Mothers with COVID-19 Unlikely to Pass it to Their Newborns

In a small study looking at 120 mothers and their newborns, the former did not transmit the coronavirus 2019 (COVID-19) to the latter after 2 weeks of breastfeeding. All mothers committed to specific hygiene precautions, which required them to wear surgical masks while holding their newborns and they had to follow frequent hand and breast washing procedures.

Findings from the study were published in The Lancet.

“We know that skin-to-skin contact and breastfeeding are important both for mother-infant bonding and for long-term child health,” Patricia DeLaMora, MD, study coauthor said. “Our findings suggest that babies born to mothers with COVID-19 infection can still benefit from these safely, if appropriate infection control measures are followed.”

This was an observational study conducted in New York City within 3 hospitals.

For testing, all of the babies underwent a PCR test from a nasal swab within 24 hours of birth and none tested positive for COVID-19. Follow-up data was available for 82 babies after 5-7 days.

The majority of this group had been sharing a room with their mothers (83%, 68/82) and three quarters were still breastfeeding (78%, 64/82). Seventy-nine babies were tested for COVID-19 again after 5-7 days and 72 babies received a further test after 2 weeks of life. None of the results were positive and none of the babies showed symptoms.

While these results are promising, guidance from health organizations on this subject has been conflicting. Whereas the American Academy of Pediatrics advises mothers infected should be temporarily separated at birth with their newborns, the World Health Organization (WHO) and the Royal College of Obstetricians and Gynecologists recommend mothers should share a room with their newborns and breastfeed with appropriate precautions.

The Academy recommends these babies are fed expressed breastmilk until mothers are deemed to no longer be infectious according to certain clinical criteria.

The WHO and Royal College group believe the benefits of breastfeeding outweigh risks of COVID-19 transmission.

“Our data suggest that perinatal transmission of COVID-19 is unlikely to occur if correct hygiene precautions are undertaken, and that allowing neonates to room in with their mothers and direct breastfeeding are safe procedures when paired with effective parental education of infant protective strategies,” the investigators wrote.

Limitations to the study included the sample size, which draw firm conclusions and larger studies will be needed. In addition, almost one third of the newborns (38) were not followed-up. Investigators surmised that the parents’ fear of leaving their homes and using public transportation to attend clinic appointments in the midst of the pandemic was the reason behind that.