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January Update: COVID-19 Pregnancy, Breastfeeding, and Young Child Advisory

January Update: COVID-19 Pregnancy, Breastfeeding, and Young Child Advisory

coronavirus pregnancy

Last updated on June 15th, 2024 at 05:00 pm

This article was updated with current information on January 26, 2021. The most recent details are included at the top of this article.

January 2021 Update

If I become sick with COVID-19, what is the risk of passing the virus on to my fetus or newborn?

Currently, only studies reporting on a limited number of cases are available to answer many questions, including this one. Many women in these case reports had COVID-19 during the third trimester of pregnancy.

Two case report studies (here and here) with a total of 47 women with COVID-19 showed that none of the newborns tested positive for the virus that causes it, SARS-CoV-2.

Another case report analyzing 33 pregnant women infected with SARS-CoV-2 found that three of their newborns were also infected with the virus and had clinical signs of infection, as well as confirmation of COVID-19 infection. It is unclear whether these newborns were infected while in the womb or if these infections were acquired after birth, as the newborns were tested when they were days old. The possibility of vertical transmission (passing the virus from mother to baby) has not been ruled out.

Reassuringly, in a study from New York City of 101 babies born to mothers with COVID-19 at the time of birth, only two babies tested positive for SARS-CoV-2. These two babies did not become ill from the virus and had no concerning symptoms.

The risk of passing the infection to a fetus appears to be very low. Currently, there is no evidence of any fetal malformations due to maternal infection with COVID-19.

If a woman has an infection with a high fever during pregnancy, it’s safest to use acetaminophen to lower temperature to avoid risk to the developing fetus.

Harvard Medical School Health Blog

Breast milk could help fight off coronavirus, researchers say

The research is still in its early stages, but indications are that breast milk may contain antibodies that can help fight off severe cases of COVID-19. Dr. Laura Ward says there is already evidence that breast milk contains antibodies which help protect against lower-respiratory issues. The new research is part of the reason why new mothers who have contracted COVID-19 are encouraged to keep breastfeeding their child. However, bacteria and viruses can be transferred through breast milk, too, which is why some doctors advise against it. Click here for more details

November 2020 Update

On November 2nd, U.S. health officials added pregnancy to the list of conditions that put people with Covid-19 at increased risk of developing severe illness, including a heightened risk of death. The CDC is now saying pregnant women are at increased risk for severe illness, where previously they said they ‘might be’ at increased risk for severe illness.

While most pregnant women infected with the coronavirus have not become severely ill, the new caution is based on a large study that looked at tens of thousands of pregnant women who had Covid-19 symptoms. The study found they were significantly more likely to require intensive care, to be connected to a specialized heart-lung bypass machine, and to require mechanical ventilation than nonpregnant women of the same age who had Covid symptoms. Most importantly, the pregnant women faced a 70 percent increased risk of death, when compared to nonpregnant women who were symptomatic.

New York Times

This new data really shows the importance of pregnant women taking extra precautions to avoid exposure to the virus, including avoiding social gatherings and interactions with people — even members of their own households — who may have been exposed or become infected.

June 2020 Update

Based on what the CDC knows at this timepregnant people might be at an increased risk for severe illness from COVID-19 compared to non-pregnant people. Additionally, there may be an increased risk of adverse pregnancy outcomes, such as preterm birth, among pregnant people with COVID-19. Therefore, if you are pregnant, be mindful about reducing your risk of getting sick. If you are caring for children, you can teach them everyday steps (such as proper handwashing) to help them stay healthy and, in turn, help protect yourself and your family.

In general, the more people you interact with, the more closely you interact with them, and the longer that interaction, the higher your risk of getting and spreading COVID-19.

  • If you decide to engage in public activities, continue to protect yourself by practicing everyday preventive actions.
  • Keep these items on hand and use them when venturing out: a mask, tissues, and a hand sanitizer with at least 60% alcohol, if possible.
  • If possible, avoid others who are not wearing masks or ask others around you to wear masks.

Actions to take if you are pregnant

  • Do not skip your prenatal care appointments.
  • Limit your interactions with other people as much as possible.
  • Take precautions to prevent getting COVID-19 when you do interact with others.
  • Make sure that you have at least a 30-day supply of your medicines.
  • Talk to your healthcare provider about how to stay healthy and take care of yourself during the COVID-19 pandemic.
  • If you don’t have a healthcare provider, contact your nearest community health center or health department.
  • Call your healthcare provider if you have any questions related to your health.
  • Seek care immediately if you have a medical emergency.
  • You may feel increased stress during this pandemic. Fear and anxiety can be overwhelming and cause strong emotions.
  • Learn more about how to reduce your risk of getting COVID-19.

