Sensationalised, social hysteria, underestimated – Coronavirus (COVID-19) is well and truly at the forefront of media headlines, and everyone has an opinion.
Whatever your view on our current global health crisis, the reality is it’s a pandemic, and we can all agree babies are vulnerable and parents want to know how to minimise their risk.
Here is a Midwife’s advice about protecting your baby from COVID-19 and the recommendations of the World Health Organisation.
Prepare In-Home Postnatal Care Options
It is common for Hospital Midwives to visit you and your baby at home in the first 1-2 weeks after having a baby. They also visit several other families that day too, and have been caring for families in the hospital setting. Sometimes you may be asked to return to the hospital for a postnatal follow up.
Although caring for other families too, private practitioners are less likely to have been exposed to large numbers of people and at-risk environments. It’s certainly something to consider in protecting yourself and your family from COVID-19.
If your baby is not yet born, or born recently, you can arrange to have postnatal care privately with a Private Midwife, or breastfeeding specific support with an International Board Certified Lactation Consultant in your home. If living in Australia, these options often incur a Medicare rebate and have minimal out of pocket cost.
Keep Baby Close
Just when I thought the benefits of babywearing couldn’t get any more appealing, throw in a pandemic and voila, babywearing is a life-saver for families yet again.
If you must venture into public places, whether out of practical necessity or for your own sanity, babywearing with a stretchy wrap such as a Chekoh, woven wrap or a structured carrier will keep baby close.
This not only comforts babe, and leaves you hands free to reapply the hand sanitiser, it also limits exposure of baby’s face (respiratory system) and clothing; often almost fully enclosing their head into your chest… with room to breathe of course.
Limit Visitors & Social Outings
There’s a lot to be said for limiting visitors in the fourth trimester regardless, but in a time of global health crisis, this couldn’t be more crucial.
To be clear, I’m not talking about self-isolating here. Though it is advisable to avoid public places/events/gatherings unless absolutely necessary.
Fourth trimester conscious families all put their own spin on limiting visitors. Some tell their friends and family they are happy for visits at the hospital, but they’d like a few days at home to themselves. Some just have immediate family and closest friends visit (in delegated times) in the first week, and everyone else can wait. COVID-19 throws in a whole other element to this though.
Now is a time to seriously consider who will be visiting your brand new baby, if at all, and when.
You may be worried about offending people – don’t be. People are actually quite understanding when it’s pointed out to them that you need space, and they most certainly wont question you if you start the conversation with
“for [insert baby’s name]’s safety, we’ve decided to hold off visiting until…”
Personally, I see a lot of new parents struggle when they have lots of visitors in the first few days anyway, whether in hospital or at home. You’re tired, overwhelmed, learning and falling in love with your new baby, sore, disturbed by Midwives & Doctors wanting to check on you and baby, bothered by other women on the ward and their crying babies and noisy visitors.
Protecting the newborn weeks isn’t just about making it easier on you and babe and protecting your family’s health, it’s about setting yourselves up for better outcomes with bonding and breastfeeding too.
DO NOT kiss the baby, no snotty toddlers, don’t visit if you’ve had any mild symptoms of any sickness…
You’d think these are a given, but appropriate social etiquette around new babies seems to commonly be ignored.
If you are having visitors, be clear before your guests arrive about what is ok and what isn’t.
Though not COVID-19 specific, these are very important boundaries in protecting the health of your baby.
At this point in time, you may also wish to consider not allowing baby to be passed around for cuddles. Remember, keep them close! Cuddles with Mum and Dad are the only cuddles that can’t wait.
Practice Exceptional Hygiene
Ensure your hygiene practices are exceptional, and then amp it up a bit.
- Wash hands before touching/feeding baby.
- Utilise hand sanitiser regularly if you need to leave the house.
- Wash your hands when you return home.
- Wipe down frequently used house surfaces often – kitchen, bathroom, handles.
- Do not clean dummies with your mouth.
- Ensure any teats/dummies are sterilised appropriately.
Feeding Your Baby In A Health Pandemic
The World Health Organisation recommends immediate skin to skin and breastfeeding to begin within an hour of birth.
Breastmilk is full of antibodies and other immune properties that cannot be replicated in artificial formulas and so is very protective against infectious diseases.
Breastmilk composition also changes to suit a baby’s needs. If a mother is exposed to a virus, the breastmilk will adapt to combat it and provide extra immune protection.
