Breastfeeding of infants born to mothers with COVID-19: a rapid review

  1. on behalf of COVID-19 Evidence and Recommendations Working Group
  2. Nan Yang
  3. Siyi Che
  4. Jingyi Zhang
  5. Xia Wang
  6. Yuyi Tang
  7. Jianjian Wang
  8. Liping Huang
  9. Chenglin Wang
  10. Hairong Zhang
  11. Muna Baskota
  12. Yanfang Ma
  13. Qi Zhou
  14. Xufei Luo
  15. Shu Yang
  16. Xixi Feng
  17. Weiguo Li
  18. Toshio Fukuoka
  19. Hyeong Sik Ahn
  20. Myeong Soo Lee
  21. Zhengxiu Luo
  22. Enmei Liu
  23. Yaolong Chen

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Abstract

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    SciScore for 10.1101/2020.04.13.20064378: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationWe used the Cochrane bias risk assessment tool for randomized controlled trials (7), Newcastle-Ottawa scale (NOS) for case control studies (8), the Institute of Health Economics’ case series quality appraisal tool (IHE) for case series (9), and the Joanna Briggs Institute’(JBI) case report quality appraisal tool for case reports (10) to assess the risk of bias.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableData extraction: Two reviewers (N Yang and S Che) independently extracted the following data from the included studies using a pre-defined extraction sheet: 1) basic information (year of publication, first author, affiliation, year, study type); 2) number of women, age, disease or virus, mode of delivery; 3) number of infants, gender, birth weight, gestational age, APGAR score, signs of infection, results of RT-PCR tests of breast milk or throat swab, and 4) protective measures used during breastfeeding (wearing a surgical mask; hygiene measures taken before close contact with the infant).

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Two groups (N Yang and J Wang, N Yang and H Zhang) carried out the search independently in the following electronic databases: Medline (via PubMed), Embase, Web of Science, the Cochrane library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), and Wanfang Data.
    Medline
    suggested: (MEDLINE, RRID:SCR_002185)
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    Cochrane library
    suggested: (Cochrane Library, RRID:SCR_013000)
    Two authors (N Yang and S Che) also searched the following websites for relevant publications: World Health Organization (WHO), the National Health Commission of the People’s Republic of China, Google Scholar, BioRxiv, SSRN, and MedRxiv.
    Google Scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    BioRxiv
    suggested: (bioRxiv, RRID:SCR_003933)
    We used the Cochrane bias risk assessment tool for randomized controlled trials (7), Newcastle-Ottawa scale (NOS) for case control studies (8), the Institute of Health Economics’ case series quality appraisal tool (IHE) for case series (9), and the Joanna Briggs Institute’(JBI) case report quality appraisal tool for case reports (10) to assess the risk of bias.
    Cochrane
    suggested: (Cochrane Library, RRID:SCR_013000)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Following limitations exist: 1) the relevant evidence included is scant and the quality of evidence is low; 2) the evidence is based on small samples of breast milk that were taken only once from each mother, so the presence of virus in breast milk over time cannot be assessed; 3) because of the small number of cases reported, the understanding about COVID-19 in children is not yet comprehensive enough. Therefore, we believe longitudinal studies testing series of breast milk samples from lactating women with different courses and degrees of severity of the disease should be encouraged. Future studies to support comprehensive understanding of the epidemiology, clinical characteristics, the proportion of severe cases, risk factors, and prognosis in children with COVID-19 are also needed. Moreover, cohort studies of breastfeeding mothers with COVID-19 taking effective precaution measures will definitely provide better evidence to inform this issue.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.21037/atm-20-3299
  3. Version published to 10.1101/2020.04.13.20064378v1 on medRxiv