Pregnant women across the US exhaled a collective sigh of relief when the American Academy of Pediatrics (AAP) reversed one of their COVID-related recommendations. Now, separating COVID-positive moms from their newborn babies is no longer advised.
The Price of Caution
In April, the AAP had advised that newborns should be separated from their mother if she tested positive for the virus. Separation was also recommended in cases where test results were not available, but it was suspected she could have the disease.
The recommendation was made out of an abundance of caution due to how little was known about the risk of transmission from mother to her baby. However, it created a difficult situation for new mothers.
New mothers have traditionally used their time in the hospital to learn how to care for their newborn. Experienced nurses teach how to diaper and bathe their baby. Lactation consultants are able to teach them how to tell when their infant wants to eat and assist them with learning how to breastfeed. The separation recommendation meant that these new moms missed out on all that.
As more moms have contracted COVID-19, more data has been collected. It has been found that the incidence of infants getting the virus from their mother is low. The vast majority of babies who do get COVID from their mother are either asymptomatic or do not get seriously ill. This has resulted in the new recommendation that does not advocate for separation.
“Current evidence suggests the risk of a neonate acquiring SARS-CoV-2 from its mother is low. Further, data suggests that there is no difference in risk of SARS-CoV-2 infection to the neonate whether a neonate is cared for in a separate room or remains in the mother’s room,” according to the CDC.
Because the virus is primarily believed to be spread by droplets, the CDC advises infected mothers to wear a mask and practice good hand hygiene whenever they are feeding or caring for their child.
Currently, the AAP provides this guidance:
- Follow the usual practice of the birth center.
- Mothers with confirmed or suspected COVID-19 should maintain a reasonable distance from their infants when possible. While performing hands-on care, the mothers should wear a mask and use hand hygiene. An isolette may facilitate distancing and provide added protection; take care to properly latch isolette doors to prevent infant falls.
- Health care workers should wear gowns, gloves, standard procedural masks, and eye protection when providing care for well infants. When this care is provided in the same room as a mother with COVID-19, health care workers may opt to use N95 respirators instead of standard procedural masks, if available.
- Mothers who are acutely ill may not feel up to providing all care for their babies. They might need to be temporarily separated or have the infant cared for by another, healthy caregiver in the room.
- Noninfected partners or other family members present during the birth hospitalization should use masks and hand hygiene when delivering hands-on care to the baby.
The AAP’s Healthy Children website advises mothers to continue taking these precautions until:
- She has been fever-free for 24 hours without taking any fever medicines (acetaminophen or ibuprofen).
- At least ten days have passed since her COVID-19 symptoms first started.
- And all your symptoms have improved.
- If you tested positive but have no symptoms, wait until at least ten days after the positive test result.
The CDC and the AAP agree that a mother with COVID-19 can breastfeed her newborn.
Of course, there will be times that a new mom is too ill to care for her infant. In those cases, a family member could stay in her room to care for the infant. The choice can also be made for the infant to be cared for in the hospital nursery.
Parentology reported on a study that showed the breast milk of COVID positive moms was high in COVID antibodies, which can protect infants.
Separating Moms and Babies COVID — Sources
AAP News – Rooming-in, with precautions, now OK in revised AAP newborn guidance
CDC – Evaluation and Management Considerations for Neonates At Risk for COVID-19
Healthy Children – Breastfeeding During the COVID-19 Pandemic