A COVID-19 Twins Delivery Without Daddy

Newborns Born to Mothers With COVID-19

Much is still unknown about the risks of COVID-19 to newborns. Here is what the CDC currently knows about newborns and COVID-19.

  • Newborns can be infected with the virus that causes COVID-19 after being in close contact with an infected person.
  • Some babies have tested positive for the virus shortly after birth. It is unknown if these babies got the virus before, during, or after birth.
  • Most newborns who have tested positive for COVID-19 had mild or no symptoms and have recovered fully. However, there are a few reports of newborns with severe illness.
  • A small number of other problems, such as preterm (early) birth and other problems with pregnancy and birth, have been reported in babies born to mothers who tested positive for COVID-19. The CDC does not know if these problems were related to the virus.

Will My Newborn Be Separated From Me at Birth if I Have COVID-19 or an Suspected of Having COVID-19?

The CDC offers this guidance on birth hospitalization if you are infected or suspected of being infected with COVID-19:

CDC recognizes that the ideal setting for the care of a healthy, full-term newborn during the birth hospitalization is within the mother’s room. Temporary separation of the newborn from a mother with suspected or confirmed COVID-19 should be considered to reduce the risk of spreading the virus to the newborn. The risks and benefits of temporary separation of the mother from her newborn should be discussed with the mother by her healthcare team. Decisions about temporary separation should be made with respect to the mother’s wishes. If the mother chooses a temporary separation to reduce risk of spreading the virus and would like to breastfeed, she should express breast milk and have a healthy caregiver who is not at high-risk for severe illness from COVID-19 bottle feed the newborn the expressed breast milk if possible.

If the mother with suspected or confirmed COVID-19 does not choose temporary separation in the hospital, she should take precautions to avoid spreading the virus to the newborn, including washing her hands and wearing a mask when within 6 feet of her newborn. The newborn should be kept ≥6 feet away from the mother, as much as possible, including the use of physical barriers (e.g., placing the newborn in an incubator).

The Logistics of Managing a COVID-19 Positive Family

What Do I Do After My Newborn(s) and I Are Discharged From the Hospital and I Have COVID-19 or Am Suspected of Having COVID-19?

Mothers who are discharged from the hospital but have not met criteria to discontinue isolation may choose to continue to separate from the newborn at home to reduce the risk of spreading the virus, if a healthy caregiver is available. If a healthy caregiver is not available, a mother with COVID-19 can still care for her infant if she is well enough while using precautions (for example, hand washing, wearing a mask).

How Should I Handle Breastfeeding if I’m Separated From My Newborn(s)?

The CDC does not know for sure if mothers with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggests this is not likely.

Separation from the newborn may make it harder for some new mothers to start or continue breastfeeding. Frequent hand expression or pumping, ideally with a hospital-grade pump, is necessary to establish and build milk supply during temporary separation. Pumping every 2-3 hours (at least 8-10 times in 24 hours, including at night), especially in the first few days, signals the breasts to produce milk and prevents blocked milk ducts and breast infections. Mothers who are unable to establish milk production in the hospital after birth, or who have to temporarily stop breastfeeding, can relactate with skilled assistance from a lactation support provider. Additional information on relactation is available.

COVID-19 Birth Plan (with FREE Printable)

For more information from the CDC if you are pregnant, breastfeeding, or caring for young children, click here.

How Does COVID-19 Affect Children?

There is much more to be learned about how this disease affects children. While some children and infants have been sick with COVID-19, most illnesses have been among adults. Some reports suggest that infants under 1 year old and those with underlying medical conditions might be at higher risk of serious illness from COVID-19 than other children.

  • Children with COVID-19 generally have mild, cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported in some children.
  • Children with certain underlying medical conditions, such as chronic lung disease or moderate to severe asthma, serious heart conditions, or weak immune systems, might be at higher risk for severe illness from COVID-19.
  • In case of emergency, call 911 or go to your local emergency department. Emergency departments have infection prevention plans to protect you and your child from getting COVID-19 if your child needs emergency care. Do not delay getting emergency care for your child because of COVID-19.

Mask Guidance for Children

CDC recommends that everyone 2 years and older wear a mask that covers their nose and mouth when they are out in the community. Because of the danger of suffocation, do NOT put masks on babies or children younger than 2 years. Parents and other caregivers should keep in mind that wearing a mask is not a substitute for social distancing, frequent hand washing, or other everyday preventive actions – please wear your mask in addition to practicing other prevention steps. A mask is not intended to protect you, the wearer, but it may prevent you from spreading the virus to others. This would be especially important if you are infected but do not have symptoms of COVID-19. Please remember that medical facemasks and N95 respirators are reserved for healthcare personnel and other first responders.

