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Table 2 Recommendations for rooming-in for the management of the mother-infant dyad exposed to SARS-CoV-2

From: The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study

Recommendation Brazilian hospital guidelines existence (n = 24) Available recommendations in Brazilian and international literature [15,16,17,18,19,20,21,22,23,24,25,26,27]
Yes (%) No (RA/NR-%)
Shared decision-making 18 (75.0) 6 (25.0)/NR RCOG, CDC and ABM encourage shared decision-making;
WHO suggests the dialog but reinforces the need of speaking about the benefits on breastfeeding;
UNICEF, UENPS and SBP do not specify.
Feeding on demand 23 (95.8) 1 (4.1)/NR None of the guidelines specifies.
Individual room for dyad 15 (62.5) 9 (37.5)/NR rBLH and UENPS recommend individual room;
RCOG and ABM offers as an option;
WHO and UNICEF do not specify;
CDC recommends separation.
Dyad separation 1 (4.1) 23 (95.8)/RA UNICEF, RCOG and WHO do not recommend;
CDC recommends;
UENPS advises against separation, allows only if mother is symptomatic or the hospital logistics forbids it;
SBP and ABM do not specify.
Companion room 4 (16.6) 20 (83.3)/RA CDC limits visits and suggests rules;
UENPS and rBLH suspend visits;
SBP, RGCO and ABM suggest healthy adult to help;
WHO and UNICEF do not specify.
Use of mask 23 (95.8) 1 (4.1)/NR RCOG, ABM, UNICEF, CDC, UENPS and SBP recommend.
Washing hands 23 (95.8) 1 (4.1)/NR RCOG, ABM, SBP, WHO, UNICEF, CDC and UENPS recommend.
Washing the face 4 (16.6) 20 (83.3)/NR WHO, CDC, RCOG, SBP, ABM, UNICEF and UENPS do not specify.
Cleaning the breast 7 (29.1) 17 (70.8)/NR WHO, CDC, RCOG, SBP, ABM and UENPS do not specify;
UNICEF recommends if mother is coughing.
Changing the clothes 2 (8.3) 22 (91.6)/NR WHO, UNICEF, CDC, RCOG, SBP, ABM and UENPS do not specify.
2 m distance 24 (100) 0 (0)/RA ABM, CDC, UENPS and rBLH recommend distance;
WHO suggests precaution, however keeping mothers and infants together day and night.
RCOG, UNICEF does not specify.
Psychological support 23 (95.8) 1 (4.1)/NR ABM, SBP, UNICEF, WHO and UENPS do not specify;
CDC and RCOG recommend.
Home environment recommendations for the mother 24 (100) 0 (0)/NR ABM and SBP do not specify;
rBLH recommends if mother is insecure;
WHO, RCOG, CDC, UNICEF and UENPS recommend.
Home environment recommendations for the family 18 (75) 6 (25)/NR ABM, WHO, UNICEF, UENPS and SBP do not specify;
RCOG and CDC recommend.
Hospital discharge (24-48 h) 19 (79.1) 5 (20.8)/RA UENPS recommends discharge in 48 h, if hospital is crowded; if it is not, it recommends 1 week in the hospital to repeat the swab test;
WHO, CDC, RCOG ABM, SBP and UNICEF do not specify.
  1. RA Recommended against, NR There was no description of the recommendation in guidelines, ABM Academy of Breastfeeding Medicine, rBLH Brazilian Network of Human Milk Banks, SBP Brazilian Society of Pediatrics CDC Centers for Disease Control and Prevention, PPE Personal Protective Equipment, RCOG Royal College of Obstetricians and Gynaecologists, UENPS Union of European Neonatal and Perinatal Societies, UNICEF United Nations Children’s Fund, WHO World Health Organization