MOTHERS WITH SARS-COV-2 INFECTION

Mothers with SARS-CoV-2 infection

Mothers with SARS-CoV-2 infection rarely pass the virus on to their newborns when basic infection control practices are followed, according to a new study by researchers at Columbia University Irving Medical Center and NewYork-Presbyterian Morgan Stanley Children's Hospital. The findings – the most detailed data available on the risk of SARS-CoV-2 transmission between mothers and their newborns – suggest that more extensive measures such as separating COVID-19-positive mothers from their newborns and avoiding direct breastfeeding may not be justified.

The study was published in JAMA Pediatrics.

"Our findings should reassure expectant mothers with COVID-19 that basic infection control measures during and after delivery – such as wearing a mask and breast and hand hygiene when holding or breastfeeding a baby – protect newborns from infection," says the Eugene Jacobson Professor of Women's Health in Obstetrics and Gynecology at Columbia University Vagelos College of Physicians and Surgeons, a maternal-fetal medicine specialist at NewYork-Presbyterian / Columbia University Irving Medical Center.

Basic infection prevention measures reduced the risk of COVID-19 in newborns.

The researchers examined the outcomes of the first 101 babies born to COVID-19-positive mothers at NewYork-Presbyterian Morgan Stanley Children's Hospital or NewYork-Presbyterian Allen Hospital.

To reduce the risk of SARS-CoV-2 transmission to newborns after delivery, hospital staff practised social distancing, wore masks and placed COVID-19-positive mothers in private rooms. The hospitals gave mothers educational material about COVID-19 and shortened the hospital stay for all mothers without delivery complications. Most of the newborns stayed with their mothers, including for the first post-delivery check. (Some were admitted to the neonatal intensive care unit for health reasons unrelated to COVID.) The babies were placed in a protective cot six metres away from their mothers' beds while the mothers rested. Direct breastfeeding and skin-to-skin contact with the babies were strongly encouraged, provided that the mothers wore masks and washed their hands and breasts with soap and water.

"During the pandemic, we continued to do what we usually do to promote bonding and development in healthy newborns, taking a few extra precautions to minimise the risk of exposure to the virus", says one of the researchers.

Only two of the newborns tested positive for SARS-CoV-2, and they had no clinical signs of illness. (The researchers were unable to determine how the babies became infected.) The doctors followed up about half of the babies, including the two who tested positive for the virus, during the first two weeks of life, and all remained well.

The data support breastfeeding and skin-to-skin contact with the baby, even if the mother has COVID-19.

Some paediatric and health organisations have issued interim guidance for pregnant women with SARS-CoV-2, recommending separating mothers and newborns during their hospital stay, no direct breastfeeding, and bathing newborns as soon as possible. (Normally, newborns are bathed after at least 24 hours of life, because bathing interferes with bonding and breastfeeding and increases the risk of dangerously low body temperature and blood sugar.)

These recommendations were made in the absence of data on mother-to-newborn SARS-CoV-2 transmission rates and are based on experience with the mother-to-newborn transmission of other infectious diseases. However, some of the recommendations contradict what we know about the developmental benefits of early breastfeeding and skin-to-skin contact. Our study shows that these measures may not be necessary for healthy newborns of COVID-19-positive mothers."

"We believe it is particularly important for mothers with COVID-19 to have the opportunity to breastfeed their newborns directly. Breast milk is known to protect newborns from many pathogens and may help protect newborns from SARS-CoV-2 infection," the lead researcher concluded.

*The content of this blog is not intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of qualified healthcare providers with any questions you may have about a medical condition.