Pregnancy, Breastfeeding, and Caring for Newborns

COVID-19 and pregnancy

Based on what we know at this time, pregnant people might be at an increased risk for severe illness from COVID-19 compared to non-pregnant people. Additionally, pregnant people with COVID-19 may be at increased risk for other adverse outcomes, such as preterm birth.

Take steps to protect yourself from COVID-19

There is no way to ensure you have zero risk of infection, so it is important to understand the risks and know how to be as safe as possible. In general, the more people you interact with, the more closely you interact with them, and the longer that interaction, the higher your risk of getting and spreading COVID-19.

Here are preventive steps you and people you live with can take:

• Limit close contact interactions with other people as much as possible.
• When going out or interacting with others outside your immediate household,
  • Wear a mask, especially when other social distancing measures are difficult to maintain. Note that wearing a mask is not a substitute for other everyday prevention actions like washing hands frequently and avoiding close contact with other people.
  • Avoid others who are not wearing masks or ask others around you to wear a mask, if possible.
  • Stay at least 6 feet away from others outside your household.
  • Wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Avoid activities where taking protective measures may be difficult and where social distancing can’t be maintained.

Continue to seek healthcare

Don’t skip your healthcare appointments during and after pregnancy.

• Visit your healthcare provider for all recommended appointments. If you need help finding one, contact your nearest hospital clinic, community health centerexternal icon, or health department.
• Talk to your healthcare provider about
  • How to stay healthy and take care of yourself and your baby.
  • Any questions you have about the best place to deliver your baby. Delivering your baby is always safest under the care of trained healthcare professionals.

If you’re concerned about going to your appointments because of COVID-19, ask your healthcare provider what steps they’re taking to separate healthy patients from those who may be sick.

• Some healthcare providers may choose to cancel or postpone some visits.
• Others may switch certain appointments to telemedicine visits, which are appointments over the phone or video.
• These decisions may be based on the situation in your community as well as your individual health risks.

Get recommended vaccines and a 30-day supply of your medicines.

Getting the recommended vaccines during pregnancy can help protect you and your baby.

• Get vaccinated against influenza (or flu).
  • Flu and COVID-19 are both respiratory illnesses that can spread from person to person. They can affect breathing and have similar symptoms, but they are caused by different viruses (read more about similarities and differences between flu and COVID-19). It is unknown how these two viruses may interact during the upcoming flu season.
  • There is no vaccine available to protect against the virus that causes COVID-19.
  • You should protect yourself against flu by getting vaccinated. Others living in your household should also get vaccinated to protect themselves and you.
• Get the whooping cough (Tdap) vaccine during pregnancy to protect your baby against whooping cough, which can also present with similar symptoms to COVID-19.

Ask your doctor and pharmacy to give you at least a 30-day supply of the medicines you need.

Call your healthcare provider if you have any health concerns.

These concerns may include:

• You think you have COVID-19 (call within 24 hours).
• You think you are experiencing depression during or after pregnancy.
• You have any questions related to your health.

Don’t delay getting emergency care because of COVID-19.

Call 911 or go to your local emergency department.

If you are going to the emergency department, call and tell them that you are pregnant and are having an emergency. They should have a plan to protect you from getting COVID-19.

If someone else is driving, call while you’re on the way. If you need to drive yourself to the emergency department, call before you start driving.​

Caring for newborns when the mother has COVID-19

Much is still unknown about the risks of COVID-19 to newborns born to mothers with COVID-19. We do know that:

• Infections causing COVID-19 in newborns born to mothers with COVID-19 are uncommon.
• Some newborns have tested positive for the virus that causes COVID-19 shortly after birth. It is unknown if these newborns got the virus before, during, or after birth from close contact with an infected person.
• Most newborns who tested positive for the virus that causes COVID-19 had mild or no symptoms and recovered. However, there are a few reports of newborns with severe COVID-19 illness.
• Preterm (less than 37 completed weeks gestation) birth and other problems with pregnancy and birth have been reported among women who tested positive for COVID-19 during pregnancy. It is unknown whether these problems were related to the virus that causes COVID-19.

Decide if your newborn is rooming-in with you in the hospital.

CDC recognizes that the ideal setting for the care of a healthy, full-term newborn during the birth hospitalization is within the mother’s room (“rooming-in”). Current evidence suggests that the risk of a newborn getting COVID-19 from its mother is low, especially when she uses appropriate precautions before and during care of the newborn, such as wearing a mask and practicing hand hygiene.

If you are diagnosed with or test positive for the virus that causes COVID-19, you should discuss with your healthcare provider the risks and benefits of having your newborn stay in the same room with you. This conversation should begin during prenatal care if possible. Having your newborn stay with you in the same room has the benefit of facilitating breastfeeding and maternal-newborn bonding. Potential risks may include giving the virus to the newborn, although current evidence suggests the risk of a newborn getting COVID-19 from their mother is low if precautions are taken. After discussing, make an informed decision of whether your newborn is staying in the same room with you while in the hospital.

Take precautions when having your newborn stay in the same room with you, if you are in isolation for COVID-19.

If you are in isolation for COVID-19 and are sharing a room with your newborn, take the following precautions to reduce the risk of spreading the virus to your newborn:

• Wash your hands with soap and water for at least 20 seconds before holding or caring for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
• Wear a mask when within 6 feet of your newborn.
• Keep your newborn more than 6 feet away from you as much as possible.
• Discuss with your healthcare provider about using a physical barrier (for example, placing the newborn in an incubator) while in the hospital.

