By Sara Baird, MD
With how things are with COVID-19 today, many parents will naturally worry about how their children may be impacted and what preventative measures can be taken. Particularly, those with newborns or infants may be wondering how to keep their child safe and healthy as they continue to grow at home.
I get it – I’m a parent of two young kids (and I’m a PEPS alumnus x 2!) and the safety of my kids is a top priority.
Below are answers to some common concerns that parents with newborns may have, and some of the steps I’m taking to protect me, my family, and the community.
How dangerous is COVID-19 for my infant?
From what we’ve seen so far, most children infected with coronavirus have a much milder form of the illness, or have no symptoms at all. In the largest pediatric study to date, only 6% of children had severe symptoms, compared to 18% of adults. Why is coronavirus milder in kids? There are a few hypotheses, but we don’t know the reason yet.
Even though infants and kids are more likely to have mild symptoms, we should still be careful, especially with newborns and infants under 1 year old. Newborns are still building up their immune system and lack the same defenses as older children.
How do I tell the difference between COVID-19 and a regular cold?
This is hard! Children and newborns are more likely to be asymptomatic or only have mild symptoms such as fever, dry cough, or fatigue. They might also have a runny or stuffy nose. When newborns are sick, you may only notice poor feeding or fussiness.
Sound familiar? Parents of toddlers are probably thinking, my kid has had a runny nose for the last 18 months!
Unfortunately, if your child has any symptoms – it’s better to play it safe. Keep them away from anyone outside the household, and even consider dividing up your living space to have a “clean” and “dirty” zone – especially if anybody is at higher risk.
And of course, if you’re worried that they are too sick – call the doctor. Avoid visiting the emergency room or an urgent care center unless instructed by your doctor (if you’re having a true emergency, call 911).
How do I protect my infant from getting COVID-19?
So far, it looks like most kids get infections from family members. So the best thing you can do is protect yourself.
You can help prevent transmission to both you and your infant by following these tips:
- Limit visitors: Your family and friends may all want to meet the new baby, but it’s ok to say no. Decide who is in your small “circle” of contacts and let them help you at home. Let others know it’s just not safe for them to visit right now.
- Practice social distancing: I prefer to call this “physical distancing.” You can still be social (more about this later), but you might have to say no to people. Ultimately, you want to limit your exposure by keeping your “circle” as small as possible. You may be able to have “no-contact” playdates outside – coordinate with other families. All of this is hard!
- Increase cleaning: Washing your hands for 20 seconds is most effective, but when you are outside without access to a sink, use an alcohol-based hand sanitizer anytime you touch a potentially contaminated surface. Wash your hands every time you come inside the house, and before close contact with your infant. Consider cleaning the infant’s toys and tableware regularly (some people recommend boiling water or dilute bleach, but I prefer soap and hot water). Avoid touching your face.
- Continue breastfeeding: The CDC encourages mothers to continue breastfeeding, if possible. Studies have not shown evidence of coronavirus transmission through breast milk. If using a breast pump, be sure to thoroughly clean the pump before and after use.
Can they still see their grandparents?
You want to protect both your kids and your parents (their grandparents). Depending on your risk of infection, and their risk factors, you may want to avoid visiting or having them visit. If you need your parents involved (for reasons of childcare, sharing a household, etc), it’s extra important to take your own steps to limit infection to help keep everyone safe.
As a doctor seeing patients in a clinic, even though I am careful, my risk of infection is higher. We also have babysitters, which increases the number of people in our “circle.” We’ve made the difficult decision not to see the grandparents, for now. Although this is hard, our family has been using free programs like Zoom and Facetime, and we talk to them almost every day. You have to make the decision that works best for your family.
What if I am pregnant now?
There is a lot we don’t know about coronavirus and pregnancy – our experience is still pretty limited. So far, babies have been born healthy, and although some newborns have tested positive, we don’t know if they got infected during pregnancy or after birth. The best thing you can do if you are pregnant is take precautions to avoid getting sick. But if you do get sick, call your provider to talk about next steps. We will learn more about how coronavirus affects pregnancy as time goes on.
