How COVID-19 Affects Pregnant and Breastfeeding Women
What is COVID-19? Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.
The World Health Organization states that most people who become infected experience mild illness and recover, but it can be more severe for others.  Here is a link to the Center for Disease Prevention Fact Sheet for coronavirus disease (COVID-19).
Are pregnant women more vulnerable to COVID-19? The United Nations Fund states that, to date, there is no scientific evidence about the increased susceptibility of pregnant women to COVID-19. They went on to state, however, that “pregnancy brings physical changes that might make some pregnant women more susceptible to viral respiratory infections. Pregnant women with respiratory illnesses must be treated with the utmost priority due to increased risk of adverse outcomes.” If a woman suspects she has symptoms of COVID-19, she should contact her provider.
Should pregnant women take different or additional precautions than the general population? The United Nations Population Fund recommends pregnant women take the same preventive actions to avoid infection recommended for all adults. This includes avoiding close contact with anyone who is coughing and sneezing, washing hands often with soap and water or alcohol-based hand rub, covering mouth and nose with a tissue or elbow when coughing and sneezing, and thoroughly cooking meat and eggs. Recommended actions are available on the WHO website.
Can women transmit the virus to their preborn babies? Transmission between mom and preborn baby has not been shown to date. One recent study with a small sample size documented pregnant woman diagnosed with COVID-19 found no evidence for vertical transmission in late pregnancy.
Are pregnant women with COVID-19 at increased risk for adverse pregnancy outcomes? The Centers for Disease and Prevention states there is no increase of adverse pregnancy outcomes in pregnant women with COVID-19. However, pregnancy loss, including miscarriage and stillbirth, has been observed in cases of infection with other related coronaviruses such as SARS-CoV and MERS-CoV during pregnancy. As always, high fevers during the first trimester of pregnancy can increase the risk of certain birth defects. If a woman has symptoms of COVID-19, she should contact her physician for care.
Can moms transmit COVID-19 by breastfeeding their infants? The Centers for Disease Control and Prevention reports that the virus has not been found in the breast milk of women with COVID-19 but antibodies to fight it have been found. The CDC states that breast milk provides protection to many illnesses and encourage women to continue to breastfeed.
La Leche League International is encouraging women who have become infected, not to interrupt breastfeeding. They state in an exposure situation, “The baby has already been exposed to the virus by the mother and/or family and will benefit most from continued direct breastfeeding.”
The United Nations Population Fund recommends that breastfeeding women should not be separated from their newborns, as there is no evidence to show that respiratory viruses can be transmitted through breast milk. They advise that mothers can continue breastfeeding with precautions applied:
- Symptomatic mothers well enough to breastfeed should wear a mask when near her child (including during feeding), wash hands before and after contact with her child (including feeding), and clean/disinfect contaminated surfaces.
- If a mother is too ill to breastfeed, she should be encouraged to express milk that can be given to the child via a clean cup and/or spoon – while wearing a mask, washing hands before and after contact with the child, and cleaning/disinfecting contaminated surfaces.
The World Health Organization (WHO) offers guidance and other information on coronavirus in multiple languages on their website. UNICEF also provides information for breastfeeding through COVID-19 infection.
What action should a pregnant or breastfeeding woman take if she suspects she has become infected with COVID-19?
The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) recommend that those with symptoms of fever, cough, shortness of breath stay home and call a healthcare provider for advice. Also, they recommend those who have been in close contact with a person known to have COVID-19 or have recently traveled from an area with ongoing spread of COVID-19 contact their medical providers for recommendations. It’s important that patients call in advance before going to a doctor’s office or emergency room to tell them about any recent travel and symptoms. This will allow the health care provider to direct patients to the right health facility to prevent the spread of this virus and other infections within clinics and hospitals.
What should I do if I think I might be pregnant?
If you have missed a period and think you might be pregnant, call or schedule an appointment at RealOptions Obria Medical Clinics or visit www.realoptions.net. Our clinics are open Monday – Friday 9:00am-5pm. We have taken extra precautions and are following CDC guidelines and recommended medical standards to protect our staff and patients.
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by Christa Brown BSN, RN, LAS
 Coronavirus disease (COVID-19) advice for the public. World Health Organization WebSite https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public. Published 2020. Retrieved March 8, 2020.
 Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Huijun Chen, PhD, Juanjuan Guo, MS, Chen Wang, PhD, Fan Luo, PhD, Xuechen Yu, MD, Prof Wei Zhang, PhD. VOLUME 395, ISSUE 10226, P809-815, Published: February 12, 2020D
Coronavirus Disease 2019 (COVID-19). CDC Web Site: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-faq.html. Published March 6, 2020. Retrieved March 8, 2020.
 Continuing to Nurse Your Baby Through Coronavirus (2019-nCoV; COVID-19) and Other Respiratory Infections. La Leche League International Website: https://www.llli.org/coronavirus/. Published February 19, 2020. Retrieved March 8, 2020.
 Coronavirus Disease 2019 (COVID-19). CDC Website: https://www.cdc.gov/coronavirus/2019-ncov/about/share-facts.html. Published March 6, 2020. Retrieved March 8, 2020.