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. 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.

Early essential newborn care can be applied for both vaginal and Caesarean births if mothers and babies are stable. Mothers should wear medical masks, especially when they are in contact with their newborn infants, and wash their hands or use hand sanitiser before and after touching their baby or direct feeding. Surrounding surfaces should be cleaned frequently and contact with family members should generally be restricted to one key family member. If preterm and low birth weight babies are unable to breastfeed, breast milk should be expressed every two to three hours and administered by cup, spoon or nasogastric tube in line with national policies. Ideally, larger longitudinal studies are needed to provide definitive data on infection rates of newborn infants born to mothers with COVID-19 managed with and without separation and breastfeeding, for both vaginal and Caesarean section births. Currently available data suggest that prolonged skin-to-skin contact and early and exclusive breastfeeding are still the best strategies for reducing morbidity and mortality for both the mother with COVID-19 and her baby, in tandem with rigorous infection prevention and control measures.

Acta Paediatr, 2020 Sep;109(9):1713-1716