COVID-19 and birth: mums and babies should stay together

Two recent studies have evidenced the value of vaginal birth, breastfeeding and mother-baby contact, even when a woman has confirmed COVID-19. Not only are these safe, but they offer advantages and should be encouraged.

 

No increase in risk of infection

First, a systematic review showed that vaginal birth, breastfeeding and mother-baby contact do not increase the chance of a baby being infected with SARS-COV-2, even where a mother has confirmed COVID-19. (Walker et al 2020).

The authors of this study began by explaining why the research was needed.

“Early reports of COVID‐19 in pregnancy described management by caesarean, strict isolation of the neonate and formula feeding.” (Walker et al 2020).

So they asked the same question that many people involved in birth were asking. “Is this practise justified?” (Walker et al 2020).

If you’re thinking through the options for your pregnancy and birth, you might also enjoy my book on decision making: What’s Right For Me? Making decisions in pregnancy and childbirth.

They wanted to find out whether the chance of a baby being infected with SARS-COV-2 was affected by the mode of birth (vaginal birth or caesarean), the type of feeding and whether the mum and baby stayed together or not.

 

What the studies showed

A search of the medical literature for relevant studies was undertaken. The researchers found, “49 studies which included 666 neonates and 655 women where information was provided on the mode of delivery and the infant’s infection status.”

Their findings and conclusion?

“28/666 (4%) neonates had confirmed COVID‐19 infection postnatally. Of the 291 women who delivered vaginally, 8/292 (2.7%) neonates were positive. Of the 364 women who had a Caesarean birth, 20/374 (5.3%) neonates were positive.

Of the 28 neonates with confirmed COVID‐19 infection, 7 were breast fed, 3 formula fed, 1 was given expressed breast milk and in 17 neonates the method of infant feeding was not reported.

Neonatal COVID‐19 infection is uncommon, uncommonly symptomatic, and the rate of infection is no greater when the baby is born vaginally, breastfed or allowed contact with the mother.” (Walker et al 2020).

 

More evidence

The value of keeping mums and babies together in cases of COVID-19 was further confirmed in another paper published just a few days later. This one was by Thi Tran et al (2020). It is titled “Appropriate care for neonates born to mothers with COVID‐19 disease.”

“The global COVID‐19 pandemic has been associated with high rates of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) transmission, morbidity and mortality in the general population. Evidence‐based guidance on caring for babies born to mothers with COVID‐19 is needed. There is currently insufficient evidence to suggest vertical transmission between mothers and their newborn infants. However, transmission can happen after birth from mothers or other carers. Based on the currently available data, prolonged skin‐to‐skin contact and early and exclusive breastfeeding remain the best strategies to reduce the risks of morbidity and mortality for both the mother with COVID‐19 and her baby.” (Thi Tran et al 2020).

References

Tri Tran H, Thi Kim Nguyen P, Thi Li H et al (2020). Appropriate care for neonates born to mothers with COVID‐19 disease. British Journal of Obstetrics and Gynecology https://doi.org/10.1111/apa.15413

Walker KF, O’Donoghue K, Grace N et al (2020). Maternal transmission of SARS‐COV‐2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis. British Journal of Obstetrics and Gynecology https://doi.org/10.1111/1471-0528.16362

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