What are the risks and precautions for the management and breastfeeding of the newborn when the new mother is infected with SARS-Cov-2
In times of pandemic, expectant mothers are among the social groups most likely to experience moments of anxiety and fear, for themselves and above all for the life they are carrying. The worst condition is clearly that of women who reach the end of their pregnancy having contracted Covid-19, and even more so if they present the disease in a severe form at the time of delivery.
What will happen then? And how will they deal with their newborn child?
Some reassuring answers come from the study carried out by an Italian team, which conducted research in hospitals and healthcare facilities in Lombardy.
Evaluation of Rooming-in Practice for Neonates Born to Mothers With Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Italy
Ronchi A, Pietrasanta C, Zavattoni M et al.
JAMA Pediatr. 2021 Mar 1;175(3):260-266.
For neonatologists, the management of new mothers and their newborns is an extremely delicate issue since, up to the time of publication of this research, the risks of transmission of infection from a Covid-positive mother to her child, both pre- and post-natally, have not yet been definitively clarified. After birth, in particular, respiratory secretions and saliva are of particular concern as they are the primary vehicles for human-to-human transmission of SARS-CoV-2.
Given the lack of unambiguous clinical evidence, scientific organisations and experts have given non-uniform indications: some have emphasised the importance of 'rooming-in' the newborn, while taking all appropriate precautions, while others have recommended mother-infant isolation.
In the multicentre study we report 62 infants, born to 61 mothers with SARS-CoV-2 infection (two are twins), were cared for in the room by Covid-positive mothers and in 95% of the cases breastfeeding was possible.
The infants underwent nasopharyngeal swabbing at birth and all were negative.
The mothers were in a condition to care for their babies, as they did not require respiratory support or oxygen, had a temperature of less than 38° and all their vital parameters were normal.
In handling their babies, they were instructed to wash their hands regularly (they did not wear gloves) and to use a mask at every stage of contact with the newborn, including breastfeeding.
None of the infants so cared for contracted Covid-19
The conclusions of the cohort study are, therefore, that Covid-positive new mothers, appropriately educated, and in a position to care for their babies (asymptomatic or pauci-symptomatic) should be encouraged to keep their newborn babies in the room and, when possible, breastfeed.
For more details of the study, you can read the full text here link
Good reading
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Dr. Carmelo Chines
Direttore responsabile
English 
Italian