Mothers with COVID-19 at delivery can breastfeed their newborns without passing along the infection, as long as they take certain safety precautions.
Wearing a surgical mask while nursing and cleaning hands before handling their babies kept the coronavirus from spreading from mothers to their infants, a new study finds. It adds to a growing body of evidence that suggests babies are rarely becoming infected after birth and getting severely ill from the virus.
The study took place at three hospitals in New York City, the initial epicenter of the U.S. outbreak. Doctors identified 120 babies born from late March to mid-May to 116 women who were positive for SARS-CoV-2, the virus that causes COVID-19. After donning surgical masks (SN: 6/26/20) and cleaning hands, the mothers could hold their babies within the first hour of birth. Early skin-to-skin contact promotes bonding and breastfeeding and has other health benefits.
None of the babies were positive for SARS-CoV-2 when tested a day after they were born, researchers report online July 23 in the Lancet Child & Adolescent Health. Seventy-nine of the babies were tested for the virus five to seven days after birth, by which time many had been discharged to their homes, with guidance for parents on continuing infection control. All of these infants tested negative. At this point, 64 were still breastfeeding or getting breastmilk from a bottle.
At two weeks after birth, 70 of 72 infants tested negative for SARS-CoV-2, while two had invalid test results; none of the babies had COVID-19 symptoms. The 53 infants that had a one-month telemedicine visit continued to show no signs of the illness.
The American Academy of Pediatrics also announced July 23 that they were updating their guidance on the care of newborns to mothers with COVID-19. The group’s initial recommendations in early April advised a temporary separation between infected mothers and newborns and feeding expressed breastmilk. But that guidance came at a stage of the pandemic when it was clear the virus was very contagious (SN: 4/2/20), but there was little research on infants and COVID-19.
Since then, the organization has reviewed studies and data from the National Registry for Surveillance and Epidemiology of Perinatal COVID-19 Infection. “At least so far, we don’t have any evidence that babies are getting the virus from the mother after birth and showing up at the hospital horribly sick,” says Karen Puopolo, a neonatologist at the University of Pennsylvania Perelman School of Medicine. Puopolo is the lead author of AAP’s guidance, which now states that a baby is at low risk of infection when staying with the mother after delivery if she wears a mask and cleans hands before holding her infant.
“For whatever reason, this virus is either not as contagious to newborns as it is in other settings or it’s just not as impactful,” she says. “That’s great.”