researchers designed the survey to capture variation in experiences during stay at home orders and to probe both benefits and barriers to breastfeeding across communities.
Observed benefits during lockdowns
About one third of respondents reported that stay at home orders made breastfeeding easier, allowing for more frequent nursing and longer overall duration. Mothers cited stronger mother infant bonding as a common outcome when work commutes and outside obligations were reduced. Researchers link these gains to the increased time at home and the removal of some workplace constraints that previously forced early weaning or reduced exclusive breastfeeding.
Access to lactation support and maternal stress
Despite reported benefits, many mothers encountered significant obstacles to sustained breastfeeding during the pandemic. The study found reduced access to in person lactation consultants, interrupted community support programs, and elevated levels of maternal stress that undermined breastfeeding goals. Those barriers were particularly acute for mothers who lacked reliable telehealth access or who relied on programs that temporarily expanded services early in the pandemic and later scaled them back.
Workplace return remains a major obstacle
Returning to work emerged as a leading reason for early cessation of exclusive breastfeeding, particularly where employers did not provide adequate accommodations. Mothers who attempted to pump at work reported difficulties stemming from absent or inadequate lactation spaces and insufficient breaks to express milk. While federal measures such as the PUMP for Nursing Mothers Act and the Pregnant Workers Fairness Act provide baseline protections, study authors argue these laws may not fully address the needs of women who must return to work quickly for financial reasons.
Policy recommendations from the research team
Senior author MarÃa José Romo Palafox and colleagues recommend a broader policy package that extends beyond workplace lactation rooms and break time. The team advocates for flexible work location policies where feasible, standardized telehealth lactation services through public programs such as WIC, and expanded financial and mental health supports for new mothers. Researchers say telehealth consultations, when sustained and standardized, can mitigate geographic and socioeconomic barriers and help mothers maintain breastfeeding after returning to work.
Implications for equity and public health
The study places its findings in the context of global and national breastfeeding goals, noting that exclusive breastfeeding through six months remains well below recommendations. The World Health Organization advises exclusive breastfeeding for six months, yet U.S. data show a fraction of infants meet that benchmark. Researchers warn that without targeted interventions focused on low income and racially diverse mothers, disparities in breastfeeding rates and associated health outcomes may persist.
The Saint Louis University paper points to the pandemic period as a natural experiment that demonstrated both the potential for workplace flexibility to support breastfeeding and the fragility of support systems that many mothers rely on. Policy change aimed at combining workplace reforms with accessible telehealth and strengthened social safety nets is presented as a path to more equitable maternal and child health outcomes.
