Practices and social representations of traditional midwives in the promotion of breastfeeding in Yucatán during the COVID-19 pandemic

Analyze practices and social representations (P&SR) of traditional midwives (TM) in the promotion of breastfeeding (BF) in the COVID- 19 context, in the Mexican state of Yucatán. This exploratory qualitative study was based on eighteen semi-structured interviews with twenty-four TM from Yucatán. In most cases, interviews were conducted individually, although in some instances two midwives participated together, and in one case three midwives were interviewed simultaneously. A phenomenological approach guided the discourse analysis. Midwives recognize their key role during the pandemic and the lack of recognition of their work received from health institutions. They are key in maternal care during pregnancy and childbirth as well as in relation to BF. However, they still hold P&SR regarding milk (avoiding cold, herbal or alcohol chest rubs, massages), transmission of diseases through BF (uncertainty about whether the SARS-CoV-2 virus is transmitted through breast milk), duration of BF (three to twelve months), and about formula feeding, which they often associated with disadvantages such as poorer nutrition, illness in infants, and loss of the maternal bond, potentially acting as barriers or facilitators for BF. The COVID-19 pandemic increased the attention provided by TM in BF related matters, it is necessary to reinforce and demystify their knowledge to enhance BF promotion and make them allies alongside healthcare professionals in this subject.