As news of the novel coronavirus and illnesses related to COVID-19 spread across the United States, parents and soon-to-be parents are out to arm themselves with as much information as possible about the virus and how to keep themselves and their families healthy.
If you or your partner are pregnant or currently breastfeeding, you may have a bit of extra anxiety about how to keep yourselves and baby from exchanging germs or being exposed to anything scary. So, of course, while you’re practicing social distancing, encouraging loved ones to be militant hand-washers and regularly cleaning surfaces that might get germy, you may be more cautious about your environment and its effects on your immune system while pregnant.
To give the basics how to be proactive about coronavirus Jessica Madden, MD, Board-certified pediatrician and neonatologist (and soon-to-be International Board Certified Lactation Consultant (IBCLC) and Medical Director of Aeroflow Breastpumps), gave SheKnows the rundown on what we know so far about COVID-19, pregnancy and breastfeeding and some best practices for new parents to keep in mind.
SheKnows: What do we know so far about coronavirus and pregnancy? How might the virus affect pregnant women differently?
Madden: The physiologic and immune changes that women undergo during pregnancy lead to an increased risk of infections. For example, we know that pregnant women who get influenza are at an increased risk of getting viral pneumonia. Per early reports from China, pregnant women with COVID-19 do not appear to be at higher risk of complications, however, this might change as we get more information from cases during pregnancy in the U.S. and other countries.
As of now there are no reports of the virus being able to cross the placenta to affect babies during pregnancy (vertical transmission), nor are there any cases of babies contracting the virus during labor and delivery. There have been reports of a possible association between COVID-19 and preterm labor in China, but there are no other known pregnancy complications at the present time
SK: Are there any unique risks/vulnerabilities for pregnant people when it comes to coronavirus — particularly pregnant people in different age demos/with different conditions?
Madden: We do not currently have information in this regard outside of the possible association with prematurity. We do know that other viral illnesses, such as parvovirus and zika virus, are associated with pregnancy complications, including miscarriage, babies being small for gestational age, and a higher risk of moms needing hospitalized for complications during pregnancy.
There is a possibility than pregnant women who are “high-risk” due to problems such as pre-eclampsia and gestational diabetes may be at higher risk of COVID-19 related complications, but there have not been enough documented cases in pregnant women to come to conclusions in regards to this.
It’s really important that pregnant women who think they might have COVID-19, or have been exposed, contact their obstetrician or midwife for guidance on how to proceed. In addition, any pregnant woman with cough, fever, and shortness of breath should be evaluated in person ASAP.
SK: For folks who are breastfeeding are there any additional risks that need to be highlighted?
Madden: There are no known cases of COVID-19 being passed from mother to baby via breastmilk. Breast milk samples from Chinese mothers with coronavirus that have been tested have not found the virus in milk.
Breastfeeding helps to bolster your baby’s immune system and is one of the best ways that you can help prevent your baby from getting coronavirus. So at this time it’s recommended to continue breastfeeding, even if you have been exposed.
SK: If breastfeeding and you’re exposed to coronavirus what are the risks to baby?
Madden: The most important thing is to avoid exposing your baby to the virus. The CDC has published guidelines for breastfeeding when a mother has confirmed or suspected COVID0-19. The guidelines include all of the following:
- Wash your hands before touching and feeding your baby.
- Wear a mask while breastfeeding.
- If pumping, make sure to wash your hands before pumping and thoroughly clean pump parts after each pumping session.
- Consider having someone who is well feed your baby pumped milk.
SK: What can new moms/pregnant people to do to be proactive about their health and baby’s health amid coronavirus fears?
To protect yourself during pregnancy:
- Be diligent about practicing good hand hygiene. Wash your hands frequently, especially before eating and after being out in public.
- Do not come in close proximity with people who have been diagnosed with coronavirus and/or exposed to coronavirus. Limit contact with others who are currently sick (i.e. with a fever and cough). Consider avoiding places and gatherings with large crowds.
To protect your newborn:
- Wash your hands or use hand sanitizer every time you touch your baby.
- Limit visitors in the first few weeks after giving birth and make sure that people who have recently been sick and/or possibly exposed to COVID-19 do not visit. Visitors wearing masks will not be enough to protect a newborn from this virus.
- Breastfeed, if possible, to help bolster your baby’s immunity. Even partial breast milk will make a big difference in helping your baby to fight off infection!
- If you are pumping breast milk, make sure to clean and disinfect your pump and all parts before and after every use.
- Call you baby’s doctor if you have any concerns about his or her symptoms, including a fever, quick breathing, cough, and/or refusing to eat.
SK: Are there any pervasive myths/misinformation re: this topic you’ve seen that needs to be dispelled?
Madden: One myth is that pregnant women should avoid hospital births due to a risk of contracting the virus at a hospital. It’s important for pregnant women to continue to get regular obstetric care with their doctor or midwife, and continue to plan for a hospital delivery, especially if one’s pregnancy is “high risk.” Another myth is that babies cannot get the virus. While the chances of a newborn getting sick from the virus are low, there is a risk of community-acquired spread. Thus people who have recently been sick and/or might have coronavirus need to stay away from newborns. The third myth is that coronavirus is “just like the flu” and nothing to be worried about. This is a brand new virus to which none of us have immunity, there is not a vaccine available, and the fatality rates in all countries are higher than the rates for the seasonal flu.
SK: What is the one thing breastfeeding/pregnant moms really need to hear during health news events like this?
Madden: Whether or not you are exposed to coronavirus and/or get coronavirus, chances are that you and your baby are going to be okay. Thus far there have only been two newborn babies in China with documented coronavirus infection. Overall, the mortality rate for this virus is very low in infants, children, and women of child-bearing age compared to the elderly and other “at-risk” populations.
A version of this story was published March 5, 2020.