As cities and states begin relaxing their restrictions around COVID-19, I wanted to share the most up-to-date information regarding COVID-19’s impact on pregnancy, childbirth, and breastfeeding. As an RN and IBCLC, I thought it would be helpful to compile some opinions from leading health organizations so you’re empowered to make informed decisions for your family.
There is so much still unknown, but I hope that having some key views in one place will help your decision-making process. You’ll likely encounter certain restrictions and medical guidelines that must be considered, as well as disagreement amongst medical providers -- you’ll even see differing views below! But remember to trust your mama instincts and follow the recommendations of your health care team!
How can I protect myself from COVID-19 if I’m pregnant?
Staying healthy during pregnancy is a top priority for most families. Along with eating a healthy diet, staying hydrated, and exercising regularly, here is some information about how to protect yourself from COVID-19 while pregnant:
- “Washing your hands frequently with an alcohol-based hand rub or soap and water.
- Keeping space between yourselves and others and avoiding crowded spaces.
- Avoiding touching your eyes, nose and mouth.
- Practicing respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose of the used tissue immediately.”
“Much is still unknown about the risks of COVID-19 to the pregnancy and to the baby.
Mother-to-child transmission of COVID-19 during pregnancy is unlikely. However, after birth, a newborn can be infected after being in close contact with an infected person, including the baby’s mother or other caregivers.
A small number of babies have tested positive for the virus shortly after birth, according to limited published reports. However, it is unknown if these babies got the virus before, during, or after birth.
A small number of other problems, such as preterm birth, have been reported in babies born to mothers who tested positive for COVID-19 late in their pregnancy. However, we do not know if these problems were related to the virus.”
Can I touch, room-in, and hold my baby after birth if I have COVID-19?
As stories of babies being separated from their mothers soon after birth come to light, many expectant mamas are concerned. Research shows the vast benefits of skin-to-skin contact, so whether or not to separate a mother from her newborn should be carefully considered.
“This is a controversial question, and experts are divided on the best course of action. While there is some information showing that most newborns who are exposed to mothers who have COVID-19 do well, some infants can get very sick. The risk to the infant in this situation is simply unknown at this time. While difficult, the safest course of action from the perspective of minimizing the likelihood of the infant becoming infected is to separate mother and infant, at least temporarily. This may provide time for the mother to become less infectious.
Temporary separation may be accomplished by admitting the infant to an area separate from mother and separate from unaffected infants. Gowns, gloves, standard procedural masks, and eye protection (face shields or goggles) should be used while caring for these newborns.
However, separation of mother and infant has downsides. If after discussion with the clinical care team, the mother chooses to room-in, or if rooming-in is necessary because the healthcare facility cannot provide care for the infant in a separate area, specific steps should be taken to minimize the risk of the newborn acquiring postnatal SARS-CoV-2 infection. The mother should maintain a distance of at least 6 feet from her infant when possible. A non-infected caregiver should help provide hands-on care to the infant whenever possible. When the mother provides hands-on care, she should wear a mask and perform hand-hygiene. Use of an isolette may facilitate distancing and provide the infant an added measure of protection from respiratory droplets.”
“Infants born to patients with known COVID-19 at the time of delivery should be considered infants with suspected COVID-19. As such, infants with suspected COVID-19 should be tested, isolated from other healthy infants, and cared for according to the Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19)...
To reduce the risk of transmission of the virus that causes COVID-19 from the patient to the newborn, facilities may consider temporarily separating (eg, separate rooms) patients who have confirmed COVID-19 or are persons under investigation from their newborns until the patient’s transmission-based precautions are discontinued. ACOG recognizes that separation of patients from their newborns may be linked to additional risks including, but not limited to, undue stress on the patient and disruption of breastfeeding. The determination of whether to keep patients with known or suspected COVID-19 and their infants together or separated after birth should be made on a case-by-case basis, using shared decision-making between the patient and the clinical team.”
“Yes. Immediate and continued skin-to-skin care, including kangaroo mother care, improves the temperature control of newborns and is associated with improved survival among newborn babies. Placing the newborn close to the mother also enables early initiation of breastfeeding which also reduces mortality.
The numerous benefits of skin-to-skin contact and breastfeeding substantially outweigh the potential risks of transmission and illness associated with COVID-19.”
Can I breastfeed my baby if I have COVID-19?
Like skin-to-skin contact, the benefits of breastfeeding are endless, but in this challenging period, many new mothers are worried about keeping their babies safe while nursing.
“The AAP strongly supports breastfeeding as the best choice for infant feeding. To date, breast milk is considered to be an unlikely source of transmission of SARS-CoV-2. Mothers may express breast milk after appropriate breast and hand hygiene, and this may be fed to the infant by other uninfected caregivers. If the mother requests to nurse her infant, she should comply with strict preventive precautions, including the use of a mask and breast and hand hygiene.”
“Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and health care professionals. Currently, the primary concern is not whether the virus can be transmitted through breast milk, but rather whether an infected mother can transmit the virus through respiratory droplets during the period of breastfeeding. A mother with confirmed COVID-19 or who is a symptomatic person under investigation should take all possible precautions to avoid spreading the virus to her infant, including breast and hand hygiene and wearing a face mask, if possible, while breastfeeding. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is not sick feed the expressed breast milk to the infant.”
“Breast milk provides protection against many illnesses and is the best source of nutrition for most infants. Learn more about breastfeeding.
- You, along with your family and healthcare providers, should decide whether and how to start or continue breastfeeding.
- We do not know for sure if mothers with COVID-19 can spread the virus to babies in their breast milk, but the limited data available suggest this is not likely.
- If you have COVID-19 and choose to breastfeed:
- Wear a cloth face covering while breastfeeding and wash your hands before each feeding.
- If you have COVID-19 and choose to express breast milk:
- Use a dedicated breast pump.
- Wear a cloth face covering during expression and wash your hands before touching any pump or bottle parts and before expressing breast milk.
- Follow recommendations for proper pump cleaning [Español] after each use, cleaning all parts that come into contact with breast milk.
- If possible, expressed breast milk should be fed to the infant by a healthy caregiver who does not have COVID-19, is not at high-risk for severe illness from COVID-19, and is living in the same home.”
“Yes. Women with confirmed or suspected COVID-19 can breastfeed if they wish to do so. They should:
- Wash hands frequently with soap and water or use alcohol-based hand rub and especially before touching the baby;
- Wear a medical mask during any contact with the baby, including while feeding;
- Sneeze or cough into a tissue. Then dispose of it immediately and wash hands again;
- Routinely clean and disinfect surfaces that mothers have touched.
It is important to replace medical masks as soon as they become damp and dispose of them immediately. Masks should not be reused or touched in the front.”
It’s understandable if you’re feeling anxious and frustrated about your pregnancy, childbirth, and breastfeeding journeys. I know how tough this period is, but I also know you’re doing a great job. I know you’re being brave, and I know you’re the perfect mama for your baby.
Research is still being done, and doctors are learning more and more every day about COVID-19 and how it affects pregnant and breastfeeding mothers and their infants. While there is some disagreement, the general consensus is that moms and babies should be evaluated on a case-by-case basis, and families should be supported in the decisions they make regarding bonding and breastfeeding.
Even though the information can feel confusing since it’s constantly evolving, I know you'll do what is best for your family unit. If you would like additional support from the Kindred Bravely community, join our Facebook group, KindredMamas, and follow us on Facebook, Instagram, and Pinterest.