COVID-19 INFO

INFORMATION FOR NEW MOMS:

The recent outbreak of COVID-19 can create some fear and insecurities for moms trying to stay healthy and continue to breastfeed.

Can moms transmit COVID-19 by breastfeeding their infants?

The Center for Disease Control and Prevention reports that the virus has not been found in the breast milk of women with COVID-19 but antibodies to fight it have been found. The CDC states that breastmilk provides protection to many illnesses and encourage women to continue to breastfeed.

[a] La Leche League International is encouraging women who have become infected, not to interrupt breastfeeding. They state in an exposure situation, “The baby has already been exposed to the virus by the mother and/or family and will benefit most from continued direct breastfeeding.

[b] Symptomatic mothers well enough to breastfeed should wear a mask when near her child (including during feeding), wash hands before and after contact with her child (including feeding), and clean/disinfect contaminated surfaces.

If a mother is too ill to breastfeed, she should be encouraged to express milk that can be given to the child via a clean cup and/or spoon – while wearing a mask, washing hands before and after contact with the child, and cleaning/disinfecting contaminated surfaces.

The World Health Organization (WHO) offers guidance and other information on coronavirus in multiple languages on their website. UNICEF also provides information for breastfeeding through COVID-19 infection.

[a] Coronavirus Disease 2019 (COVID-19). CDC website: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-faq.html. Published March 6, 2020. Retrieved March 8, 2020.

[b] Continuing to Nurse Your Baby Through Coronavirus (2019-nCoV; COVID-19) and Other Respiratory Infections. La Leche League International Web Site: https://www.llli.org/coronavirus/. Published February 19, 2020. Retrieved March 8, 2020.

 

Coronavirus while pregnant or giving birth: here’s what you need to know – 

Having a baby is stressful enough without a coronavirus (COVID-19) pandemic and all the associated misinformation.
.
As COVID-19 is a new virus, we are learning more about it every day. As most pregnant women are young and generally healthy, they’re less likely to be severely affected (which is good news). But as there is also a baby to consider, the picture can be more complex.
.
A baby born recently to a mother in the UK with COVID-19 recently tested positive soon after birth but we are not sure whether it was infected in the womb (unlikely) or after birth (more likely).
.
As far as we know, the baby is fine and the mother is being treated. Other reports on babies with COVID-19 have also shown they had mild symptoms and a good recovery.
.
If you’re pregnant and/or due to give birth soon, it’s best to get information from trusted sources such as the World Health Organization, the Royal College of Obstetricians and the Australian Government Department of Health.
.
http://theconversation.com/coronavirus-while-pregnant-or-gi…

 

Are pregnant women more vulnerable to COVID-19? 

The United Nations Population Fund states that, to date, there is no scientific evidence about the increased susceptibility of pregnant women to COVID-19.

They went on to state, however, that “pregnancy brings physical changes that might make some pregnant women more susceptible to viral respiratory infections. Pregnant women with respiratory illnesses must be treated with the utmost priority due to increased risk of adverse outcomes.” If a woman suspects she has symptoms of COVID-19, she should contact her physician for advice.

http://theconversation.com/coronavirus-while-pregnant-or-gi…

 

Should pregnant women take different or additional precautions than the general population? 

The United Nations Population Fund recommends pregnant women take the same preventive actions to avoid infection recommended for all adults.

This includes avoiding close contact with anyone who is coughing and sneezing, washing hands often with soap and water or alcohol-based hand rub, covering mouth and nose with a tissue or elbow when coughing and sneezing, and thoroughly cooking meat and eggs.

Recommended actions are available on the WHO website.

 

Can women transmit the virus to their preborn babies? 

Transmission between mom and preborn baby has not been shown to date.

One recent study with a small sample size documented pregnant woman diagnosed with COVID-19 found no evidence for vertical transmission in late pregnancy.[3]

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

 

Will I be able to breastfeed my baby if I have suspected or confirmed coronavirus?

Yes. At the moment there is no evidence that the virus can be carried in breastmilk, so it’s felt that the well-recognized benefits of breastfeeding outweigh any potential risks of transmission of coronavirus through breastmilk.

The main risk of breastfeeding is close contact between you and your baby, as you may share infective airborne droplets, leading to infection of the baby after birth.

A discussion about the risks and benefits of breastfeeding should take place between you and your family and your maternity team.

This guidance may change as knowledge evolves.

If you choose to breastfeed your baby, the following precautions are recommended:

  • Wash your hands before touching your baby, breast pump or bottles
  • Try and avoid coughing or sneezing on your baby while feeding at the breast.
  • Consider wearing a face mask while breastfeeding, if available
  • Follow recommendations for pump cleaning after each use
  • Consider asking someone who is well to feed expressed breast milk to your baby.

