A couple weeks ago we had women share their pandemic birth stories. Many new moms and dads are also having fears about what comes next during a pandemic. What about after birth?
After some searching, we found an excellent source that describes some of what your life may look like caring for a newborn during the coronavirus pandemic. See below for an excerpt from US News and World Report.
“As the information we gather about the virus and its presence in our communities grows, there are some additional planning measures to consider. Here are some tips to help prioritize newborn and parent safety and wisely manage the first few weeks at home:
Understanding the Coronavirus in Infants.
One of the fascinating trends throughout this pandemic is the consistent reporting that the novel coronavirus is causing limited illness in infants and children. This is remarkable because viral and bacterial illnesses typically cause aggressive disease in young children.
As a pediatrician and a parent, this news continues to provide reassurance and comfort. Physical distancing during essential visits, respecting community-directed stay-at-home orders, and vigilant hand hygiene remain the best ways to prevent illness in both our children and ourselves.
First Doctor Visit After Being Discharged Early From the Hospital
Many hospitals are allowing new parents to be discharged from the hospital earlier than is typically routine to lessen families’ potential exposure to COVID-19. Before discharge, all babies should still have procedures completed, including newborn lab work, hearing and cardiac screening, and medications that prevent complications (like eye ointment and vitamin K).
After leaving the hospital, however, it is important to remember that a baby’s physiology is changing rapidly during the first few days after birth. Heart defects, metabolic issues, growth failure and high jaundice levels are just a few significant issues that may not be detected until well beyond early hospital discharge. Follow-up appointments with a pediatrician are crucial during these early days to discover and manage these problems.
Rest assured that pediatric offices across the country have modified office procedures to allow safe newborn visits. Be sure to call your pediatrician to arrange follow-up before you leave the hospital. And expect to visit the pediatrician’s office more frequently, if directed to do so.
Breastfeeding
At this time, both the Centers for Disease Control and Prevention and the World Health Organization report that the novel coronavirus has not been found in breast milk. It is unclear, though, how infants are getting infected with the virus. Specifically, studies have been inconclusive regarding if the virus is passed from an infected mother before or during birth.
For mothers choosing to breastfeed, it is possible the virus can be spread through respiratory droplets from mom to babe during the act of breastfeeding. It is recommended that COVID-19-positive moms use meticulous hand hygiene and wear a mask or facial covering during close contact.
For mothers who are too ill to breastfeed or who require separation from their baby after birth due to illness, consultation with a lactation specialist is highly recommended to support feeding goals. Alternatively, a mother who has the coronavirus could choose to pump breast milk to feed her baby. Routinely sanitizing the pump parts remains important, and routine storage of the milk is suggested.
Visitors
It may seem that if an entire family has been isolating for weeks and is feeling well, a quick visit to another person’s home to meet a new baby might be OK. But the short story is, it’s not.
Asymptomatic infection remains a significant problem. For example, in hospitals in New York City where all pregnant people were tested for the virus when admitted for delivery, as many as 1 in 8 were positive for the virus and did not have any symptoms.
This is significant because it suggests the infection rate in certain communities is much higher than expected, including for those who are pregnant. It also reaffirms that people at greatest risk of death and dying from COVID-19 (grandparents) need to continue practicing physical distancing to avoid contracting the illness from an asymptomatic person. The decision to keep people from visiting the new baby is tough, but we must stand firm in the goal of protecting one another until it is deemed to be safe to relax such measures.
Early Development
Infants do not need “social time” for many weeks after birth. Early infant development is entirely dependent on interaction and attachment to parents. Although isolation is, well, isolating, don’t stress about how a lack of visitors or lack of interaction with other children could be negatively affecting early cognitive and social development for your newborn.
Tummy time, high-contrast cards and toys, getting outside to take a walk with appropriate distancing (babies should not wear a mask or facial covering when outside), singing and talking with your baby, and reading stories – these are the things that all infants need for secure early development and attachment. The good news is that all these things can be done at home and without any fancy devices, tricks or toys.
If Mom or Dad Are Sick
If a parent has any kind of symptoms that may could be caused by COVID-19, separating from other members of the household is suggested to prevent transmission. Since this virus is affecting individuals differently, it will be important to stay in touch with your doctor to establish an individualized plan for the care and feeding of your new infant should a parent become ill.
Maternal Mental Health
Especially during these days of unexpected and sustained stress, I urge new parents to begin addressing mental health well before the infant is born.
We know that maternal anxiety and stress have been shown to affect infants in the womb, so learning self-directed methods to reduce stress and anxiety should begin today. These may include exploring mindfulness or stress reduction exercises that work for you, connecting with an online support group or therapist, and working on better sleep practices.
In addition, preparing for postpartum mental health support should be part of every parent’s birth plan. This would include open dialog between partners regarding expectations for support and infant care, discussing with your OB the interventions that are available should your mental health suffer after your baby is born, and connecting with local therapists in your area who specialize in postpartum support.
Most therapists are still offering virtual appointments and group classes that can be accessed from the comfort of your home. You will be thankful to have these support anchors in place should help be urgently needed in the first few weeks after birth.
Vaccines
Keeping your child up to date on vaccinations remains critically important during this pandemic. Although it may “feel” safer to delay vaccines when stay-at-home orders are in place, lethal viral and bacterial diseases can still be spread by people who don’t have symptoms and vaccine-preventable illnesses are still circulating.
Your infant’s best defense against preventable illness continues to be routine vaccines. The hepatitis B vaccine should be offered prior to leaving the hospital. Your baby should get his or her first set of vaccinations between 6 to 8 weeks of life.
Your child’s pediatrician will be able to outline measures the office is taking to support social distancing and make the appointment safe for you and your child. Just call ahead to discuss your options.
Where to Turn for Help
Choosing to receive information and advice from reputable sources is critical as news on the coronavirus pandemic breaks and recommendations evolve. Up-to-date information for pregnant people and newborns can be found at cdc.gov, healthychildren.org and acog.org.
Use these sources routinely, but also be equally mindful of the needless stress that continuous connection with the news may bring. Take breaks from the news when needed and allow yourself to connect with your baby and partner, distraction-free, as much as you are able."
There were a couple articles out there about caring for your infant during this pandemic, but this one was well organized and informative. A special thanks to Dr. Natasha Burgert for contributing to this, as well.
For some general information on newborn protocol, check out our other two blog posts "What Should I Do Before Visiting a Newborn" and "Things to Remember When Visiting a Newborn".
We would also like to point out the sections discussing importance of recognizing early newborn complications and the focus on maintaining mental health. Hiring a baby nurse is something that can greatly help with both issues! Having a nurse in the home to recognize potential medical issues and relieve anxieties gives some peace of mind. Please contact us if this is something you feel would be a good fit for your family.
As always, like, comment, and share!
Jeri Ford, RN, BSN, CPN