on our new #OA pub When #Separation is not the Answer: #Breastfeeding Mothers and Infants affected by #COVID19 in @mcnjournal w @DrKarleenG @AunPalmquist Mija Ververs & @GYNOBioethicist @JHUNursing 1/n https://onlinelibrary.wiley.com/doi/abs/10.1111/mcn.13033?campaign=wolacceptedarticle

The @WHO has provided comprehensive guidance that promotes #proximity and #breastfeeding for mothers and infants affected by #COVID19. They have been consistent & excellent! 2/n https://twitter.com/DrTomori/status/1255135380795359237

Some settings followed @WHO guidance, while others implemented policies that impose various degrees of #separation on #COVID19-affected mothers and infants. See, eg Philipphines, Malaysia, Japan & US 3/n

Separation policies aim to protect infants from potential harm from maternal infection with #SARSCoV2, but fail to account for the cumulative impacts of #separation. 4/n

The harms of #separation are numerous & significant: separation limits #breastfeeding's protection frm #infectiousdisease, compounds impacts of #insufficient #breastfeeding on vulnerable #infants & policies include hidden assumptions about the replaceability of #breastfeeding 5/n

#Separation also does not necessarily ensure lower #infant #SARSCOV2 exposure during hospitalization or afterwards (other routes of exposure from people handling separated infant) & adds to the burden of often overwhelmed health systems. 6/n

#Separation has enormous implications for #healthequity for both #infants & #mothers - the harms disproportionately affect those who have most to lose from disruptions to #breastfeeding. 7/n

Since #separation has many detrimental effects & does not necessarily ensure lower viral exposure, it may result in potential excess deaths. 8/n

#Separation policies intend to minimize harm, but may inadvertently impose more risks than benefits. We recommend that health services take an #integrative approach & consider the full impacts of separating mothers and infants in their policies. 9/n

The @WHO guidance builds on decades of work on #maternal & #infant health, including knowledge gained from emergencies #IYCFE & other #epidemics, like #HIV We need to heed these lessons now more than ever. 10/fin