The COVID Mothers Study: How ABM’s Worldwide Network of Physicians Collaborated on Urgent Research

By Melissa Bartick, MD, MS, FABM

This week, the results of the COVID Mothers Study were published in Breastfeeding Medicine, providing more evidence that it may be safe to keep mothers and newborns together and, importantly, that separating them causes significant harm.  Indeed, as the authors point out, the “significantly low rate of [neonatal] hospitalization in the literature indicates it may be nearly impossible to demonstrate a clinical benefit from disrupting Baby-Friendly practices.”

Like other studies involving COVID-19, coordinating and launching this study had to be done quickly, for answers were urgently needed.  As the World Health Organization declared a pandemic on March 11, news stories appeared about infected mothers being forcibly separated from their infants with the rationale of protecting infants from infection, without evidence to support this practice, which violated existing quality standards of maternity care from the World Health Organization.  By the end of March, I, together with Dr. Lori Feldman-Winter, and Dr. Verónica Valdés had planned to gather such evidence. Lori and I had known one another for many years and had collaborated before, and we both met Verónica when she volunteered to help us after I sent out an email to the ABM membership.  Lori and I are Americans; Verónica is Chilean. We met and planned out a study using a survey, initially thinking we would quickly and easily get a large number of respondents by recruiting from social media platforms. Lori was also able to recruit statistical support (Dr. John Gaughan, PhD) and medical student manpower with social media expertise (Nikhil Bhana, B.S.) from her university.

We took full advantage of ABM’s internal communications networks to help us line up people who could translate and distribute the survey. Word of the study spread around the world. Having heard of the study through an Italian ABM member, we were thrilled to be approached by Angela Giusti, PhD of the Italian National Institute of Health (ISS) and Elise Chapin, MEd of the Italian National Committee for UNICEF, and they joined our team. Not long afterward, Dr. Maite Hernández-Aguilar, an ABM member, joined us and became instrumental in getting the survey around Spain, where cases numbers were very high.  Other ABM members in Germany (Dr. Elien Rouw) and Saudi Arabia (Dr. Fouzia AlHreashy) came forward, and still other members led us to contacts that helped with translation and recruitment in Brazil and other parts of Latin America, as well as Asia. This is how we came to meet nursing professor Elysângela Dittz Duarte, RN, PhD of Brazil, an important member of the research team. 

When it became clear that there were not nearly as many birthing women with histories of active COVID as the news led us to believe, we relied on our networks of doctors and their colleagues, including midwives and other health professionals, to get the survey to patients they knew.  We engaged Lucia Jenkins, RN, IBCLC of Baby Café USA to send the survey out immediately via social media to her network of 158 breastfeeding support sites in 28 U.S. States, expanding geographical reach. We are able to engage many American ABM members, including those who worked in COVID “hot spots,” to directly reach their patients. Together, our total sample size of 357 infants is one of the largest to date for a single study, and the neonatal subset of 129 infants, with 84 SARS-CoV-2+ mothers, is among one of the larger sizes for a COVID study.

We could not have done this study without the amazing network that ABM provided, as well as many other people we knew or got to know around the world.  We are grateful to all of them, and to the mothers who took the time to answer our survey.