Newborn Care and COVID-19 by Julie Kim https://padlet.com/jlippskim/rmfkjhsoydcg Information for PAFMG physicians caring for newborns en-us 2020-04-01 23:16:28 UTC 2026-02-19 15:17:56 UTC hello@padlet.com Visitor Policies jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489766176 Most hospitals are allowing only one support person for laboring moms.  No other visitors may visit during this time.  

Families can refer to the hospital's website for current visitor information (Stanford and ECH links below) ]]> 2020-04-02 19:19:38 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489766176 Stanford Children's Hospital jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489770524 2020-04-02 19:22:05 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489770524 El Camino Hospital jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489775404 2020-04-02 19:25:00 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489775404 Screening for COVID-19 in our laboring moms jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489779238 All pregnant women will be screened at the entrance of the hospital to determine if possible PUI (e.g fever, cough, resp symptoms).  If the mom is determined to be a PUI, the hospital’s L&D triage policy will be applied to manage mom and baby.  Testing for COVID-19 will be performed on the mother.  This could mean separation of mom and baby but not necessarily.   The support person will also have significant restrictions on their movement in the hospital.  Once she delivers, the infant will be treated as a PUI until mom is determined to be negative.    ]]> 2020-04-02 19:27:15 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489779238 CDC Guidance on Pregnancy jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489782054 2020-04-02 19:28:56 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/489782054 Summary of AAP Guidance on newborns exposed to COVID-19 jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/491910615 2020-04-03 20:53:53 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/491910615 AAP Report on Management of Infants Born to Moms with COVID-19 jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/491911414 2020-04-03 20:54:44 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/491911414 FAQ from AAP jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/491912209 2020-04-03 20:55:37 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/491912209 From Stanford Children's jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492045459 2020-04-04 00:27:47 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492045459 Breastfeeding & COVID-19 jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492051342 Transmission through breast milk has not been documented but the data is limited.  CDC recommends feeding the baby expressed milk rather than direct breastfeeding.  Precautions should be taken when pumping to ensure the pump parts are clean and good hand washing.  
  • Hand hygiene before pumping
  • After each pumping session, all parts that come into contact with breast milk should be thoroughly washed and the entire pump should be appropriately disinfected per the manufacturer’s instructions.  
  • This expressed breast milk should be fed to the newborn by a healthy caregiver.
  • If a mother and newborn do room-in and the mother wishes to feed at the breast, she should put on a facemask and practice hand hygiene before each feeding.

]]> 2020-04-04 00:42:40 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492051342 Breastfeeding and Pregnancy FAQ’s from CDC jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492052241 2020-04-04 00:44:34 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492052241 CPQCC website jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492102612 2020-04-04 02:58:12 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492102612 Risk of COVID-19 to Newborn: jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492668656 It is unclear if COVID-19 can be transmitted vertically to babies.  There are a few articles about this possibility but the numbers are small.  The AAP report published on 4/3/2020 reviews the most current evidence.  It does appear that the risk is low and infants generally do well.  

CDC recommends separation of mother and infant right after delivery to decrease risk of transmission of COVID-19 to the baby.  However,  rooming-in is acceptable if the family declines separation or if the hospital does not have space to separate mom and baby.  If the baby remains in mom’s room, precautions should be in place to minimize the chance of transmission to the baby:  
  • Baby at least 6 feet from mom in isolette
  • Barrier/curtain between mom and baby
  • Healthy support person provides care to baby in PPE
  • Feed expressed milk but if mother chooses to breastfeed, she must wear a mask and perform hand hygiene.  
  • Bath after delivery (no delayed bath)
  • No skin to skin after delivery
Follow PPE guidelines when caring for the infant.

]]> 2020-04-04 18:41:05 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492668656 What to expect when coming to the hospital jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492674052 Families should understand that the current hospital environment is very different due to the pandemic.  Everyone entering the hospital is screened for illness and visitors are restricted.  Strict measures are in place to protect patients, families and health care workers.  

