Since the introduction of COVID-19 restrictions and social distancing measures, everyone providing breastfeeding support in Ireland, from hospital IBCLCs to voluntary breastfeeding supporters, has had to make significant changes to how they help breastfeeding parents . Many have had to switch from doing face-to-face support to doing virtual antenatal and postnatal breastfeeding support.
Hospital staff have cancelled face-to-face antenatal breastfeeding classes and many are now doing them online via a range of different platforms. Some record the classes and provide them to parents via a link, while others are doing interactive live classes. Staff provide breastfeeding support as normal during the mother’s hospital stay, albeit while wearing PPE. Midwives and IBCLCs are trying to provide care from a distance wherever possible. They will demonstrate using a doll and breast wherever possible to avoid going closer. Efforts are being made to minimise the mother’s postnatal stay in the hospital, and discharged, staff will continue to provide support over the phone. One of the biggest challenges in the maternity hospital system in Ireland has been how to safely facilitate parent visits and breastfeeding for babies in the NICU and SCBU. At the moment, parents are limited to one 15-minute visit per day, but ongoing discussions around this continue.
Public health nurses, who normally do a couple of home visits to a mother after she has been discharged from hospital, have made a number of changes to how they work. They are doing phone consults where possible. And if they need to do a home visit, they will wear PPE and do a risk assessment to ensure there is no one in the home with symptoms of COVID-19. They will advise that only the mother and baby be in the room, try to maintain social distancing and keep the visit under 15 minutes (some will set an alarm to go off 15 minutes after the visit starts). For parents who prefer not to have anyone in their home, the PHNs will also offer clinic visits and apply the same precautions. The Dublin North Central PHNs have set up a mothers’ peer-to-peer WhatsApp group and they have found it to be invaluable. None of the PHNs are in the group themselves, but they have a couple of mothers who are admins and will add mothers when provided with their phone numbers by the PHNs.
The HSE is in the process of rolling out a new telehealth platform which will enable HSE staff to offer secure video consults to people, including mothers seeking breastfeeding support. In the meantime, HSE IBCLCs are continuing to provide breastfeeding support online 10am – 3pm, Monday to Friday, via www.mychild.ie.
IBCLCs in private practice are unable to do home or clinic visits while the restrictions are in place, so most have switched to providing online video consultations using platforms such as Zoom, IntakeQ, Skype and WhatsApp video. The consensus among the private practice IBCLCs is that these video consultations can be effective in providing breastfeeding support, and that they help to promote breastefeding self-efficacy. However, they have limitations and most IBCLCs tend to find them more tiring than face-to-face consultations.
Voluntary breastfeeding supporters are continuing to provide breastfeeding support over the phone, and they are all currently running their breastfeeding support groups virtually using Zoom. Apparently, these groups are proving just as popular as the face-to-face support groups.