Breastfeeding and Caring for Newborns if You Have COVID-19

We still have much to learn about the risks of COVID-19 for newborns of people with COVID-19, however we do know these facts:

• Although the absolute risks are low, people who are pregnant or recently pregnant are more likely to get severely ill from COVID-19 compared with people who are not pregnant. People who have COVID-19 during pregnancy are also more likely to give birth early and experience a stillbirth.
• Most newborns of people who had COVID-19 during pregnancy do not have COVID-19 when they are born.
• Some newborns have tested positive for COVID-19 shortly after birth. We don't know if these newborns got the virus before, during, or after birth.
• Most newborns who tested positive for COVID-19 had mild or no symptoms and recovered. Reports say some newborns developed severe COVID-19 illness.

Caring for your newborn in the hospital if you have COVID-19

Current evidence suggests that the chance of a newborn getting COVID-19 from their birth parent is low, especially when the parent takes steps (such as wearing a mask and washing hands) to prevent spread before and during care of the newborn.

Decide if your newborn is rooming-in with you in the hospital.

Talk to your healthcare provider about the risks and benefits of having your newborn stay in the same room with you. Having your newborn stay in the room with you has the benefit of making breastfeeding easier, and it helps with parent-newborn bonding.

Take precautions if your newborn is rooming-in with you in the hospital.

If you are in isolation for COVID-19 and are sharing a room with your newborn, take the following steps to reduce the chance of spreading the virus to your newborn:

• Wash your hands with soap and water for at least 20 seconds before holding or caring for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Wear a mask whenever you are within 6 feet of your newborn.
• Keep your newborn more than 6 feet away from you as much as possible.
• Talk to your healthcare provider about how you can protect your newborn, such as using a physical barrier (for example, placing the newborn in an incubator) while in the hospital.

When your isolation period has ended, you should still wash your hands before caring for your newborn, but you do not need to take the other precautions. You most likely will not pass the virus to your newborn or any other close contacts after your isolation period has ended.

• If you had symptoms, your isolation period ends after:
  • 10 days since symptoms first appeared, and
  • 24 hours with no fever, without fever-reducing medicine, and
  • Other symptoms of COVID-19 are improving.
• If you never had symptoms, your isolation period ends after
  • 10 days have passed since you tested positive for COVID-19.

These timeframes do not apply if you have a severely weakened immune system or were severely ill with COVID-19. Please refer to "When you can be around others after you had or likely had COVID-19 " and consult with your health care professional about when it is safe for you to end your isolation period.

Caring for your newborn at home if you have COVID-19

If you are in isolation for COVID-19, take the following precautions until your isolation period has ended:

• Stay home to separate yourself from others outside your home.
• Isolate (stay away) from other household members who are not infected, and wear a mask in shared spaces.
• Have a healthy caregiver who is fully vaccinated and not at higher risk for severe illness provide care for your newborn newborn (see recommendations below).
  • Follow recommended precautions if you must care for your newborn before your isolation period has ended.

Recommended precautions for healthy caregivers helping care for newborns:

• Caregivers should wash their hands for at least 20 seconds before touching your newborn. If soap and water are not available, they should use a hand sanitizer with at least 60% alcohol.
• If the caregiver is living in the same home or has been in close contact with you and is not yet fully vaccinated for COVID-19, they might have been exposed.
  • People who have come into close contact with someone with COVID-19 should be tested to check for infection:
    • Fully vaccinated people should be tested 5-7 days after their last exposure.
    • People who are not fully vaccinated should get tested immediately when they find out they are a close contact. If their test result is negative, they should get tested again 5-7 days after their last exposure or immediately if symptoms develop.
• They should wear a mask when they are within 6 feet of your newborn for the entire time you are in isolation, and during their own quarantine after you complete your isolation.

If a healthy caregiver is not available, you can care for your newborn if you are well enough.

• Wash your hands with soap and water for at least 20 seconds before touching for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Wear a mask when within 6 feet of your newborn and other people during your entire isolation period. The mask helps prevent you from spreading the virus to others.

• Others in your household, and caregivers who have COVID-19, should isolateand avoid caring for the newborn as much as possible. If they have to care for the newborn, they should follow hand washing and mask recommendations above.

Once yourisolation period has ended, you should still wash your hands before caring for your newborn, but you don't need to take the other precautions. You most likely won't pass the virus to your newborn or any other close contacts after your isolation period has ended.

• If you had symptoms, your isolation period ends after:
  • 10 days since symptoms first appeared, and
  • 24 hours with no fever without fever-reducing medicine, and
  • Other symptoms of COVID-19 are improving
• If you never had symptoms, your isolation period ends after
  • 10 days have passed since you tested positive for COVID-19.

These timeframes do not apply if you have a severely weakened immune system or were severely ill with COVID-19. Please refer to "When you can be around others after you had or likely had COVID-19" and consult with your health care professional about when it's safe for you to end your isolation period.

Monitor your newborn for COVID-19 symptoms.

If your newborn has one or more of these signs or symptoms, they may have early symptoms of COVID-19 or another illness, and you should contact your healthcare professional.

• Fever (a temperature of 100.4 or higher is considered an emergency)
• Lethargy (being overly tired or inactive)
• Runny nose
• Cough
• Vomiting
• Diarrhea
• Poor feeding
• Increased work of breathing or shallow breathing

See CDC's webpage on Evaluation and Management Considerations for Neonates At Risk for COVID-19 for more information.

Breastfeeding and COVID-19

Current evidence suggests that breast milk is not likely to spread the virus to babies.

COVID-19 vaccination is recommended for people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future. In addition, everyone who is ages 18 and older, including those who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future, should get a booster shot. You should always wash your hands with soap and water for 20 seconds before breastfeeding or expressing breast milk, even if you don't have COVID-19. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.

If you have COVID-19 and choose to breastfeed:

• Wash your hands before breastfeeding
• Wear a mask while breastfeeding and whenever you are within 6 feet of your baby.

If you have COVID-19 and choose to express breast milk:

• Use your own breast pump (one not shared with anyone else), if possible.
• Wear a mask as you express breast milk.
• Wash your hands with soap and water for at least 20 seconds before touching any pump or bottle parts, and before expressing breast milk.
• Follow recommendations for proper pump cleaning < /a>after each use. Clean all parts of the pump that come into contact with breast milk.
• Consider having a healthy caregiver feed the expressed breast milk to the baby. The caregiver should be fully vaccinated (at least two weeks after the 2nd dose of a 2-dose vaccine or two weeks after a 1-dose vaccine) and not be at increased risk for severe illness from COVID-19. If the caregiver is living in the same home or has been in close contact with you and is not yet fully vaccinated for COVID-19, they might have been exposed.
  • People who have come into close contact with someone with COVID-19 should be tested to check for infection:
    • Fully vaccinated people should be tested 5-7 days after their last exposure.
    • People who are not fully vaccinated should get tested immediately when they find out they are a close contact. If their test result is negative, they should get tested again 5-7 days after their last exposure or immediately if symptoms develop.
• Any caregiver feeding the baby should wear a mask when caring for the baby for the entire time you are in isolation and during their own quarantine period after you complete isolation.

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