Additionally we are screening all laboring moms for COVID-19 if they have symptoms.  If mom is found to be COVID+, her care will look very different from what the family has likely planned for.  Babies are bathed right after delivery (no delayed bath), no skin to skin time, and likely separation from her baby.  All these measures are to protect the baby but likely will be very difficult for the family.  
]]> 2020-04-04 18:49:31 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492674052 CDC Guidance on Obstetric Care jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492686926 2020-04-04 19:09:02 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492686926 LPCH Management of Newborns Born to COVID+ moms jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492689462 The family will be offered two options:  
1) Separate the infant from the mom. 
  • Feeding:  provide expressed milk, banked breast milk or formula.  
  • NO contact with mother unless her COVID returns negative.  
  • Support person can stay with baby or mom
  • Bathe baby soon after delivery
2) Baby stays in mom’s room.  
  • Baby is kept 6 feet away from mom in an isolette.  
  • Mom to wear mask and perform hand hygiene before feeding baby.  
  • Support person must be healthy and wear full PPE to care for baby.
  • Bathe baby soon after delivery
]]> 2020-04-04 19:12:54 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492689462 Sending home a baby with a COVID+ Mom jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492703369 The family should continue to follow practices to minimize risk of exposure for the baby: 
  • Baby at least 6 feet away from mom except during breastfeeding
  • Mom wears a mask if breastfeeding and practices breast care/hand hygiene
  • Hand hygiene for all household members
  • Clean high contact surfaces in the home
  • Uninfected individuals >60 years of age and those with comorbid conditions should not provide care if possible
]]> 2020-04-04 19:34:06 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492703369 Isolation Guidelines jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492703996 Per CDC recommendations, all infants born to COVID+ mothers will have a throat/NP swab for COVID-19 performed at 24 and 48 hours of life.  If both are negative and the baby is asymptomatic, the baby is not considered to be infected.  However, many babies born by vaginal deliveries will be discharged prior to the second swab being performed.  Additionally, the infant is still potentially exposed if staying in the same household as the parents.  For outpatient care and infection control, we should consider these asymptomatic babies as PUI's until 14 days after birth. ]]> 2020-04-04 19:35:15 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492703996 Summary of CDC Recommendations: jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492710314 If mom is COVID-19, an asymptomatic baby is considered to be a PUI until the following criteria are met:
  1. Test-based strategy.
  • Two negative test results from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart
  1. Non-test-based strategy.
    • 14 days of quarantine at home
For Symptomatic or COVID+ Patients, the Non-test-based strategy:
  • At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
  • At least 7 days have passed since symptoms first appeared

]]> 2020-04-04 19:45:58 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492710314 CDC Guidelines for Discontinuing Home Isolation jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492710877 2020-04-04 19:46:55 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492710877 Caring for sick persons at home jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492721366 2020-04-04 20:03:12 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492721366 COVID-19 Testing on Babies jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492750000 If mom is COVID-19+, throat/NP swab testing performed at 24 and 48 hours is recommended for the newborn.  If both swabs are negative and the baby is asymptomatic, isolation precautions can be discontinued on the baby.  However, risk of exposure exists if the baby is in contact with an infected mom.   Additionally, many babies will be discharged before a second swab can be performed. 

]]> 2020-04-04 20:54:50 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492750000 Procedures on PUI Babies jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492750736 Currently AAP recommends performing  procedures (i.e. circumcisions and tongue tie releases) on all well newborns before leaving the hospital if clinically indicated. 

At LPCH, PUI babies are not allowed in nursery therefore circumcision cannot be performed before discharge.   

PAMF Urology is unable to perform outpatient circumcisions at this time.  ]]> 2020-04-04 20:56:19 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/492750736 Advice for Families jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/493936599 Many families ask how to keep their babies and families healthy during this pandemic.  It is important they understand all the steps that have been taken at PAMF to keep patients and staff healthy like separating sick patients into a completely different site, cancelling non-essential patient visits to decrease traffic in our clinics, screening everyone who enters the building for symptoms, and wearing masks during patient encounters.  Hopefully families understand we have taken these steps to protect both our patients and staff.  

Advice for families for home:
  • Good handwashing for all family members
  • Shelter in Place - stay home except for essential errands like doctor's appointments or groceries. 
  • No visitors including grandparents.  This is very important to prevent the spread of COVID-19 since people can shed virus before they realize they are sick.
  • Provide breast milk for the baby if possible.  It has antibodies which helps prevent infection in the newborn.

]]> 2020-04-06 03:28:46 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/493936599 Scheduling Newborn Visit jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/493937360 Since these babies are considered PUI’s, scheduling the first newborn visits will require care to ensure staff and patients are not compromised.  
  • For all PUI babies, notify the PCP and site clinic physician T1 when scheduling the baby.  
  • Flag the face sheet when registering the baby so the clinic staff are aware special scheduling protocols are needed. 

ALAMEDA REGION:
TBD

CAMINO REGION:
  • Schedule the babies in the MV Respiratory Clinic.
  • Notify PCP and site T1 physician lead

MILLS PENINSULA REGION
TBD
PALO ALTO REGION:
  • Palo Alto site:  
    • Baby will be seen in the isolation room.  
    • Notify the PCP and the Tier 1 (Harry Dennis) about the need for the appointment with as much advance warning as possible.  
    • Do not book COVID+ families with Drs. Dennis, Heneghan or DeHovitz.  
  • Los Altos site:  
    • Do not have an isolation room.  
    • Baby to be seen at PA site until cleared from isolation.  Follow PA process.
  • San Carlos site:  
    • Follow the PA Process

SANTA CRUZ REGION:
TBD

]]> 2020-04-06 03:30:26 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/493937360 Resource from Hospitalist Wellness Subcommittee jlippskim https://padlet.com/jlippskim/rmfkjhsoydcg/wish/497239773 2020-04-07 16:56:21 UTC https://padlet.com/jlippskim/rmfkjhsoydcg/wish/497239773