Taking Care of Newborns during Cold, Flu and COVID-19 Season

mom breastfeeding during covid

Entering cold and flu season is always an unnerving time for pregnant women and new moms, but this year it’s amplified by the COVID-19 pandemic. This winter is especially stressful with fears surrounding getting sick with coronavirus and has left many new moms wondering what will happen if they get sick before or after giving birth, if the baby can get sick from breastmilk, and whether or not it’s safe to get the COVID-19 vaccine while breastfeeding. Let’s dive into these concerns below.

Can newborns contract COVID-19?

According to the American Academy of Pediatrics’ Perinatal COVID-19 registry (which includes data on over 5000 mother-baby dyads) most women who have COVID-19 during late pregnancy, labor, and delivery, do not pass the virus to their newborn. If the mother does pass the virus to their baby during or after birth, it appears most newborns do not get seriously ill.

However, due to community spread, newborns are at risk of contracting the virus after they are born, especially after going home from the hospital. COVID-19 symptoms too look out for in babies are similar to symptoms of RSV and other fall/winter respiratory viruses, like influenza, including fever, pneumonia (infection in the lungs), bronchiolitis (inflammation in the airways), lethargy and fatigue, vomiting, and poor feeding.

How can I protect myself and my newborn from all cold and flu viruses this winter, including COVID-19?

While it may be difficult, it’s important to limit visitors during the newborn period, especially those who have recent been sick or are exhibiting symptoms of COVID-19.

Additionally, if you or any other members of your household have been exposed to the virus, consult with your doctor and get tested if recommended. If anyone tests positive for COVID-19 and/or is symptomatic, it’s recommended to always wear a mask (if over the age of two) and maintain distance from your baby when possible until fully recovered. The same precautions should be taken if coming down with a cold or flu. Any sick household member should maintain distance from newborns to prevent them from getting sick.

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Can I breastfeed if sick?

Yes, you should continue breastfeeding your baby if possible. Breastmilk is full of immune proteins and antibodies that can protect your baby against getting sick with viruses, including influenza, common cold viruses and COVID-19. Recent research shows that IgA antibodies against SARS-CoV-2, the virus that causes COVID-19, are found in the breastmilk of moms who have, or have recently had, COVID-19, and can be passed to babies during feeding. It’s important to note that even if you can only provide breastmilk for a short time, this will still protect your baby more than not getting any milk at all.

If you have symptoms of COVID-19 and/or test positive for the virus, in order to safely breastfeed you should wash your hands before touching your baby and wear a mask at all times around your baby until you are no longer infectious. As of the writing of this article, there are no documented cases of infants getting COVID-19 from their moms’ milk, so most pregnancy and pediatrics experts recommend that mothers with the virus continue to breastfeed.  

If you are pumping and bottle feeding your baby breastmilk, it’s crucial to practice meticulous hygiene right now. Wash your hands before and after every pumping session, wash and sanitize all pump parts after every pumping session, and make sure that expressed breast milk is handled and stored properly and safely.

Additionally, if visitors from outside of your household will be bottle feeding your baby pumped milk or formula, make sure they are not currently ill, have not had recent exposure to or tested positive for COVID-19, and that they always wash their hands and wear face masks when handling the baby to provide an additional layer of protection.

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Can I get the COVID-19 vaccine while breastfeeding?

As it stands, all other vaccines, except those for smallpox and yellow fever, are safe to get while breastfeeding, and can provide protection to newborns from viruses, like influenza, through IgA antibodies passing from moms to babies through breast milk. With this in mind, the American College of Obstetricians and Gynecologists (ACOG), the Academy of Breastfeeding Medicine (ABM), and the CDC all declared that women who are breastfeeding can get the new COVID-19 vaccine.

According to a recent statement from the ABM, “Antibodies and T-cells stimulated by the vaccine may passively transfer into milk. Following vaccination against other viruses, IgA antibodies are detectable in milk within 5 to 7 days. Antibodies transferred into milk may therefore protect the infant from infection with SARS-CoV-2.”

Having a baby in the middle of a pandemic can be very stressful but know that it’s ok to make the decisions that are best for you and your family. Don’t feel pressured to do anything you’re not comfortable with, follow guidance from your healthcare provider, CDC and public health officials and remind yourself that this will all come to an end soon!

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Jessica Madden, MD, is the Medical Director at Aeroflow Breastpumps, and she is a board-certified pediatrician and neonatologist who has been taking care of newborn babies for over 15 years. She is currently on staff in the neonatal intensive care unit (NICU) at Rainbow Babies and Children’s Hospital in Cleveland, Ohio, and has experience working in NICUs in the Boston Children’s Hospital and Cleveland Clinic Children’s Hospital networks. Dr. Madden provides in-home newborn medicine and lactation support through Primrose Newborn Care, a small business that she opened in 2018. In her free time, she enjoys traveling, yoga, reading, and spending time with her four school-aged children.

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