A 36-year-old woman, who tested positive for COVID-19 , delivered a baby girl at a private hospital in Vile Parle on April 19. But she is yet to hold the newborn in her arms or breastfeed her. Soon after delivery, the baby was wrapped in a sterile cloth and taken to an isolation Neonatal Intensive Care Unit to prevent the mother’s infection from passing on to the baby. On the other hand, a civic hospital in the city, that has perhaps carried out the maximum number of deliveries of COVID-19 positive women, has kept the new mothers and babies together and allowed them to breastfeed. As the pandemic evolves, hospitals and medical experts across the city are following varied protocols in order to prevent mother-to-child transmission of SARS-CoV-2 .
“We are all learning and the steps we take now will tell us what works and what doesn’t,” said gynaecologist Dr. Suruchi Desai, who delivered the 36-year-old woman’s baby at the Nanavati Hospital through a caesarean section. The woman, a resident of Mumbai Central, has seen her newborn on a video call arranged by the doctors. Not allowed to be in the hospital to avoid unnecessary exposure, the father too saw the baby through a video call and a few pictures sent to him on WhatsApp.
Expert views on the separation of COVID-19 positive mothers and babies and breastfeeding differ globally. The World Health Organization (WHO) states that the mother and baby can share the same room and breastfeeding can be done after following strict hand and respiratory hygiene. The Centers for Disease Control and Prevention (CDC) states that mother-to-child transmission of coronavirus during pregnancy is unlikely, but after birth, a newborn is susceptible to person-to-person spread. CDC states that the family members and doctors should take a call on breastfeeding. A Chinese expert consensus, however, states that if the mother is positive, she should be quarantined, the neonate should be isolated and breastfeeding should be avoided.
“If the mother and baby are kept together, what if the mother falters in her hand hygiene? There is always a risk of a negative baby turning positive because of such faltered exposure,” said Dr. Desai, adding they were following Standard Operating Procedures set by senior medical experts at the hospital.
The civic-run Nair Hospital in Mumbai Central has carried out more than 20 deliveries of COVID-19 positive women. Head of Paediatrics, Dr. Sushma Malik said that they were following the WHO guidelines. “Only in cases where the mother has severe symptoms or the baby is already sick due to some reasons, we are avoiding their contact. In all other cases, the mother is kept with the baby and allowed to breastfeed after following the hygiene protocol,” said Dr. Malik, adding that all the newborn babies had tested negative for COVID-19 so far.
Allow breast feeding
Medical experts say that the protocols vary from one hospital to another but the ultimate aim is to break the chain of transmission of the virus and safety of mother and the baby. “Several studies have shown that the virus is not present in the breast milk. The problem is with the contact of mother and child. Considering the crucial role of breast milk in developing the baby’s immunity, the mother can be allowed to breastfeed after following strict hygiene,” said Dr. Alpesh Gandhi, president of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), adding that while in the same room, the mother and the baby should be kept at a two-meter distance from each other.