The emergence of COVID-19 brought concerns for parents and caregivers about its effects on newborns. Understanding the specific risks, how the virus can be transmitted to infants, and the most effective ways to protect them is a priority for families. This information aims to provide a clear overview of what is currently known about COVID-19 in the earliest stage of life.
Understanding COVID-19 in Newborns
Newborns can contract SARS-CoV-2 but are less susceptible to severe illness than adults. While infants under one year may face a greater risk than older children, most newborns who test positive for the virus are asymptomatic or experience only mild symptoms. In fact, more than 40% of infected neonates show no signs of illness at all.
When symptoms appear in newborns, they resemble those of other common respiratory viruses. These can include fever, cough, nasal congestion, and difficulties with feeding. Less frequently, more moderate to severe symptoms like lethargy, respiratory distress, and vomiting can occur. Premature infants or those with underlying health conditions are at a higher risk for more serious complications.
A rare but serious condition known as multisystem inflammatory syndrome in children (MIS-C) has been linked to COVID-19, where different body parts can become inflamed. This condition is uncommon, and the overall prognosis for newborns with COVID-19 is positive. Most infants recover fully with supportive care focused on ensuring proper hydration and comfort.
How COVID-19 Spreads to Newborns
The transmission of SARS-CoV-2 to a newborn can occur through a few pathways. The possibility of the virus passing from mother to baby during pregnancy or childbirth is known as vertical transmission. While this has been a concern, current evidence suggests this form of transmission is uncommon, as studies have not consistently found the virus in samples of amniotic fluid or cord blood.
The more frequent method of transmission is postnatal infection, which happens after birth through close contact with an infected caregiver. The virus spreads through respiratory droplets that are expelled when an infected person coughs, sneezes, or talks. These droplets can be inhaled by the newborn or land on surfaces that the baby later touches.
This postnatal exposure is the primary way newborns contract COVID-19. The close physical contact inherent in caring for a newborn, such as feeding and holding, creates opportunities for the virus to pass from an infected adult to the infant. The environment and the health of the caregivers are significant factors in the baby’s risk of infection.
Safeguarding Newborns from COVID-19 Infection
A primary strategy for protecting a newborn is maternal vaccination against COVID-19 during pregnancy. Vaccination generates protective antibodies that are transferred to the fetus across the placenta, providing the newborn with passive immunity. Studies show antibody levels in cord blood can be similar to or even higher than those in the mother, and this protection has been shown to reduce the risk of COVID-19 hospitalization for infants under six months by approximately 61%.
These maternal antibodies persist in the infant for several months after birth, offering a defense when the baby is too young to be vaccinated. Research indicates detectable antibodies in infants for at least the first six months of life. The highest levels of protection are observed when the mother received a vaccine between weeks 20 and 32 of pregnancy. Breastfeeding can also transfer additional antibodies.
Beyond vaccination, maintaining strict hygiene practices is important. All caregivers should wash their hands with soap and water before touching the newborn, preparing bottles, or handling a breast pump. Limiting the baby’s exposure to people outside the immediate household, especially in crowded indoor spaces, can reduce the risk. Creating a safe home environment involves cleaning frequently touched surfaces and ensuring that all close contacts are up to date on their vaccinations.
Managing Newborn Care with Parental COVID-19
If a parent or primary caregiver tests positive for COVID-19, they can still safely care for their newborn by taking specific precautions. Health organizations recommend that a mother with COVID-19 continue to breastfeed. Current evidence indicates the virus is not transmitted through breast milk; in fact, breast milk contains antibodies that can help protect the infant.
To minimize transmission risk during care, the infected parent should wear a well-fitting mask and wash their hands with soap and water before holding or feeding the baby. These hygiene measures are important for both direct breastfeeding and bottle-feeding. Rooming-in, where the baby stays in the same room as the mother, is also encouraged to facilitate bonding, provided these precautions are followed.
If a mother is too unwell to breastfeed directly, she can express her milk, which can then be given to the baby by a healthy caregiver. Before pumping or hand-expressing, the mother should wash her hands and clean all pump parts and bottles. These steps ensure the infant continues to receive the benefits of breast milk while minimizing potential viral exposure.