The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.

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冠状病毒爆发对巴西医院和妇产科母乳喂养指南的影响：一项横断面研究

世界卫生组织认识到纯母乳喂养是大多数人道主义紧急情况下儿童可获得的安全营养来源，正如当前由严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）引起的当前大流行一样。尽管巴西制定了保护母乳喂养的国家准则，但仍然存在许多保护婴儿免受感染母亲的担忧。这项研究旨在分析巴西的医院和妇产科机构如何促进和支持怀疑或诊断患有冠状病毒疾病（COVID-19）的母亲。这是一项描述性的多中心研究，从2020年3月至2020年7月间收集了来自24家巴西医院和妇产科服务的数据。这些机构的代表根据促进和支持母乳喂养的行为填写了一份调查表，《爱婴医院倡议》以及巴西的联邦法律建议。结果显示，在分娩室中，有98.5％的服务禁止母亲与婴儿之间立即和不间断的皮肤接触，并且不支持母亲在第一个小时内开始母乳喂养。在产后病房，98.5％的服务允许母乳喂养，同时采取呼吸卫生措施以防止COVID-19的传播。83.3％的医院禁止母亲同伴。出院时间大多在24到28小时之间（79.1％）；出院指南没有个体化。此外，家庭环境的健康社区网络发现缺乏支持（83.3％）。允许医院和家庭抽乳（87.5％），但不接受母乳捐赠（95.8％）。缺乏有关婴儿安抚策略使用的指导。所评估的材料未涵盖针对弱势人群的特定准则。在巴西，在COVID-19爆发期间，医院未遵循保护，促进和支持母乳喂养的建议。国际准则之间存在分歧是一个重大问题。在大流行期间缺乏有关母乳喂养支持的建议，导致在巴西不同地区和世界其他国家的医院之间制定标准方面存在困难。科学界需要讨论如何改善母婴护理服务，以保护当前大流行中的母乳喂养。所评估的材料未涵盖针对弱势人群的特定准则。在巴西，在COVID-19爆发期间，医院未遵循保护，促进和支持母乳喂养的建议。国际准则之间存在分歧是一个重大问题。在大流行期间缺乏有关母乳喂养支持的建议，导致在巴西不同地区和世界其他国家的医院之间制定标准方面存在困难。科学界需要讨论如何改善母婴护理服务，以保护当前大流行中的母乳喂养。所评估的材料未涵盖针对弱势人群的特定准则。在巴西，在COVID-19爆发期间，医院未遵循保护，促进和支持母乳喂养的建议。国际准则之间存在分歧是一个重大问题。在大流行期间缺乏有关母乳喂养支持的建议，导致在巴西不同地区和世界其他国家的医院之间制定标准方面存在困难。科学界需要讨论如何改善母婴护理服务，以保护当前大流行中的母乳喂养。在大流行期间缺乏有关母乳喂养支持的建议，导致在巴西不同地区和世界其他国家的医院之间制定标准方面存在困难。科学界需要讨论如何改善母婴护理服务，以保护当前大流行中的母乳喂养。在大流行期间缺乏有关母乳喂养支持的建议，导致在巴西不同地区和世界其他国家的医院之间制定标准方面存在困难。科学界需要讨论如何改善母婴护理服务，以保护当前大流行中的母乳喂养。