Georgia Southern study finds link between breastfeeding rates and COVID-19 outcomes across Georgia

A new Georgia Southern University study suggests that long-standing differences in maternal and child health, specifically breastfeeding rates, may help explain why some communities were affected more severely by COVID-19 than others.

Led by faculty in the Jiann-Ping Hsu College of Public Health, the study found that Georgia counties with lower breastfeeding initiation rates experienced higher COVID-19 cases and related mortalities across the overall county population.

Published in the scientific journal Breastfeeding Medicine, the study examined COVID-19 cases and death rates across all 159 counties in Georgia, from March 2020 through February 2022. 

“Our findings show a strong association at the community level,” said lead author and Professor of Health Policy and Community Health Joanne Chopak-Foss, Ph.D. “It raises important questions about how early-life health investments, like breastfeeding support, contribute to long-term resilience and health outcomes.”

Counties were grouped by breastfeeding rates and compared after accounting for demographics and public health interventions. The research team, which included JPHCOPH master’s and doctoral students, analyzed more than 2 million reported COVID-19 cases. They found the biggest differences in rural communities, a gap the researchers also link to social factors such as income and healthcare infrastructure.

“COVID-19 exposed structural inequalities that existed long before the pandemic,” said co-author and Professor of Epidemiology Jian Zhang, M.D. “Our work suggests that breastfeeding support may be an underrecognized component of community preparedness, one that warrants further research and sustained public health investment.”

Although the study does not prove that breastfeeding directly prevents COVID-19 infection, it adds to growing evidence that breastfeeding may provide health benefits that extend beyond infancy. 

“Breastfeeding is one of the earliest and most sustainable investments communities can make in health,” said Nandi A. Marshall, DrPH, MPH, JPHCOPH associate dean and president of the American Public Health Association. 

“These findings remind us that support for breastfeeding may generate benefits that may contribute to stronger, healthier, and more resilient communities over the long term.”

Building on this research, the team looks to expand its work beyond Georgia to examine whether similar patterns exist nationwide and how these results can guide future public health planning.

“Looking at data across the country helps us see the bigger picture,” Chopak-Foss said. “We hope our findings will provide new insights and contribute to the national conversation.”