The effect of maternal smoking habits during the perinatal period on breastfeeding

Aim: The aim of the present study is to assess maternal smoking habits during the perinatal period in the midst of COVID-19 pandemic and to investigate possible correlations with the duration and discontinuation of breastfeeding.Material-Methods: This research is a prospective, descriptive cohort study. Overall 847 mothers were enrolled, who were recruited from five tertiary hospitals in Attica during the year 2020 (January -December). Data were obtained using a structured questionnaire during their hospitalization in the maternity ward and via telephone contact at 1, 3 and 6 months postpartum.Results: Smoking rates decreased significantly during pregnancy (11.8%) compared to the pre-pregnancy period (31.3%, p<0.001) and during breastfeeding (7.4%) compared to the antenatal period (p<0.001). In contrast, the smoking rate increased significantly after breastfeeding cessation (13.8%) compared to the rate during breastfeeding (p<0.001), but remained significantly lower than the pre-pregnancy rate (p<0.001). Women who smoked more during pregnancy (OR= 1.34; 95% CI: 1.17 1.54, p<0.001) were significantly more likely to cease breastfeeding. In addition, lower daily number of cigarettes consumed before pregnancy (beta=-2.64, SE: 0.38, p<0.001) was associated with longer duration of breastfeeding.Conclusions: Smoking decreased in the perinatal period compared to the pre-pregnancy period. Fear of illness during the vulnerable perinatal period in the course of the COVID-19 pandemic may have influenced the declining trend in smoking. However, smoking was associated with lower duration and discontinuation of breastfeeding. There is an urgent need to counsel mothers and implement effective strategies for smoking cessation during the prenatal, perinatal and postnatal periods.