How Are Babies Affected by the Coronavirus? Everything We Know Right Now
It's normal to feel concerned. Here's what parents should know now.If you have a baby or are about to have a baby, it’s understandable to be worried about the coronavirus and the respiratory disease it causes, COVID-19. Part of being a parent is worrying about your baby, even when we’re not facing a global pandemic — and it’s only natural to be concerned about how COVID-19 could affect your little one. Research about the coronavirus and its impact on babies and young children is ongoing, but here's what experts know right now about COVID-19, and what you can do to keep your family safe.
What is the coronavirus?There are seven different types of coronaviruses known to infect humans, according to the Centers for Disease Control and Prevention (CDC). Many are mild and cause colds, but some forms of the virus, specifically MERS-CoV, SARS-CoV and 2019-nCoV (aka COVID-19) can lead to severe illness. On March 11, the World Health Organization (WHO) officially declared COVID-19 a global pandemic.
How are babies affected by the coronavirus?Coronaviruses, including COVID-19, usually spread from an infected person to other people via respiratory drops that get into the air by coughing or sneezing, the CDC says. Close contact with an infected person, like touching or shaking hands, or touching a surface that has been contaminated with the virus and then touching your mouth, nose or eyes before you wash your hands can also spread the virus, the organization says. Health experts are still learning about COVID-19, but people who have had confirmed cases have experienced the following symptoms, according to the CDC:
- Shortness of breath
- New loss of taste or smell
- Shaking with chills
- Muscle pain
- Sore throat
- Runny nose
- Gastrointestinal symptoms such as diarrhea
What does the coronavirus mean for your baby?In general, babies with COVID-19 seem to do better compared to people in other age groups, experts say. Children under age 18 also make up a small number of the total confirmed COVID-19 cases in the U.S. “Fortunately, pediatric patients appear to be less severely impacted than the adult population,” says Dr. Golioto. “However, it appears that infants under 1 year of age have a higher likelihood of being severely or critically ill compared to older children.” The data we have is still limited. A study published in the medical journal Pediatrics in March analyzed data from more than 2,100 children in China who contracted the coronavirus. About 4 percent of the children studied had no symptoms, 51 percent had mild illness and 39 percent had a moderate illness. Around 6 percent had severe or critical illness, compared to 18.5 percent of adults. Infants had higher rates of severe illness than older children. The researchers weren’t entirely sure why children generally felt better than adults after contracting COVID-19, but theorized that it may be because children have fewer opportunities for exposure, higher levels of antibodies against viruses or different responses from their developing immune systems. "Early reports are reassuring," says Justin S. Brandt, M.D., an assistant professor in the Division of Maternal-Fetal Medicine at Rutgers Robert Wood Johnson Medical School. However, there have been a few reports of children who have died after testing positive for COVID-19. In May, a study published in the journal JAMA Pediatrics looked at 48 cases of children with confirmed COVID-19 in intensive care units in the U.S. Of the 48 patients, most (40) had preexisting medical conditions, 18 needed to be placed on ventilators and two died. The study reiterates that COVID-19 can be severe in younger populations, but luckily, most babies and children seem to have mild forms of the virus.
Can babies spread the coronavirus to other people?Experts are still learning about how babies spread COVID-19, and the role they play in the transmission of the virus continues to be a topic of debate among scientists. However, "babies and children seem to have a less severe course of illness but they can transmit the virus to others,” says Rajeev Fernando, M.D., an infectious disease expert in Southampton, New York and member of the What to Expect Medical Review Board.
Can the coronavirus affect unborn babies?Research on COVID-19 is new and still ongoing, but the CDC says it's unlikely that the coronavirus can pass from a mother with confirmed COVID-19 to her unborn baby (a process known as vertical transmission). There have been a few case reports of preterm birth among babies whose mothers had COVID-19 — but it's unclear whether the coronavirus was the cause. In March, a newborn born to a mother in the U.K. with COVID-19 tested positive, but again, it's unclear if the baby was born with the virus or contracted it shortly after birth. And one case report published in JAMA in March suggested that vertical transmission might be possible. However, in other small studies and case reports, new moms who tested positive for COVID-19 gave birth to healthy babies.
What happens if you test positive for COVID-19 just before giving birth?According to guidance from the AAP, infants born to mothers with a confirmed case of COVID-19 should be temporarily separated to lower the risk that the baby will be infected. The same is true for babies who are born to moms with a suspected case of COVID-19. Those babies should also stay in an area that’s separate from unaffected infants, per the guidance. Other important things to keep in mind, per the AAP:
- If you choose to keep your baby in your room despite the recommendations, your baby should be at least six feet away from you.
