Covid-19: how to avoid transmission between mother and baby
Since we are in a health emergency, the Italian Society of Neonatology (Sin) has made public a series of updates to the document "Lactation and Sars-CoV-2 infection" (last updated 21 March 2020). This is because the management of pregnant women and the possible transmission of the virus infection before, during and after childbirth is a very delicate aspect of the emergency due to the spread of Covid-19.
Mom and baby
According to reports from the neonatology centres in Milan, Bergamo, Brescia and Piacenza, infants suspected of viruses currently have two reassuring elements: those born from a positive mother are generally negative to Covid-19. While the positive ones have returned from home for symptomatology not serious, acquired after a few weeks of life at home.
Therefore, the Italian Society of Neonatology establishes first of all that, whenever possible, the choice to be supported is that of the joint management of mother and newborn, in order to facilitate interaction and encourage the initiation of breastfeeding. This option is feasible when a mother who has recently given birth, previously identified as Covid-19 positive, is asymptomatic or with mild or recovering symptoms.
In case the mother is symptomatic and therefore has fever, cough, respiratory secretions and compromised general condition, mother and newborn should be momentarily divided, waiting for the results of the swab for Covid-19. If the results are positive, mother and child should be managed separately, but the newborn should continue breastfeeding with squeezed breast milk (although an assessment of the compatibility of breastfeeding with any drugs administered to the woman with Covid-19 is necessary first); otherwise, rooming-in for mother-in-law can be implemented, compatible with maternal conditions.
The choice of whether or not to divide mother and newborn should be made in every single case. In fact, it is necessary to take into account the informed consent of the parents, the logistical situation of the hospital and, if necessary, the local epidemiological situation regarding Covid-19.
If the mother is Covid-19 positive, strict measures must always be followed to prevent possible transmission of the virus. Therefore, all ministerial instructions for the exact use of PPE and hand washing should be adopted to protect the newborn baby, other hospitalized patients and healthcare personnel.
A clinical examination of the child should be carried out at 7 days after birth, before discharge, with repeated RT-PCR, with subsequent neonatological checks up to 28 days old.
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