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4 Things to know about COVID-19 and your newborn

By Dr. Kristina Adams Waldorf, Sara Rutz, Isabelle Crary and Carly Baxter

Every mother wants to protect their newborn following delivery. Given the ongoing COVID-19 pandemic and unknown long-term effect of infection in infancy, it can be daunting to know how to best protect your newborn from this virus. Below are several key takeaways about COVID-19 and your newborn, grounded in the latest medical research.

The COVID-19 virus can be transferred from mother to baby in pregnancy.
In a study of 3,750 infants born to pregnant individuals with COVID-19, 8.1% of newborns tested positive for COVID-19. Although most infants hospitalized with COVID-19 did not have major complications, we are unsure of how severe COVID-19 can affect the longer term health of these children. Another study analyzed the outcomes of children in 62 hospitals across 31 U.S. states. Infants (less than 1 year old) made up 20% of all severe COVID-19 cases among children. This is a very high percentage as they included all cases from children and adolescents younger than 18 years old. Of the infants with severe disease, 75%  were younger than 6 months of age. This data suggests that young infants are particularly vulnerable to COVID-19.  It is important to note that this study was done before the COVID-19 vaccine was available to pregnant women. This means  that these infants did not have the vaccine antibodies that transfer from mother to child if the mother is vaccinated. Vaccination of the mother during pregnancy helps to send these protective antibodies to the fetus, which helps to protect them for many months after birth. COVID-19 can infect newborns and young children with serious impacts on their health. Infants who are hospitalized with COVID-19 may need to be admitted to the intensive care unit and require a breathing tube and other means of life support. Getting vaccinated can help protect your infant from this situation, as 88% of the infants who were admitted to the ICU in this study had mothers who were unvaccinated. 

If you are pregnant, getting vaccinated against COVID-19 can help protect your newborn.
Many studies show that when pregnant women receive the COVID-19 vaccine, the mother’s immune system produces protective antibodies to defend against COVID-19. These antibodies make their way into the fetal blood before birth and into breast milk, which continues to provide some protection to the baby after birth. By 15 days after a mother’s first vaccine dose, the levels of antibodies in the fetus are nearly as high as in the mother, helping to protect the infant from severe COVID-19 disease once born. Completing the vaccine series against COVID-19 while pregnant offers partial protection for the newborn from being hospitalized for COVID19. In a study of hospitalized infants with and without COVID-19, the researchers compared how likely it was in each group that the mother had completed a COVID-19 vaccine series (2 vaccines) during pregnancy.  They found that vaccination of the mother was linked to a  32-80% decrease in risk of infant hospitalization from COVID-19. 

Antibodies from the COVID-19 vaccine transfer through breast milk and can protect your baby. 
Breast milk offers much more than nutrition and has long been known to protect infants against numerous infections.  Breast milk contains protective antibodies that act to protect the infant from a variety of infections.  Many studies of pregnant women have shown that protective antibodies against COVID-19 transfer in breast milk following COVID-19 vaccination of the pregnant person. The two major societies that serve U.S. pregnant women (ACOG, SMFM)  strongly recommend COVID-19 vaccination in pregnancy, both to protect the mother and her infant. 

Infants rely on their mother for protection from infections. 
Infants have relatively weak immune systems when they are born. Until their immune system is fully functional, infants rely on antibodies from their mother to help them fight infections. Antibodies from the mother can cross the placenta to reach the fetus before birth. After birth, antibodies can transfer to newborns through breast milk. Getting the COVID-19 vaccine helps the mother make antibodies, which can help protect a baby long before their immune system is ready to fight the infection on its own. 
If you have more questions, please visit our homepage, www.OneVaxTwoLives.com

Meet the Authors

Kristina Adams Waldorf, MD

Kristina Adams Waldorf, MD is a Professor of Obstetrics and Gynecology and Adjunct Professor of Global Health at the University of Washington School of Medicine. She is an internationally recognized expert in how infections impact pregnancy and how vaccines and therapeutics protect the mother and fetus. She is Chair of the National Institutes of Health Obstetrics and Maternal-Fetal Biology Study Section. She is a member of the Center for Reproductive Sciences and the Center for Innate Immunity and Immune Diseases. Her grant support has come from the National Institutes of Health, the March of Dimes, Burroughs-Wellcome Fund, the Canadian Institute for Health Research and the Australian National Medical Research Council.

Sara Rutz

Sara Rutz graduated from the University of Alaska, Anchorage with a Bachelor of Science degree in Natural Sciences and a minor in Psychology. She is now a third year medical student at the University of Washington School of Medicine. Prior to medical school, she worked with diverse & underserved populations in patient care settings and as an insurance specialist for 5 years. She has been involved in research on improving outcomes for infants with Neonatal Opioid Withdrawal Syndrome, quality improvement in obstetric care, and providing up to date information as a volunteer for the COVID-19 Literature Surveillance Team. She is passionate about reproductive medicine and improving access to care for rural and underserved populations.

Carly Baxter

Carly Baxter graduated from the University of Puget Sound with a Bachelor of Science degree in Biology and a minor in French studies. She is now a 2nd year medical student at the University of Washington School of Medicine. She has worked with the MaMHA (Maternal Mental Health Access) group coordinated by the University of Washington and WA Department of Health in an effort to reduce maternal mortality rates in WA state. She is passionate about reproductive justice, equitable health care access and volunteering within her community at local health fairs.

Isabelle Crary

Isabelle Crary graduated from Stanford University with a Bachelors of Arts in Human Biology. She is now a second year medical student at the University of Washington. She has been involved in research on anemia in pregnancy, breast cancer prevention and treatment, and adolescent nutrition. She is passionate about healthcare for individuals who are pregnant, reproductive justice and nutrition education.