The coronavirus outbreak may affect your birth plan. Already, some hospitals and birth centers are forced to limit the number of support people allowed in the building. You will still be taken care of! These are extraordinary times, and remember that even if it’s not the birth plan you would have wanted, these policies are to protect the health and safety of you, your newborn, and all the staff and other patients of the hospital. I don’t know what policies will be in place for the next few weeks – talk to your pregnancy care provider (family doctor, midwife, or obstetrician) about what to expect.
What about well-child checkups?
Understandably, you may be worried about taking your child into the clinic for their well-child checkup during this time. The American Academy of Pediatrics currently advises that pediatricians continue with the important immunizations to protect your child, while balancing the potential risk of exposure. As a result, pediatricians may be isolating specific rooms for well-visits, only taking well-visits at a particular time of day, or other precautions. Every pediatrician may be taking different measures from the next, and this also depends on the age of your kids. It’s best to call to find out what your doctor recommends.
How to cope with social distancing with a newborn
Caring for a newborn is already a stressful and trying time for parents. With the latest calls in social distancing and staying at home, it can be much more overwhelming and isolating. Social and emotional support for parents of newborns are critical and not having support has been associated with an increased risk of postpartum depression.
Below are some tips to ensure you and your baby are staying healthy, both physically and emotionally:
- Pay attention to your own needs: Your health and well-being is as important as your child’s. Rest as much as you can (everyone says “try sleeping when the baby does” – which seems next to impossible – but truly… nap as much as you can!). Make time for yourself when your partner watches the baby and give a friend or family member a call, catch up on your favorite TV show, relax with a cup of tea, or… sleep!
- Stay connected: You may not be able to have your family or friends over, but staying connected through phone calls or video chats is particularly important in this current situation. Your support system can be your emotional beam to lean on during these trying times, especially when caring for your newborn can sometimes feel like too much.
- Have “physical distancing” dates: Especially as the weather improves, find ways to connect with people both safely and in-person. Go for a walk! Sit outside together! Exercise! You can find ways of doing all these things while respecting the recommended 6 foot boundary.
- Let others help you: Even if you can’t have visitors, there may be ways someone can help! For example, let them drop off groceries or other supplies on your front porch. They can wave hello from a safe distance! Feel like you need more support – let them know and tell them what they can do! For example, scheduled phone dates.
- Seek online support groups: You may not be seeing as many people as you are used to, but by no means are you alone. Online communities built on support for families with newborns are just a quick Google or Facebook search away. There are tens of thousands of parents who are going through what you are and can serve as a sounding board and support system, in addition to your family and friends.
In addition to PEPS virtual groups, here are some examples:
- Smart Patient’s Postpartum Community: https://www.smartpatients.com/partners/ppd
- The Fussy Baby Site Support Group on Facebook: https://www.facebook.com/groups/fussybabysite
Looking for more help?
This is a stressful time and it’s ok to feel scared. It is scary! If you feel overwhelmed, there is help available.
- Perinatal Support Washington Warm Line: https://perinatalsupport.org/for-parents/warm-line
- Postpartum Support International: https://www.postpartum.net
We are experiencing a global event unlike anything we have seen in our lifetime – and it may feel scary. We can feel scared, but we are also strong, and we will adapt as we all learn how to live in this “new normal” together. Reach out to others, and find ways of connecting – use technology!
Need access to the internet? Comcast is offering free internet service, for a limited time, to eligible families and individuals. The City of Seattle also has a list of resources for those who need information about rent, food, childcare, domestic violence, and others.
And, be sure to check out this comic that you can use to talk to your (older) kids about coronavirus.
About the Author
Sara Baird, MD is a family physician and mother of two, who works and lives in the Seattle area. Many thanks to Jonathan Hong and Martin Keil, UC San Diego medical students, who helped write this article.