This occurs through not only exposure of the mother’s immune system, but also through cross sampling between the baby’s saliva and the breastmilk, which is one reason why direct breastfeeding can be of more benefit than expressed breastmilk, particularly during a pandemic.
The World Health Organisation recommends direct breastfeeding as the most effective way to ensure child health and survival. If unable to directly breastfeed, the mother’s own expressed breastmilk is the advised nutrition, followed by donor breastmilk, followed by artificial formulas.
In situations where it is not possible to give baby your own breastmilk, and wish to access donor breastmilk, sites such as Human Milk 4 Human Babies can assist. Some mothers also source donor breastmilk from local social media groups.
It is illegal in Australia to sell or purchase breastmilk, so milk donations are free, though you may be asked to supply the mother with breastmilk storage bags so she can continue to donate to yourself or others.
Should I Wear A Face Mask?
If you are not symptomatic, and have not been diagnosed with COVID-19, you do not need to wear a face mask to be with your baby.
Parents of babies may wish to wear a face mask if they themselves are unable to avoid going in to a public place.
Though not an iron-clad guarantee you won’t contract COVID-19, face masks will provide some level of protection from droplet transmission.
What If I Need To Go To Hospital?
If you need to present to hospital and are breastfeeding, take your baby with you and continue feeding.
With regards to COVID-19, Le Leche League International advise:
“If someone who is breastfeeding becomes ill, it is important not to interrupt direct breastfeeding. The baby has already been exposed to the virus by the mother and/or family and will benefit most from continued direct breastfeeding.”
If you are encouraged by a health provider to be separated from baby and provide them expressed breastmilk, see below…
Do I Keep Breastfeeding If I’m Diagnosed With COVID-19? Should I Express?
The general consensus on this is a resounding YES, keep breastfeeding directly at the breast, you do not need to express. Mothers diagnosed with COVID-19 should wear a face mask whilst feeding their infant, avoid kissing, and practice good hygiene as above.
The World Health Organisation, Dr Thomas Hale (Medications & Mothers’ Milk) and Le Leche League International have all advised that it is in fact of most importance that direct breastfeeding continues during illness with COVID-19.
Disruption to direct breastfeeding can cause emotional trauma for mother and baby, reduction of milk supply, breast refusal due to the use of bottles, decreased protective immune factors for the baby and increased risk of becoming unwell (Le Leche League International, Coronavirus, 2020).
If disruption to direct breastfeeding is deemed medically necessary, expressing and giving baby the expressed milk is an option.
Can I Keep Breastfeeding If I’m Given Medication?
It is very unfortunate that women are commonly given misinformation regarding medications and breastfeeding, that leads to abrupt unnecessary weaning.
Though a mother may feel confident in her GP’s, psychologists’s or other health practitioner’s advice, it is important to remember these practitioners’ scope of practice often isn’t medication in breastfeeding.
If ever informed a particular medication isn’t safe for breastfeeding, it is recommended to confirm this prior to weaning.
One way to do this is to download the InfantRisk app. You can enter the name of the drug and the app will tell you if it is safe in the trimester of pregnancy you are in, or for breastfeeding. The InfantRisk app is aimed at ensuring safe pregnancy and breastfeeding when using medications and is based on the text book Medications & Mothers’ Milk by Dr. Thomas Hale.
If you live in Australia, another option to confirm whether or not your medication is safe to use whilst breastfeeding is to contact Dr Rodney Whyte – Senior Pharmacist, Monash Medicines Information, Monash Medical Centre / Australian Breastfeeding Association.
I myself have utilised Dr. Whyte’s wealth of knowledge on occasion and he is always obliging. His contact details can be found by a quick Google search.
Can I Travel With A Baby?
Travel restrictions, dispersed information and guidance, and knowledge about COVID-19 are rapidly developing. It is advised to avoid travel with a baby at this time, and follow your national Government’s updates regarding restrictions.
As a final note, it is important to remember, at the time of this article being posted, no deaths of babies due to COVID-19 have been reported. There are mixed feelings regarding the ‘hype’ of Coronavirus – whilst fear and panic are not conducive to the cause, neither is a laissez-faire approach. Babies are inherently vulnerable with regards to the transmission of any virus, and so their health should always be taken seriously. Parents should take a rational and active approach in the prevention of transmission and protection of their young infant’s wellbeing.
For further information regarding COVID-19, see the Centers for Disease Control and Prevention.