Early and close contact between the mother and neonate (newborn) has many well-established benefits. The ideal setting for care of a healthy, term newborn while in the hospital is in the mother’s room, commonly called “rooming-in.” Current evidence suggests the risk of a neonate acquiring SARS-CoV-2 from its mother is low. Further, data suggests that there is no difference in risk of SARS-CoV-2 infection to the neonate whether a neonate is cared for in a separate room or remains in the mother’s room.
There is, however, a potential risk of SARS-CoV-2 transmission to the neonate via contact with infectious respiratory secretions from the mother, caregiver, or other person with SARS-CoV-2 infection, including just before the individual develops symptoms when viral replication may be high. As such, all caregivers should practice infection prevention and control measures (i.e., wearing a mask, practicing hand hygiene) before and while caring for a neonate.
Mothers with suspected or confirmed SARS-CoV-2 infection may feel uncomfortable with this potential risk. Ideally, each mother and her healthcare providers should discuss whether she would like the neonate to be cared for in her room or a separate location if she is suspected or confirmed of having COVID-19, weighing the considerations listed below. It’s easiest to begin this conversation during prenatal care and continue it through the intrapartum period. Healthcare providers should respect maternal autonomy in the medical decision-making process.
Considerations for discussions on whether a neonate should remain in the mother’s room include:
Mothers who room-in with their infants can more easily learn and respond to their feeding cues, which helps establish breastfeeding. Breastfeeding reduces morbidity and mortality for both mothers and their infants. Mothers who choose to breastfeed should take measures, including wearing a mask and practicing hand hygiene, to minimize the risk of virus transmission while feeding. Additional information for healthcare providers on breastfeeding in the context of COVID-19 is available.
Mother-infant bonding is facilitated by keeping the neonate with its mother.
Rooming-in promotes family-centered care and can allow for parent education about newborn care and infection prevention and control practices.
Mothers with suspected or confirmed SARS-CoV-2 infection should not be considered as posing a potential risk of virus transmission to their neonates if they have met the criteria for discontinuing isolation and precautions:
At least 10 days have passed since their symptoms first appeared (up to 20 days if they have more severe to critical illness or are severely immunocompromised), and
At least 24 hours have passed since their last fever without the use of antipyretics, and
Their other symptoms have improved.
Mothers who have not met these criteria may choose to temporarily separate from their neonates in effort to reduce the risk of virus transmission. However, if after discharge they will not be able to maintain separation from their neonate until they meet the criteria, it is unclear whether temporary separation while in the hospital would ultimately prevent SARS-CoV-2 transmission to the neonate, given the potential for exposure from the mother after discharge.
Separation may be necessary for mothers who are too ill to care for their infants or who need higher levels of care.
Separation may be necessary for neonates at higher risk for severe illness (e.g., preterm infants, infants with underlying medical conditions, infants needing higher levels of care).
Separation in order to reduce the risk of transmission from a mother with suspected or confirmed SARS-CoV-2 to her neonate may not be necessary if the neonate tests positive for SARS-CoV-2.
Snippet from: cdc.gov/caring for newborns