Care of newborns born to mothers with COVID-19 infection; a review of existing evidence

Abstract

Background

The novel Coronavirus disease 2019 (COVID-19) pandemic is already wreaking havoc on families and communities’ welfare. It is critical to discuss newborn care of infected mothers with COVID-19 based on the latest international guidelines and national guidelines of countries with the highest incidence of COVID-19 cases.

Objective

We discuss how to care for a newborn of a suspected or infected mother with COVID-19 using existing evidence.

Method

As of 16 April 2020, we reviewed articles and guidelines related to COVID-19 in the reproductive health field, mother, and newborn health. Our review yielded in 10 categories (i) the risk of diagnostic procedures in suspected mothers on fetus/infant health, (ii) the risk of intrauterine or postpartum transmission to the fetus/infant, (iii) appropriate method and delivery time in women with confirmed COVID-19, (iv) umbilical cord clamping and skin to skin contact, (v) clinical manifestations of infected infants, (vi) confirmation of infection in a suspected neonate/infant, (vii) instructions for infant’s care and how to feed her/him, (viii) bathing the baby, (ix) the criteria of discharging baby from the hospital, (x) the impact of isolation on the maternal mental health.

Results

Our findings showed that the possibility of intrauterine or perinatal transmission of COVID-19 is still questionable and ambiguous. However, what has been agreed upon in the existing texts and guidelines is that the close contact of mother and infant after birth can transmit the virus to the baby through droplets or micro-droplets.

Conclusions

Based on our findings, it is recommended to separate the baby from the mother with confirmed (or suspected) COVID-19 infection for at least 2 weeks. Since the motivation and stable situation of mothers allow breastfeeding during the isolation, infected mothers should be taught about breast expression skills, common breast problems, the symptoms of their baby’s infection, and the principles of personal hygiene to protect the infant against COVID-19 infection.

Keywords:

• Coronavirus Disease 19
• COVID-19
• Breastfeeding
• Pandemic
• Newborn Care

Acknowledgments

Special thanks to the Education Department and Midwifery team of Kamali Hospital in Karaj, Iran, for sending us the Iran’s Ministry of Health guideline on Breastfeeding and Neonatal Care in COVID-19 pandemic.

Author contributions

SSS designed the work and collected the relevant articles. SSS, and MEK, contributed to the review of articles, to draw conclusion and to write recommendations.

Disclosure statement

No potential conflict of interest was reported by the author(s).