- If you plan to breastfeed, ideally you would express breast milk for your baby after you wash your hands and clean your breasts. Then, your baby would be fed by someone who is not infected. If you want to directly breastfeed your baby, the AAP says it’s important to use a mask and follow “meticulous” breast and hand hygiene.
- If your baby needs to go to the NICU, the AAP recommends that she is admitted to a single-patient room with the potential for negative room pressure or other air filtration system. If that’s not available, there should be at least six feet between your baby and others, and/or she should be placed in an air temperature-controlled isolette.
- If testing is available, it’s recommended that your baby is tested for COVID-19 at 24 hours of age, and again when she’s 48 hours old. If your baby can’t be tested, she should be treated as if she’s positive for the virus for a 14-day observation period.
If a mother has COVID-19, can she still breastfeed?"Studies so far have shown that COVID-19, the new coronavirus, is not found in breast milk," says Leana Wen, M.D., an emergency room physician and public health leader. "However, it could be transmitted through the respiratory route. And so it's just because of how contagious this disease is, there will need to be other precautions taken." In late April, the CDC released updated guidelines for breastfeeding mothers and healthcare providers caring for them. The CDC notes that breast milk can help protect babies against many illnesses. The organization stresses that while limited data suggests the coronavirus cannot be transmitted through breast milk, there are still a lot of unknowns about the virus. The CDC currently recommends the following for breastfeeding mothers with suspected, probable or confirmed COVID-19:
- Breastfeeding mothers should wash their hands using soap and water before touching their baby.
- If breastfeeding mothers do not have soap and water available to them, they should use hand sanitizer with at least 60 percent alcohol.
- Breastfeeding mothers should wear a cloth face covering while nursing.
- Mothers should practice good hand hygiene when expressing breast milk.
- If possible, consider letting expressed breast milk be bottle-fed to the baby by a healthy caregiver.
- If a breastfeeding mother tests positive for COVID-19, her baby should be "considered as having suspected COVID-19 for the purposes of infection control" and remain isolated at home for 14 days.
- If the breastfeeding mother requires lactation services that cannot be done virtually, the lactation provider should follow recommended infection prevention and control measures, and wear personal protective equipment (PPE).
Is it still safe to go outside with your baby?“It is not recommended that adults or children participate in any unnecessary travel at this time,” Dr. Golioto says. “Infant travel should be limited to medical appointments.” Many well-baby visits are now being done virtually; if you have a routine checkup scheduled in the next few weeks, call your child's pediatrician and ask how they are handling well visits during the outbreak. Keep in mind that it's still important to stick to your child's vaccination schedule during this time, so some appointments may still need to occur in person. Ultimately, though, it’s really best to keep your baby home as much as possible. If you need groceries or medication and you’re able to leave your baby at home with a partner or caregiver, it’s best to do so. That said, you don’t need to stay cooped up indoors with your baby 24/7. “It is acceptable for parents to be outside with their children in the vicinity of the home for fresh air when the weather allows,” Dr. Golioto says. Note that the CDC's recommendations that everyone wear cloth face coverings in public to prevent the spread of infection does not apply to babies under 2. If you have to go outside with your baby or toddler, you should wear your baby, carry him in a car seat with a cover or put a cover over his stroller.
How can parents keep babies safe during the pandemic?Parenting during the coronavirus pandemic can make you feel helpless. But there are a few steps you can take to keep your family safe:
- Practice good hand hygiene. You've heard it time and time again, but wash your hands often with soap and water for at least 20 seconds.
- Follow social distancing guidelines. It’s crucial to follow the advice of the CDC and your local government and practice social distancing, Dr. Golioto says. “The child should stay home with a healthy caregiver as much as possible and avoid contact with anyone who is ill or at risk,” she says. That includes trips to the playground, since the coronavirus can linger on surfaces.
- Stock up. You don't need to go overboard, but it is a good idea to have supplies for your baby in your home to last for “at least” a few weeks, Dr. Golioto says. “People need food, common medicines including Tylenol, thermometers and other common household items such as soap, toilet paper and washing detergent,” Dr. Brandt says. Making sure you have a solid supply of diapers and wipes is also important.
- Order in. If there are delivery options in your area, order in rather than bring your baby to the grocery store or pharmacy. “When possible, patients should take advantage of delivery services rather than going to markets and other stores where people may congregate,” Dr. Brandt says.
- Keep baby's gear clean. In addition to cleaning high-touch surfaces in your home, regularly clean your child's toys and gear with warm water, particularly plush toys, says the CDC. Don't forget to also clean baby's bottles, plastic toys, bedding and clothes.