Mothers who have been diagnosed with COVID-19 are unlikely to pass the virus onto their newborn babies as long as correct hygiene protocols are followed.
That's according to a new observational study published in the Lancet Child and Adolescent Health Journal, which also supports breastfeeding and babies "rooming in" with their mothers after birth.
"We have shown that rooming in with the mother and breastfeeding are safe if associated with adequate parental education of safe infection control practices, such as use of surgical masks at all times and frequent hand hygiene," the authors write of their findings, which were published on Friday.
As part of the study, researchers observed 120 babies born to mothers who tested posted with COVID-19 across three New York City hospitals. Mothers were able to practice skin-to-skin contact and breastfeed in the delivery room but were required to wear a surgical mask when near their baby. They were also required to practice proper hand hygiene before skin-to-skin contact, breastfeeding and routine care. Babies were kep in a closed crib in the same room as their mothers.
All babies were tested for the coronavirus in the immediate postnatal period, and again at five to seven days and 14 days. None returned a positive result.
"All infants remained asymptomatic during the study period," the authors write, adding that their finding supports previous reports of a low risk of perinatal transmission with strict infection control practices in place.
"We know that skin-to-skin contact and breastfeeding are important both for mother-infant bonding and for long-term child health," said co-author Dr Patricia DeLaMora. "Our findings suggest that babies born to mothers with COVID-19 infection can still benefit from these safely, if appropriate infection control measures are followed."
While the study is only small, co-author Dr Christine Salvatore said she hoped it would provide some reassurance to new mothers that the risk of passing COVID-19 to their babies is "very low". "Larger studies are needed to better understand the risks of transmission from mother to child," she said.
An accompanying comment piece by Melissa Medvedev, who was not involved in the study, notes that, "given the dynamic state of viral transmission during the peak of the pandemic, this study represents a snapshot in time and setting." "Many parents were fearful of leaving their homes and using public transportation to attend follow-up, highlighting the potential indirect effects of the pandemic on vulnerable populations," she said.
Current guidelines from The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) note that women who have been diagnosed with COVID-19 should be encouraged and supported to breastfeed.
"At the moment there is no evidence that the virus is carried in breastmilk and, therefore, the well-recognised benefits of breastfeeding outweigh any potential risks of transmission of COVID-19 through breastmilk," the college notes. "If the mother has COVID-19 infection she should not be automatically separated from her baby, but should take enhanced precautions with general hygiene and consider a face mask when feeding."
On Friday, the Australian National COVID-19 Clinical Evidence Taskforce also released conditional recommendations around rooming-in of mums and babies.
GUIDELINES UPDATE: Version 14.0 of our Guidelines is now live. This week's update includes our third conditional recommendation for Pregnancy & Perinatal Care - Rooming-in of mother and newborn. https://t.co/er7a3oJND6#COVID19Aus#healthprofessionals pic.twitter.com/scw11W93R5— National COVID-19 Clinical Evidence Taskforce (@evidenceCOVID19) July 23, 2020
"For women with COVID-19 who have given birth, support rooming-in of mother and newborn," the new guidelines state. "However, women with COVID-19 should use infection control and prevention measures (mask and hand hygiene) while infectious."
In addition, they note that there is no evidence to indicate that a woman with a known COVID-19 infection should be separated from her newborn to prevent transmission. "As there are substantial known benefits for keeping mother and newborn together postpartum, women should be supported to be with their newborn as per usual care.
It comes after Victoria's Chief Health Officer Brett Sutton clarified rules for hospital visits in Victoria following concerns the partner or support person of a woman giving birth could not stay longer than a two-hour period.
"The direction states that a support person or partner can stay as long as is desired and needed for the labour and birth process, as long as is required," he said. "That is not limited at all. For subsequent days post-delivery, there is a visit limit of one person for two hours."
Professor Sutton acknowledged the confusion had been stressful for expectant parents.
"I absolutely understand the distress," he said. "Someone who feels like they can't be there for the most critical time in their partner's life and indeed in their life, it must be a distressing element."