If your isolation period has ended, you should still wash your hands before caring for your newborn, but you don’t need to take the other precautions. You most likely won’t pass the virus to your newborn or any other close contacts after your isolation period has ended.

• If you had symptoms, your isolation period ends after
  • 10 days since symptoms first appeared, and
  • 24 hours with no fever without fever-reducing medications, and
  • Other symptoms of COVID-19 are improving
• If you never had symptoms, your isolation period ends after
  • 10 days since the date of your positive COVID-19 test

Take precautions at home if you are in isolation for COVID-19.

If you are still in isolation for COVID-19 and have returned home, take the following precautions until your isolation period has ended:

• Stay home to separate yourself from others outside your home.
• Consider isolating from other household members within your home who are not infected.
• Have a healthy caregiver who is not at increased risk for severe illness provide care for your newborn.
  • Caregivers should wash their hands for at least 20 seconds before touching your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
  • If the caregiver is living in the same home or has been in close contact with you, they should wear a mask when they are within 6 feet of your newborn for the entire time you are in isolation and for two weeks after you completed isolation.
• If a healthy caregiver is not available, you can care for your newborn if you are well enough.
  • Wash your hands with soap and water for at least 20 seconds before touching for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.
  • Wear a mask when within 6 feet of your newborn and other people during your entire isolation period. The mask helps prevent you from spreading the virus to others.

Others in your household and caregivers who have COVID-19 should isolate and avoid caring for the newborn as much as possible. If they have to care for the newborn, they should practice hand hygiene and wear a mask.

Do not put a face shield or mask on your baby.

A face shield could increase the risk of sudden infant death syndrome (SIDS) or accidental suffocation and strangulation. Babies move frequently. Their movement may cause the plastic face shield to block their nose and mouth, or cause the strap to strangle them.

There are also no data supporting the use of face shields among babies for protection against COVID-19 or other respiratory illnesses.

CDC recommends all people 2 years of age and older wear a mask in public settings and when around people who don’t live in their household. CDC does not recommend use of face shields as a substitute for masks for the general public, including pregnant or breastfeeding mothers.

Ensure safe sleep for your baby.

Safe sleep is an important part of keeping babies healthy.

During the COVID-19 pandemic, parents of babies may experience increased stress and fatigue that could affect their ability to ensure that their baby is sleeping safely. Help reduce your baby’s risk of sudden infant death syndrome (SIDS) and other sleep-related deaths by doing the following:

• Place your baby on his or her back for all sleep times – naps and at night.
• Use a firm, flat sleep surface, such as a mattress in a crib covered by a fitted sheet.
• Have the baby share your room but not your bed. Your baby shouldn’t sleep on an adult bed, cot, air mattress, couch, or chair, whether he or she is sleeping alone, with you, or with anyone else.
• Keep soft bedding, such as blankets, pillows, bumper pads, and soft toys, out of your baby’s sleep area.
• Do not cover your baby’s head or allow your baby to get too hot. Signs your baby may be getting too hot include sweating or his or her chest feeling hot.
• Don’t smoke or allow anyone to smoke around your baby.

Learn more about how to reduce the risk of SIDS.

Bring your baby for newborn visits.

Ideally, newborn visits are done in person so that your baby’s healthcare provider can

• Check how you and your baby are doing overall.
• Check your baby’s growth and feeding.
• Check your baby for jaundice.
• Make sure your baby’s newborn screening tests were done (including a bloodspot, hearing test, and a test for critical congenital heart defects) and do any repeat or follow-up testing, if necessary.

Make sure to call and notify your baby’s healthcare provider before visiting if you or your baby have COVID-19.

COVID-19 and breastfeeding

Current evidence suggests that breast milk isn’t likely to spread the virus to babies.

You, along with your family and healthcare providers, should decide whether and how to start or continue breastfeeding. Breast milk provides protection against many illnesses and is the best source of nutrition for most babies. We don’t know for sure if mothers with COVID-19 can spread the virus to babies in breast milk, but the current evidence suggests that this isn’t likely.

Helpful tips for breastfeeding

You may find it harder to start or continue breastfeeding if you are not sharing a room with your newborn in the hospital. Here are some helpful tips:

• Frequent hand expression or pumping, ideally with a hospital-grade pump, will help you establish and build milk supply if you are separated from your newborn.
• Pump or feed every 2-3 hours (at least 8-10 times in 24 hours, including at night), especially in the first few days. This signals the breasts to produce milk and prevents blocked milk ducts and breast infections.
• If you are unable to establish milk production in the hospital after birth, or have to temporarily stop breastfeeding during your COVID-19 illness because you do not feel well enough, get help from a lactation support provider. Learn more about relactation.
• You should always wash your hands with soap and water for 20 seconds before breastfeeding or expressing breast milk even if you don’t have COVID-19. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.

If you have COVID-19 and choose to breastfeed

• Wash your hands beforehand
• Wear a mask while breastfeeding

If you have COVID-19 and choose to express breast milk

• Use a dedicated breast pump (not shared).
• Wear a mask during expression and wash your hands with soap and water for at least 20 seconds before touching any pump or bottle parts and before expressing breast milk.
• Follow recommendations for proper pump cleaning after each use, cleaning all parts that come into contact with breast milk.
• Consider having a healthy caregiver who does not have COVID-19, is not at increased risk for severe illness from COVID-19, and is living in the same home feed the expressed breast milk to the baby. Any caregiver feeding the baby should wear a mask when caring for the baby for the entire time you are in isolation and for two weeks after you completed isolation.