The Covid-19 pandemic has had huge impacts on families and children, with particular impact during pregnancy and new parenthood [1,2], as emphasised by the #ButNotMaternity campaign. We welcome the recent commitment by the Government to provide rapid Covid-19 testing to maternity and paediatric patients as a priority.

However, as restrictions tighten again, increasing numbers of mothers are still being separated from their babies where one or both are hospitalised, including cases where separation actively increases the risks of severe or prolonged illness because of its impact on lactation.

Bliss - the charity for families with babies cared for in neonatal units - has highlighted the critical importance of parental access in hospital settings, reinforcing that parents are not visitors [3]. We amplify this call, and also emphasise that when the baby is breastfed, this constitutes not only essential nutrition but also protects infant development in both the short- and long-term [4]. Furthermore, separation due to hospitalisation increases the risk of maternal complications caused by the abrupt cessation of breastfeeding, such as mastitis [5], and decreases the likelihood of breastfeeding being established.

We call upon all hospitals caring for families to review their practices urgently, aiming:

- To keep mothers and children together as much as possible, acknowledging that neither is a ‘visitor’ when the other is hospitalised
- To work in accordance with evidence-based guidelines already published [6,7,8]
- To ensure provision of breast pumps and feeding support if separation is necessary
- To value and prioritise the breastfeeding relationship when a breastfeeding mother or child are hospitalised
- To support parents and children with compassion

Moreover, we call for the urgent convening of a working group to draw up national policies that specifically address the needs of families during pregnancy, birth and breastfeeding to ensure hospital care minimises any negative impact on mental health, bonding and infant feeding in these challenging times. The likelihood of long-term adjustments due to the ongoing Covid-19 pandemic means it is not acceptable for ad hoc arrangements to be made leading to inequity across hospital settings and across the country. There is an urgent need for the implementation of clear and universal guidelines and standards to protect the lives and long-term health of UK families.[9]

References:
1. https://onlinelibrary.wiley.com/doi/10.1111/mcn.13088
2. https://www.bestbeginnings.org.uk/news/the-babies-in-lockdown-report
3. https://www.bliss.org.uk/health-professionals/information-and-resources/parental-access-covid19
4. Victora C, Bahl R, Barros A, França G, Horton S, Krasevec J et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490.
5. https://cks.nice.org.uk/topics/mastitis-breast-abscess/
6. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/
7. https://www.rcpch.ac.uk/resources/bapm-covid-19-frequently-asked-questions-within-neonatal-services
8. https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.13033 
9. https://ukbreastfeedingtrends.files.wordpress.com/2017/03/wbti-uk-report-2016-part-1-14-2-17.pdf

Note:
We understand that not all lactating people identify as mothers. Understanding the impact of lactation on hospital admission for an adult or a child is needed for all, regardless of gender identity