Lindsay Feldman, a Las Vegas mom of two daughters including a 10-week-old, knows this struggle well. She’s been “cooped up in the house” for months, with covid-19 amplifying her already self-proclaimed germaphobe tendencies. Her pediatrician didn’t have to tell her twice to limit contact with others, so just an aunt and her mother have held the baby. Feldman’s hesitancy to have to take her newborn to the emergency room with a fever mirrors concerns from parents across the country, with more questions than answers.
We asked experts what parents of newborns — and all those friends and relatives who can’t wait to visit — need to know.
Should newborns have any visitors?
Yes, newborns can have visitors, but with precautions. Parents should consider limiting the number of visitors the baby is in close contact with, according to Jorge Perez, a neonatologist and founder of Kidz Medical Services in Coral Gables, Fla. “There is no magical number about how many visitors, and this is relevant with any newborn, before or during a pandemic and post-covid,” Perez says. “Since babies are unprotected when they are separated from the placenta, I recommend that households with an infant limit their exposure for two to three months. The flu, RSV or other viruses are dangerous to an infant who can’t fight them off.”
What precautions do visitors need to take?
Similar to pre-pandemic times, visitors should be washing their hands before touching a newborn, Perez says. He recommends visitors mask up regardless of vaccination status, and potentially meet the baby outside. “Six feet apart, outside and vaccinated would be better,” he says.
Because covid-19 is spread primarily through respiratory droplets, parents should ask visitors to avoid kissing the baby, which Perez says is just best practice for not transmitting other diseases as well.
Should parents allow only vaccinated visitors?
This can be a touchy subject, according to Tamika Cross, an obstetrician and gynecologist in Pearland, Tex., who says it’s important to give her patients autonomy over their choices. But if guests “are vaccinated it’s more reassuring than if they aren’t,” Cross says, adding that early data show that vaccines can help prevent spread of covid-19 from people without symptoms, but that the subject is still being studied.
And don’t forget to ask when they were vaccinated, she says, because it takes two weeks after vaccination (after the second dose for Pfizer or Moderna) for the body to build protection: “When did they get vaccinated? Yesterday or last month? That’s important to consider. You don’t just get a vaccine and say, ‘Hey I’m coming over to visit.’ It’s still important to wear a mask, and I advise moms to have visitors wear a mask regardless,” she says.
Do siblings or the parents themselves need to wear masks?
Pediatricians across the country are delivering contradictory messages on this, according to Talitha Phillips, a labor and postpartum doula in Los Angeles: “Recently a pediatrician told the family that they needed to wear masks around the child all the time.” She’s also heard doctors say no masking is needed around newborns.
Chad Sanborn, a pediatric infectious-disease physician at Palm Beach Children’s Hospital at St. Mary’s Medical Center in Palm Beach County, Fla., says he’d consider masking for siblings over the age of 2 or 3 because kids are less likely than adults to practice proper hygiene and remain socially distant from a newborn: “A lot of infants who come to the hospital with illness we probably could trace back to siblings.”
However, he acknowledges this may not be practical for daily family life, and that they are still more likely to get sick from an adult than a sibling, because adults expel more respiratory droplets.
Perez adds that a common way siblings might transfer an illness to a newborn is by kissing the baby on the lips, or putting their hands in their mouths and touching the baby’s hands (which they then put in their mouth, naturally).
Most experts agree that parents need to wear masks at home only if they are covid-positive, in which case a mother can even wear a mask while she’s breastfeeding or is in close contact with the baby to prevent transferring respiratory droplets.
How at risk are newborns for contracting covid-19 or getting severely ill from it?
It’s been well documented throughout the pandemic that children are both less likely to contract covid-19 than adults and also less likely to get severely ill from it.
“The great majority of [newborns] who acquire it are minimally ill, which is great,” Sanborn says. “It’s a higher percentage than older children who get it, but the majority are not very sick. Of the children who develop covid and require hospitalization, 50 percent will be within 1 year of age.” This trend generally holds true for other infections, such as urinary tract infections and bad pneumonia, he says.
Sanborn has seen a slight increase in the number of covid-19 cases in children, possibly because of variants. “The data lags a bit. … We aren’t necessarily seeing sicker patients, but rather more children testing positive than in the past.”
To put the risk of a newborn contracting the virus into perspective, experts look to a recent study of mostly breastfeeding, covid-positive mothers and their newborns. Sanborn says the risk of the babies contracting covid-19 in this case was only 2 percent.
Do babies have antibodies from their previously covid-positive or vaccinated mother?
It’s not recommended for babies to get tested for antibodies, but preliminary studies show that pregnant parents who received the vaccine while pregnant were likely passing antibodies on to their babies. Perez says, “If the mom is infected, hopefully the baby has some kind of immunity. We don’t know the extent and how long it will last.”
For these reasons, experts don’t recommend relying on the probability of the baby carrying antibodies to make choices about precautions, but instead to take the precautions anyway. Some mothers vaccinated earlier in their pregnancies remain unsure, as do their doctors, about how long antibodies will last after the birth. Jenna Fletcher of Allentown, Pa., for example, is in her second trimester and has questions about how long her baby will carry antibodies. She was vaccinated early in her pregnancy. “You don’t want to play around and tempt fate,” she says. “If people want to see the baby, they must be vaccinated.”
What are the other risks of not allowing visitors?
After a year of major mental health declines across the country, the risk of not having the support of a “village” may outweigh the covid-19 risks for some families. Many studies have tied a lack of social support to increased risk of postpartum depression. Phillips asks the families she works with to ask themselves, “Would it give you more peace having people around?”
“Especially with postpartum depression and anxiety on the rise, a lot of it stems from lack of support and lack of community and isolation. For some people, I’ll say, ‘Would it help reduce fear and anxiety if you had somebody here?’”
What questions should visitors ask before showing up?
Phillips encourages visitors to ask the new parents what would be the most supportive route for them to take, whether it’s simply dropping a meal at the door without coming in, or having a full-on visit with the newborn.
She encourages visitors to follow a couple of essential tips to ensure they are prioritizing the family’s physical and mental health:
- Ask the family what they need: help with child care for other children? Assistance with cleaning or yardwork? Emotional support such as grabbing a coffee and having a good chat with the mom? A grocery trip?
- Be aware and communicate cold symptoms as well as covid-19 symptoms.
- Be willing to see the baby at a distance, and possibly outside, rather than holding and kissing them.
“This shows respect. … We just need to love them where they are at.”