The decision to touch and hold a newborn while infected involves carefully balancing the profound benefits of early bonding and breastfeeding against the risk of viral transmission. Current medical guidance from major health organizations aims to minimize neonatal exposure while recognizing the importance of the initial postpartum period. These recommendations focus on practical precautions to allow for safe physical contact and care of the infant.
Understanding COVID-19 Transmission Risk in Newborns
COVID-19 transmission to a newborn primarily occurs after birth, through close contact with an infected person’s respiratory droplets. The virus spreads when an infected person coughs, sneezes, or talks, releasing droplets that the baby can inhale or that can land on surfaces the baby touches. Conversely, the risk of vertical transmission, where the virus passes from the mother to the baby before or during birth, is considered low. Studies suggest that only a small percentage of newborns exposed to SARS-CoV-2 in utero test positive for the virus shortly after delivery. While newborns can contract the virus, the majority experience mild or no symptoms, although severe illness is possible.
Official Guidance on Rooming-In and Temporary Separation
The decision regarding the mother and newborn staying together, known as rooming-in, is a shared choice made by the parents and the healthcare team. This discussion is informed by the mother’s clinical condition and the available hospital resources. The current consensus leans toward supporting mother-infant proximity due to the benefits of bonding and breastfeeding, provided strict infection control measures are followed. One common approach is a modified rooming-in, where the mother and baby share a room, but a physical distance of about six feet is maintained when the mother is resting or not directly interacting with the infant.
Temporary separation, where the infant is placed in a well-baby nursery or separate room, is typically reserved for mothers who are too ill to safely care for the baby or when the parents elect for this option to reduce infection risk. If temporary separation is chosen, the mother can still participate in care by pumping breast milk and having a non-infected caregiver feed the baby. The chosen option must be continuously reassessed based on the mother’s improving symptoms and the newborn’s health status. The goal is to reunite the mother and baby once she meets the criteria for ending isolation, such as being fever-free and having passed a set number of days since symptoms first appeared.
Essential Safety Protocols During Physical Contact
The first step for any interaction is meticulous hand hygiene, requiring the mother to wash her hands with soap and water for at least 20 seconds immediately before touching the baby or handling any feeding equipment. If soap and water are not readily available, an alcohol-based hand sanitizer containing at least 60% alcohol should be used. The mother must wear a well-fitting mask whenever she is within six feet of her newborn, including during feeding, holding, and any other close-contact care.
The safety protocols should also include guidance for a healthy support person, who can take on the majority of the baby’s care when the mother is resting or unable to maintain precautions. The support person should also practice frequent hand hygiene and may need to wear a mask if they live in the same household and have been in close contact with the infected mother. Furthermore, routinely cleaning and disinfecting high-touch surfaces in the immediate environment, such as bedside tables and pump parts, adds another layer of environmental control.
Breastfeeding While Infected
Current medical evidence strongly supports the continuation of breastfeeding, even when the mother has a confirmed COVID-19 infection. Studies show that the SARS-CoV-2 virus is not transmitted through breast milk; in fact, the milk contains antibodies that may offer immunological protection to the newborn. If the mother is well enough to directly nurse, she should perform hand hygiene before each feeding and wear a mask during the entire session. The decision to engage in direct breastfeeding should be made in consultation with the healthcare provider. If the mother is separated from the baby or chooses to pump, strict hygiene must be maintained during milk expression, including washing hands before touching any pump or bottle parts, and following recommendations for thorough cleaning and sanitation of the equipment after each use.