Can a mother breastfeed if she is positive? What are the symptoms of a newborn baby infected with the new coronavirus? Experts say...

Recently, with the optimization and adjustment of the national COVID-19 prevention and control policies, the issue of breastfeeding for newborns has attracted the attention of many people. So, can "Bao Ma" breastfeed after being infected with the new coronavirus? How to prevent newborns from being infected with the new coronavirus? What should mothers who are positive for the new coronavirus pay attention to when breastfeeding? Can newborns take antipyretics when they have a fever after being infected with the new coronavirus? Focusing on these hot issues, the scientific rumor-busting new media team invited Zhou Li, chief physician of Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University, to provide scientific interpretations.

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01

Pregnant women infected with the new coronavirus

Will the baby be infected?

"Among newborns born to mothers who are COVID-19 positive, the vast majority are not infected and are in good condition at birth, and only a small number of newborns have mild symptoms of infection. Studies have shown that maternal vaccination may have a certain protective effect on newborns." Zhou Li introduced that there are two main ways for newborns to be infected with the new coronavirus: vertical transmission and horizontal transmission. The scope of vertical transmission includes intrauterine, delivery or early postnatal. Some studies at home and abroad have not detected the new coronavirus in the vaginal swabs of mothers who are COVID-19 positive, indicating that vaginal delivery is safe. Horizontal transmission is mostly due to contact with positive mothers or other caregivers after birth, which is the main route of infection for newborns. According to the time of infection, it can be further divided into early-onset infection (1 week after birth) and late-onset infection (2-4 weeks after birth).

02

Mother suspected or confirmed to be infected with the new coronavirus

Can I continue breastfeeding?

Zhou Li said that if the mother is suspected or confirmed to be infected with the new coronavirus, it is not an absolute contraindication to breastfeeding. She mentioned that most research results show that no new coronavirus nucleic acid is detected in the breast milk of mothers who are positive for the new coronavirus. So far, there is no literature report that the new coronavirus can be transmitted to newborns through breast milk, so there is no reason to avoid or stop breastfeeding. "Some studies have found that antibodies specific to the new coronavirus are found in breast milk samples, indicating that breastfeeding has a certain protective effect on preventing newborns from being infected with the new coronavirus." Zhou Li added.

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03

Breastfeeding by COVID-19 positive mothers

What should I pay attention to?

Zhou Li pointed out that if the mother is diagnosed with COVID-19 and still wants to breastfeed, she can breastfeed. However, because COVID-19 is a contact infection, mainly transmitted through the respiratory tract, if protection is not in place, face-to-face breastfeeding between mother and baby will pose a risk of respiratory transmission. Bottle feeding does not directly contact the baby, which can prevent infection.

Zhou Li reminded that if the mother wants to breastfeed herself, she should try to avoid transmitting the virus to the baby through close contact. Wash your hands with soap or hand sanitizer before contacting the baby; wear a medical mask strictly when in contact with the baby; pay attention to cleaning and disinfecting the surface of objects that the mother has touched.

If the mother has two negative nucleic acid tests (24 hours apart), or has no fever for more than 3 days and no clinical symptoms, and directly breastfeeds, the risk of neonatal infection is low. In addition, it is not recommended for breastfeeding mothers to stop breastfeeding after receiving the new coronavirus vaccine.

"The many benefits of breastfeeding far outweigh the possible transmission and illness risks associated with the new coronavirus," said Zhou Li.

04

How to prevent newborns from being infected with the new coronavirus?

Zhou Li pointed out that whether it is the original strain with relatively strong virulence, Delta, or the current Omicron, the rate of newborns developing pneumonia and developing severe illness is lower than that of adults. Currently, there is no newborn vaccine coverage, but since the risk of newborns being exposed to infection is relatively low and the symptoms are milder, young parents do not need to be overly anxious and can just do a good job of daily protection.

She suggested that newborns should avoid going to closed, poorly ventilated public places or places where crowds gather; reduce the number of visitors at home, and pay attention to ventilation and cleaning and disinfection; caregivers must strictly maintain hand hygiene when contacting newborns, wear masks, avoid exhaling on newborns or kissing babies, and reduce close contact transmission and droplet transmission.

05

Newborns infected with COVID-19

What are the symptoms?

Zhou Li said that a considerable number of neonatal infections are asymptomatic. Due to the physiological characteristics of newborns, the clinical manifestations of neonatal infections are diverse, and their symptoms may be atypical and difficult to identify. Taking the currently prevalent Omicron strain as an example, from the perspective of neonatal novel coronavirus infection cases at home and abroad, the clinical symptoms of neonatal infection cases are mostly mild, the fever does not last long, and they generally recover quickly within 3 to 5 days. Some are accompanied by coughing, vomiting, poor feeding, and diarrhea.

"If you find that a newborn has difficulty breathing, rapid breathing, cyanosis (purple lips and nails), unclear consciousness, or the baby is unwilling to breastfeed, you need to seek medical attention or help from professional medical staff in time," Zhou Li emphasized.

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Newborns develop fever after being infected with the new coronavirus

Can I take antipyretic medicine?

Zhou Li said that newborns cannot take antipyretics, as they are prone to liver, kidney and gastrointestinal damage. Physical cooling methods are recommended. For example, less wrapping and less clothing can be used to cool down the baby; or bathing or sponging. Parents can use warm water towels to wipe the baby's forehead, neck, palms, soles of feet, etc., but do not use alcohol to wipe the body of the newborn. In addition, nursing care needs to be strengthened, and water and fluids should be given in time.

"The use of medication for newborns is a very professional job. Parents should not use medication for them without authorization. If you encounter serious conditions, you must consult a doctor. If necessary, go to the neonatal or pediatric department of the hospital in time." Zhou Li specially reminded.

Author | Zhong Yanping

Review | Zhang Liwen Director of the Department of Obstetrics and Gynecology, the Fifth Affiliated Hospital of Fudan University

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