If you choose to feed your baby with formula or expressed milk, it is recommend that you follow strict adherence to sterilization guidelines. If you are expressing breast milk in hospital, a dedicated breast pump should be used.

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

 

What action should a pregnant or breastfeeding woman take if she suspects she has become infected with COVID-19?

The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recommend that those with symptoms of fever, cough, shortness of breath stay home and call a healthcare provider for advice. Also, they recommend those who have been in close contact with a person known to have COVID-19 or have recently traveled from an area with ongoing spread of COVID-19 contact their medical providers for recommendations.

It’s important that patients call in advance before going to a doctor’s office or emergency room to tell them about any recent travel and symptoms. This will allow the health care provider to direct patients to the right health facility to prevent the spread of this virus and other infections within clinics and hospitals.[6]

[6] Coronavirus Disease 2019 (COVID-19). CDC Web Site: https://www.cdc.gov/coronavirus/2019-ncov/about/share-facts.html. Published March 6, 2020. Retrieved March 8, 2020.

 

What should I do if I think I may have coronavirus or been exposed?

If you are pregnant and you have either:

  • a high temperature
  • a new, continuous cough

You should stay at home for 7 days. Do not go to a GP surgery, pharmacy or hospital. You do not need to contact 8-1-1 Healthlink BC  to tell them you are staying at home.

You should contact the maternity unit looking after your pregnancy to inform them that you have symptoms suggestive of coronavirus, particularly if you have any routine appointments in the next 7 days.

You should use the online coronavirus service, or call 8-1-1 Healthlink BC:

 

Will being in self-isolation for suspected or confirmed coronavirus affect where I give birth?

As a precautionary approach, pregnant women with suspected or confirmed coronavirus when they go into labour, are being advised to attend an obstetric unit for birth, where the baby can be monitored using continuous electronic fetal monitoring, and your oxygen levels can be monitored hourly.

The continuous fetal monitoring is to check how your baby is coping with labour. As continuous fetal monitoring can only take place in an obstetric unit, where doctors and midwives are present, it is not currently recommended that you give birth at home or in a midwife led unit, where only midwifes would be present.

We will keep this advice continually updated as new evidence emerges.

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

 

Will being in self-isolation for suspected or confirmed coronavirus affect how I give birth?

There is currently no evidence to suggest you cannot give birth vaginally or that you would be safer having a caesarean birth if you have suspected or confirmed coronavirus, so your birth plan should be followed as closely as possible based on your wishes.

However, if your respiratory condition (breathing) suggested that urgent delivery would be needed, a caesarean birth may be recommended.

There is no evidence that women with suspected or confirmed coronavirus cannot have an epidural or a spinal block. However, the use of Entonox (gas and air) may increase aerosolization and spread of the virus, so your maternity team will discuss all the options with you in early labour to ensure you are aware of the pain relief options available to you.

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

 

What happens if I go into labour during my self-isolation period?

If you go into labour, you should call your maternity unit for advice, and inform them that you have suspected or confirmed coronavirus infection.

If you have mild symptoms, you will be encouraged to remain at home (self-isolating) in early labour, as per standard practice.

Your maternity team have been advised on ways to ensure you and your baby receive safe, quality care, respecting your birth plan as closely as possible.

When you and your maternity team decide you need to attend the maternity unit, general recommendations about hospital attendance will apply:

    • You will be advised to attend hospital via private transport where possible, or call 111/999 for advice as appropriate
    • You will be met at the maternity unit entrance and provided with a surgical face mask, which will need to stay on until you are isolated in a suitable room
    • Coronavirus testing will be arranged
    • Your birth partner(s) will be able to stay with you throughout, but visitors should be kept to a minimum

 

Could I pass coronavirus to my baby?

As this is a new virus, there is limited evidence about managing women with coronavirus infection in women who have just given birth; however, there are no reports of women diagnosed with coronavirus during the third trimester of pregnancy having passed the virus to their babies while in the womb

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

 

Will I be able to stay with my baby/give skin-to-skin if I have suspected or confirmed coronavirus?

Yes, if that is your choice. Provided your baby is well and doesn’t require care in the neonatal unit, you will be kept together after you have given birth.

There are some reports from China which suggest women with confirmed coronavirus have been advised to separate from their baby for 14 days. However, this may have potential negative effects on feeding and bonding.

A discussion about the risks and benefits should take place between you and your family and the doctors caring for your baby (neonatologists) to individualize care for your baby.

This guidance may change as knowledge evolves.

https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/