May 2020 Update

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

This list does not include all possible symptoms. CDC will continue to update their list as they learn more about COVID-19.

Look for emergency warning signs* for COVID-19. If someone is showing any of these signs, seek emergency medical care immediately:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face

*This list is not all possible symptoms. Please call your medical provider for any other symptoms that are severe or concerning to you.

Call 911 or call ahead to your local emergency facility: Notify the operator that you are seeking care for someone who has or may have COVID-19.

Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19

Multisystem inflammatory syndrome in children (MIS-C) is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. We do not yet know what causes MIS-C. However, we know that many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19. MIS-C can be serious, even deadly, but most children who were diagnosed with this condition have gotten better with medical care.

For more information on MIS-C, click here.

March 30 Update

Melissa DeRosa, the secretary to Gov. Andrew M. Cuomo, announced that an executive order would be issued that required all hospitals in New York, both public and private, to allow women to have a partner in the labor and delivery room — in compliance with the latest guidance from the New York State Department of Health. Click here for details

Many new parents of twins are reporting that their hospital is no longer allowing them to visit their babies in the NICU. Be sure to check with your doctor to learn what policies your hospital may have recently put in place regarding NICU parent visitors.

March 27 Update

Some hospitals are restricting ANY guests in Labor and Delivery, even your partner, depending on your area’s rate of infection. Check with your obstetrician and hospital to learn what NEW policies your hospital has put into effect due to COVID-19 that may affect your twin delivery and postpartum stay.

Many providers of postpartum support, such as lactation consultant and postpartum doulas, are having to move their services online to eliminate possible exposure to their patients. If you were planning to have postpartum support, we advise that you still reach out to these providers and ask what services they are offering virtually that you can use.

Finally, if you are planning to breastfeed and/or pump for your twins in the hospital, Twiniversity advises that you bring your own breast pump with you in case there is a shortage of pumps available at your hospital. As you’ll read below, the CDC is advising mothers who are confirmed COVID-19 or suspected to have COVID-19 to pump in the hospital, which may mean a shortage for those who are not infected. We recommend that you learn how to hand express as well, which is recommended within the first few hours of delivery if your babies are not able to come to breast.

March 11 Update

How Can I Reduce My Risk of Contracting the Novel Coronavirus?

If you have children at home you need to be on high alert for symptoms coming from adults or children. Kids can’t help but be ALL OVER US. They love us and why not…we are awesome! But there are things we can do to help minimize the risk to our families. If you haven’t already implemented new rules in your house for sanitation, now is the time. Here are some suggestions:

  • Require shoes to be removed immediately upon entering the house
  • Require adults and kids to wash hands thoroughly with soap for at least 20 seconds right when they get home and again before leaving the house. Ask Alexa to set a timer if you need to.
  • Keep hand sanitizer and/or hand sanitizing wipes with you when you go out of the house and use them often. Keeping these in your car is a good idea!
  • Limit or stop kissing on the face. Since the virus is passed through saliva, a smooching pause at home may be called for.
  • Wipe down all surfaces with disinfectant on a daily basis (don’t forget doorknobs, toilet handles, faucet handles, and light switches). READ the instructions of the product you are using. Sometimes a “quick spray” isn’t enough. Some sanitizing agents need to sit for a while to work. SO READ PLEASE.
  • If anyone in your home is starting to feel ill, keep them home.
  • Create a family plan in case of a quarantine! Live with someone who has health concerns? What’s the plan if you need to care for them and you are infected? You should calmly plan for all scenarios.
  • If you start showing signs of coronavirus (coughing, fever, shortness of breath) quarantine yourself and use a face mask when you are around people. Call your doctor or take advantage of virtual hospital visits (check your local area to see who offers this) to learn how you can get tested for COVID-19.
  • For the most up to date information and recommendations from the CDC, click here

In addition, if you have children who may be showing signs of worry or anxiety about the coronavirus, the American Academy of Pediatricians (AAP) offers tips on preventive healthcare measures for families and guidelines on how to talk with children about adverse events and help them put things in perspective.

What Will Happen to Twiniversity Classes at This Time?

Twiniversity will be conducting all of our expecting twins classes online for the foreseeable future. We will make announcements for future in-person classes in the coming months as we know more about the epidemic. We will always keep our students’ health as our top priority.

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