COVID-19 has introduced concerns for parents of infants under one. This population can experience the illness differently than older children and adults. While most infants with COVID-19 have mild illness, their developing immune systems and small airways mean that close monitoring is important. Understanding how the virus affects this age group helps ensure their health.
Symptoms and Presentation in Infants
Identifying COVID-19 signs in infants is challenging as they cannot describe how they feel. The most common symptoms are fever and cough, much like in adults. Other indicators include lethargy or extreme tiredness, a disinterest in feeding, or a decrease in appetite. An infant who is unusually sleepy or difficult to wake should be assessed by a healthcare provider.
Infants may also exhibit signs of an upper respiratory infection, such as a runny or stuffy nose and sneezing. Some babies experience gastrointestinal issues, including vomiting, diarrhea, or stomach pain. In very young infants, these digestive problems can be the most prominent signs of infection. Increased crying or fussiness can also be related to the discomfort caused by the virus.
It is important to monitor an infant’s breathing. While mild congestion is common, any signs of respiratory distress warrant immediate attention. These signs include:
- Very rapid breathing
- Flaring of the nostrils with each breath
- Grunting sounds
- The sucking in of muscles around the rib cage
Because symptoms can progress, careful observation is necessary to distinguish a mild case from one that may require medical intervention.
Transmission and Prevention
Infants contract COVID-19 from an infected person in their close circle, like a parent or caregiver. The virus spreads through respiratory droplets, making close contact the primary mode of transmission. Since infants under six months are not eligible for vaccination, protecting them relies on creating a safe environment. This involves “cocooning,” where all eligible household members and caregivers are up to date on their COVID-19 vaccinations.
Hygiene practices help prevent transmission. Frequent handwashing by anyone handling the baby is important, especially after being in public or caring for sick family members. Limiting the infant’s exposure to large indoor gatherings and individuals showing signs of illness reduces their risk. Improving home ventilation by opening windows or using air purifiers can also help.
The virus is not believed to spread through breast milk, which can be a source of protection. If a mother has been vaccinated or was previously infected, she can pass protective antibodies to her baby through her milk. This provides the infant with passive immunity that can help their body fight off the virus if they are exposed.
Diagnosis and Medical Care
If you suspect your infant has COVID-19, contact their pediatrician. For any infant under three months with a fever of 100.4°F (38°C) or higher, it is important to seek medical advice immediately. Diagnosis is confirmed with a nasal swab test, similar to those used for adults, though the sample collection may be adapted for a small child.
For infants with mild symptoms, care can be managed at home with a focus on comfort and supportive measures. This includes ensuring the baby stays well-hydrated by offering frequent, smaller feeds of breast milk or formula. A cool-mist humidifier or saline nasal drops can help ease congestion. If a fever is causing discomfort, a pediatrician may recommend an appropriate fever-reducing medication and dosage.
Hospitalization may be necessary for infants who develop more serious symptoms. Signs that require urgent medical evaluation include difficulty breathing, dehydration such as fewer wet diapers, or extreme lethargy. In a hospital, medical teams can provide oxygen support, intravenous fluids, and other interventions to help the infant recover.
Potential Complications and Recovery
While most infants recover from COVID-19, a small number may develop Multisystem Inflammatory Syndrome in Children (MIS-C). This is a rare but serious condition where different body parts, including the heart, lungs, kidneys, and brain, can become inflamed. MIS-C appears two to six weeks after the initial COVID-19 infection, and the child may not have shown many signs of the original illness.
Symptoms of MIS-C that require immediate medical attention include:
- A persistent fever lasting more than 24 hours
- A skin rash
- Bloodshot eyes
- Stomach pain with vomiting or diarrhea
- Dizziness or confusion
- A change in skin color to pale, patchy, or blue
Although MIS-C is a serious condition requiring hospitalization, most children who receive prompt medical treatment make a full recovery.
The recovery outlook for infants with COVID-19 is positive. The majority of babies experience a mild illness and return to normal within one to two weeks. Providing comfort, ensuring adequate nutrition and hydration, and allowing for plenty of rest are the foundations of supporting their recovery. Long-term complications from a mild case of COVID-19 in infancy are uncommon.