By: Karen Puopolo, MD, PhD, FAAP
It's common for expectant parents to have questions about making sure their newborn is healthy during and after delivery in the hospital. But what if you are delivering a baby soon and have tested positive for SARS-CoV-2, the virus that causes
COVID-19?
There is still a lot to learn about COVID-19. Let's look at what you can expect when it is time to have your baby and find out what steps can help keep everyone safe.
If I have COVID-19 when I have my baby, will my newborn be sick?
So far, very few babies born to mothers with
COVID-19 test positive for the virus in the first few days. Also, there are no published reports of newborns who have died during their initial birth hospitalization as a direct result of SARS-CoV-2 infection. Newborns and young infants who do catch the virus can become sick enough to need to be hospitalized, but most often they recover.
If I test positive for COVID-19, will my partner be able to be in the delivery room when I have my baby?
Based on the latest evidence, the American Academy of Pediatrics (AAP) supports allowing women with COVID-19 to have their partner with them while they labor and give birth. However, each hospital has its own rules on this issue, so check with the one where you plan to have your baby.
You should wear a face mask while giving birth to help stop the virus from spreading to your baby or others during delivery. Your non-infected partner should also wear a face covering and follow all hospital or birth center safety precautions.
What will happen right after my baby is born?
Your infant will receive all the usual care in the moments right after birth. For example, it is normal to wait to clamp the umbilical cord. Unless you are too sick, you should be able to hold your baby against your skin. Your baby will be bathed after
delivery to remove any virus from the skin.
Can my well newborn stay in my hospital room if I have COVID-19?
When steps are taken to prevent the virus from spreading, mothers and babies can safely stay together. It is also safe and good for you to
breastfeed your baby. Wear a cloth face covering and
wash your hands or use hand sanitizer with at least 60% alcohol whenever you directly care for your baby. Partners and other family members should use cloth face coverings and wash their hands often when holding or touching the baby, even if they do not have COVID-19.
If your newborn stays in your room, be sure to keep a safe distance when you are not directly caring for your baby. The hospital may provide a clear plastic enclosed crib that helps protect your baby from germs in the hospital room. It also helps you keep a safe distance while still letting you see your baby.
If your symptoms are severe, it may not be possible for you to take care of your infant and yourself safely. In this case, it may be best to stay in a separate room from your baby or have a non-infected caregiver take care of your baby in your room.
Should my newborn be tested for COVID-19 at the hospital?
Yes, if
testing is available. Newborns of mothers who have COVID-19 are usually tested 24 hours and 48 hours after they are born. If the test is positive, your baby may get tested every 48-72 hours until there are two negative tests in a row.
If your baby tests positive but does not have any symptoms, plan to follow up often with your baby's pediatrician during the first 14 days after your baby was born.
Can I visit my baby if a stay in the NICU is needed?
During the pandemic, most neonatal intensive care units (NICUs) are limiting visitors to help protect infants from catching the virus. If you or your partner have confirmed or suspected COVID-19, you should not visit the NICU while you are able to transmit the virus.
Mothers who cannot visit the NICU are encouraged to provide pumped
breast milk for their infant.
What about after I head home with my new baby?
Once you are home, wash your hands with soap and water for at least 20 seconds before holding or touching your baby. Use
hand sanitizer with at least 60% alcohol if soap and water are not available. Along with good hand washing, keep using a cloth face covering until:
you have been without a fever for 24 hours without fever-reducing medicines and it has been at least 10 days since your symptoms first appeared.
at least 10 days have passed since the positive test if you never had symptoms.
symptoms have improved and at least 10 days have passed since you first felt sick.
10 days have passed from a positive test when you came in to give birth.
If anyone in your household is sick with COVID-19, they should stay at least 6 feet away from the baby when possible. They should wear a cloth face covering and wash their hands if they must care for your baby.
As you welcome your new little one home during the pandemic, don't forget to take care of yourself. Adjusting to life with a newborn can be hard in normal times. With a new baby at
home during COVID-19, it is important to get help when you need it.
Remember
We continue to learn more about how COVID-19 affects babies before, during and after delivery. If you have any questions about your newborn's health during COVID-19,
call your pediatrician. Regular checkups with your doctor are important to make sure your baby's development is on track, to talk about nutrition and behavior, and to get the vaccines your baby needs to stay healthy. It's safe and your pediatrician wants to hear from you.
More information
About Dr. Puopolo
Karen Puopolo, MD, PhD, FAAP, is a member of the AAP Committee on Fetus and Newborn and an attending neonatologist at the Children's Hospital of Philadelphia and chief of the Section on Newborn Pediatrics at Pennsylvania Hospital.