As the first case of a newborn baby with the novel coronavirus has been recorded in the UK, pregnant women are likely to be worried about catching the virus and the risk of passing it on to their babies.

Early research in a small group of nine women who developed COVID-19 in late pregnancy in China did not find the virus in the amniotic fluid surrounding their babies in the womb or in the blood in the umbilical cord. Once born, the newborns didn’t have the virus on swab testing. The researchers did not find coronavirus in the women’s breastmilk either. These findings offer some reassurance that the virus doesn’t seem to be passed on in these ways, but larger studies are needed to confirm this.

Joint guidance from several UK national bodies and professional societies in the United states say that the main risk for babies being fed by mothers with COVID-19 is that the close contact could allow droplet transmission.

They outline steps that should be taken to reduce this risk, including hand washing before touching the baby, breast pump or bottles, and considering wearing a mask while breastfeeding if available.

 

Where did the story come from?

Many news articles have covered the risks of coronavirus in pregnancy, questioning whether pregnant women are at greater risk of catching the disease or being more severely affected, and whether breastfeeding is safe for the babies of mothers with the infection.

 

What is the basis for the claim?

Some viral infections, such as HIV can be passed on from untreated pregnant mothers to babies in the womb, or through breastmilk. Pregnant women may understandably be concerned about whether this could happen with the novel coronavirus.

A recent study looked at 9 pregnant women from Wuhan in their third trimesters who had COVID-19. The researchers tested the amniotic fluid, breastmilk and cord blood of the mothers, and also swabbed the babies’ throats when they were born. All these samples tested negative for the virus.

Another study tested placentas from 3 infected mothers, and also found no trace of the virus. A third study in 9 pregnant women found that all of their newborns (mostly delivered by caesarean) tested negative for coronavirus.

One newborn has been reported to have been infected with coronavirus within a day of being born to an infected mother. However, it is not clear whether this infection was transmitted before birth or might have been passed on afterwards.

There was also reportedly no evidence of transmission in the womb of the coronaviruses that caused SARS and MERS during those outbreaks.

These initial findings suggest that the virus is unlikely to be passed from infected pregnant women to their babies in the womb, or through breastmilk. Feeding at the breast does involve close contact, so this does carry the risk of mothers passing on infection to the infant in this way.

It is worth bearing in mind that the numbers of pregnant women in these studies was relatively low. More research is needed in larger numbers of pregnant women before we can be absolutely sure of the risk for newborn babies of catching the virus.

 

What do trusted sources say?

Guidance from several UK national bodies including the Royal College of Obstetricians & Gynaecologists and the Center for Disease Control (CDC) in the United States say that the main risk for babies being fed by mothers with COVID-19 is that the close contact could allow droplet transmission.

The guidance recommends the following preventive measures for women with the infection who wish to breastfeed:

  • Hand washing before touching the baby, breast pump or bottles;
  • Trying to avoid coughing or sneezing on the baby while feeding at the breast
  • Considering wearing a face mask while breastfeeding, if available
  • Following recommendations for breast pump cleaning after each use;
  • Considering asking someone who is well to feed expressed milk to the baby.

Citations

  1. Redigolo T. Coronavirus with a baby: Can I breastfeed while infected with COVID-19? Express Online. 13 March 2020 https://www.express.co.uk/life-style/health/1255041/Coronavirus-babies-newborns-breastfeed-safe-infected-coronavirus-covid-19 (Accessed 16 March 2020)

Reading list

  1. Chen H et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet 2020; 395 (10226): 809-815. https://doi.org/10.1016/S0140-6736(20)30360-3 (Accessed 16 March 2020)
  2. Chen S et al. Pregnant women with new coronavirus infection: a clinical characteristics and placental pathological analysis of three cases. Zhonghua Bing Li Xue Za Zhi. 2020 Mar 1;49(0):E005. https://www.ncbi.nlm.nih.gov/pubmed/32114744 (Accessed 16 March 2020)
  3. Rasmussen SA et al. Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. (In Press Journal Pre-proof) American Journal of Obstetrics and Gynecology 2020, https://doi.org/10.1016/j.ajog.2020.02.017 (Accessed 16 March 2020)
  4. RCOG, Royal College of Midwives, Royal College of Paediatrics and Child Health, Public Health England and Health Protection Scotland. Coronavirus (COVID-19) infection and pregnancy. COVID-19 virus infection and pregnancy. March 13 2020. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/ (Accessed 16 March 2020)
  5. American College of Obstetricians and Gynaecologists. Practice Advisory: Novel Coronavirus 2019 (COVID-19). https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Advisories/Practice-Advisory-Novel-Coronavirus2019 (Accessed 17 March 2020)
  6. Center for Disease Control. COVID-19 Pregnancy & Breastfeeding, Information about Coronavirus Disease. 2020 https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancy-breastfeeding.html (Accessed 17 March 2020)