Newborn babies and COVID-19

BEING a new mom is as amazing as it is nerve-racking. It can be a very anxious time in your life, filled with lots of fears and uncertainties. Coupled with the COVID-19 pandemic, one can imagine how uneasy new moms must be feeling in these unprecedented times.

Being a mother myself, and a physiotherapist who works with numerous mothers, I decided to get some answers from Dr Theophilus Nelson, senior resident in obstetrics and gynaecology at the University Hospital of the West Indies. Part one, involving pregnant women, was carried last week. Here is part two.

KH: Similar to pregnant women, are babies with underdeveloped immune systems considered to be in the vulnerable group for COVID-19?

Dr Nelson: That brings us to a very important point. Based on information we have in terms of coronavirus, there is no evidence of babies having the virus as a consequence of the pregnancy, or mommy having the virus and it being passed to the baby during pregnancy, but rather based on poor hygiene practices. That is the causation we are currently working with because there are no studies to show that the virus is being passed through the amniotic fluid or through the breast milk, so poor hygiene and not taking the proper precautions are the most probable ways of the virus being transmitted.

KH: That begins to answer my next question: can breastfeeding moms continue to breastfeed if they are positive for COVID-19?

Dr Nelson: The important thing is once you come to hospital and you are thought to be a potential or confirmed case of COVID-19, we deliver your baby in a special area while maintaining your privacy and dignity. We take all the necessary precautions that need to occur, and once the baby is delivered the institutional recommendation is to isolate mommy from baby. There are different schools of thought on whether or not the baby should be housed separately from mommy, but at the end of the day the decision ultimately lies with mommy. The medical team will lay out all the risks vs the benefits of keeping the baby, knowing that you have tested positive for COVID-19. You can pass on the virus to your baby based on poor hand hygiene, droplets from sneezing or coughing, etc. The recommendation by the doctor would be to express the milk and have it given to the baby, but the decision remains with the mother. If the mother decides to keep the baby around, she would have to wear a face mask and practise the appropriate hygiene, but based on institutional recommendations we prefer isolation of the baby from mommy.

KH: I have heard some bizarre stories. I have heard of mothers continuously wiping down their babies with alcohol to prevent them from contracting COVID-19, so I want you to tell us how dangerous that practice is and give us some safer methods of protecting babies from COVID-19.

Dr Nelson: That’s a very important observation. First of all the virus cannot travel without us, the human beings. Therefore, the only way a baby can contract the virus is if the baby comes in contact with an infected person or surface. So it is important to limit the baby’s possible exposure, and that can be done by limiting the number of visitors in the household, ensuring that while handling the baby proper hand hygiene is maintained, and wiping down the surfaces that are in common use in the household.

In terms of using alcohol to wipe down the baby, that’s a definite no. The usual mild soap that is normally recommended to bathe the baby is good enough to keep the baby clean. The use of alcohol has many dangers. It can be absorbed through the skin and cause intoxication, and the fumes of the alcohol can be inhaled causing the baby to become comatose, depending on the concentration of the alcohol. Even the practice of rubbing babies with alcohol when they have a fever is an unsafe practice, because alcohol causes rapid cooling of the baby’s skin, causing the baby to shiver. Shivering causes the baby’s body to respond by generating heat, causing an increase in the baby’s temperature. Alcohol is also harsh on the baby’s delicate skin so it can actually cause chemical irritation. Regular hand-washing, bathing the baby or wiping the baby down with mild soap, cleaning the items that the baby touches, as well as frequently cleaning high-traffic surfaces are better and safer practices.

KH: Mothers are concerned about whether they should take their babies out to the clinic to be vaccinated, or wait until after everything with COVID-19 dies down.

Dr Nelson: I would advise that you make contact with your health centre to see if they are still offering regular services. A lot of adjustments have been made at all facilities in terms of how they are operating. Once the service is available and you are advised to come in, there are no issues with vaccinating your baby at this time as long as the baby does not have a fever and shows no sign of illness.

KH: What are the key takeaways as it relates to pregnant women and new moms amidst COVID-19?

Dr Nelson: It is very important to note that this strain of the coronavirus is new, so there are many things we are learning as we go a long the process. The information that we do have is based on the studies that have been conducted since the virus was first detected in Wuhan. From the evidence thus far:

1. Healthy pregnant women are at no greater risk of catching COVID-19 than any other healthy individual.

2. Pregnant women are not at a higher risk of having more severe symptoms in comparison to healthy non-pregnant women.

3. There is currently no evidence of pregnant women passing on the virus to their babies during pregnancy or during birth and delivery. The earliest a baby has been discovered to have coronavirus is 30 hours post-delivery, and the most probable cause would have been contamination from mommy in terms of poor hand hygiene or water droplets (kissing, talking, or coughing over baby)

4. The virus is not found in breast milk or the amniotic fluid (the fluid that the baby swims around in during pregnancy).

5. Mothers who are positive for COVID-19 are advised to isolate from the babies and express the breast milk for feeding; however, the decision of whether or not to isolate ultimately lies with the mother.

6. Breastfeeding for mothers with COVID-19 is safe and is recommended as the milk provides the necessary antibodies to protect the baby from contracting viruses, among the other general great benefits.

7. Mothers should adhere to the guidelines provided by the Ministry of Health to practise social distancing, only go out for essential activities, practise proper hand hygiene, clean frequently contacted surfaces, and limit visitors.

8. Pregnant women with COVID-19 are not required to have C-sections. C-sections are only recommended for obstetric indications that usually require C-sections. A C-section would only be recommended for a patient with COVID-19 in the event their breathing status is so compromised that having the patient labouring for a long time would be of more harm than benefit.

Kimberly Hoffman is a physiotherapist who is currently specialising in women’s health and fitness.