Children and COVID-19 Research Library

Evidence and objective assessment are needed more than ever to help enhance the rights and well-being of the world’s children. Researching the changing world around us and evaluating progress are two sides of the same coin, both critical to reimagining a better future for children. In recognition of this, UNICEF celebrates and showcases innovative and influential research and evaluations from our offices around the world every year. For 2020, Innocenti and the Evaluation Office joined forces to find the most rigorous UNICEF studies with greatest influence on policies and programmes that benefit children.

The aim of this article is to advocate perspectives to strengthen existing healthcare systems to prioritize maternal health services amidst and beyond the COVID-19 pandemic in low- and middle income countries. COVID-19 directly affects pregnant women causing more severe disease and adverse pregnancy outcomes. The indirect effects due to the monumental COVID-19 response are much worse, increasing maternal and neonatal mortality.

The nutrition contents of breastmilk directly participate in neonatal immune response. The alternations of the components of breastmilk under the context of viral infection not only reflect the physiological changes in mothers but also affect neonatal immunity and metabolism via breastfeeding. Herein, this paper attempts to answer the important questions whether breastmilk production is affected by COVID-19 and whether breastfeeding is still a safe or recommended operation for COVID-19 puerperant women.

Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in an already strained health system. 

In Kenya, millions of children have limited access to nurturing care. With the Coronavirus disease 2019 (COVID-19) pandemic, it is anticipated that vulnerable children will bear the biggest brunt of the direct and indirect impacts of the pandemic. This review aimed to deepen understanding of the effects of COVID-19 on nurturing care from conception to four years of age, a period where the care of children is often delivered through caregivers or other informal platforms. The review has drawn upon the empirical evidence from previous pandemics and epidemics, and anecdotal and emerging evidence from the ongoing COVID-19 crisis. Multifactorial impacts fall into five key domains: direct health; health and nutrition systems; economic protection; social and child protection; and child development and early learning. The review proposes program and policy strategies to guide the reorientation of nurturing care, prevent the detrimental effects associated with deteriorating nurturing care environments, and support the optimal development of the youngest and most vulnerable children. These include the provision of cash transfers and essential supplies for vulnerable households and strengthening of community-based platforms for nurturing care.

The Covid-19 pandemic has caused increased hardship for new mothers and their young children. Increased isolation, lack of in-person doctor visits and decreased interaction within the community, has pregnant and postpartum women in need of additional support. Occupational therapists often work with infants and their mothers due to feeding concerns. Difficulty with early feeding adds additional stress on the mother–infant dyad relationship. This case study describes a mother’s traumatic experience giving birth during Covid-19 and the occupational therapy intervention provided to the mother–infant dyad. In order to improve outcomes for the mother and child with feeding concerns, this case study is a call to action for paediatric occupational therapy practitioners to include the promotion of positive mental health of mothers in their practice, particularly during the pandemic.

Young children need comprehensive nurturing care which includes good health, adequate nutrition, early learning opportunities, responsive caregiving, and safety and security. Severe, lifelong impacts can result from deprivations during the early years if children do not have these critical inputs to ensure optimal child development. The World Bank’s Investing in the Early Years framework lays out three pillars to ensure children reach their full potential: i. Children are healthy and well-nourished, especially in the first 1,000 days ii. Children receive early stimulation and learning opportunities and iii. Children are nurtured and protected from stress. In the following three pages, we set out specific risks that children face under each of these pillars due to the COVID-19 (Coronavirus) crisis, together with response options, potential platforms and country examples. While health and nutrition are key elements of the COVID-19 (Coronavirus) emergency response and are more likely to be addressed immediately, empowering parents to provide warm and responsive caregiving and ensuring safety and security of young children and early learning opportunities for young children is essential and risks falling through the cracks.

This brief is meant to provide information specific to infant and young child feeding (IYCF)in the context of COVID-19. This Brief does not cover wider mitigation and response measures available in other guidance. As a nutrition community, we will continue to develop our understanding on practical solutions to deliver programming in the context of COVID-19. Documenting and disseminating these lessons and emerging evidence will be key to implementing the most appropriate and effective responses in the face of this pandemic.