COVID-19: What pregnant + breastfeeding moms need to know

If you’re pregnant or nursing a newborn right now you are likely extra worried about viruses. We want to protect ourselves and our babies during these vulnerable times in our lives and the spread of COVID-19 understandably has many new and expecting parents on edge.

We understand that there is a lot of information to take in right now, mama. You’ve got a lot on your plate and it isn’t fair that this is getting thrown at you, too. But please don’t let headlines about the pandemic steal your joy. If you are feeling like COVID-19 is making you anxious, please speak to your health care provider and people in your support system.

If you feel like it would be helpful to know more about how the virus can impact pregnancy and nursing, read on.

Are pregnant people at higher risk for COVID?

The Centers for Disease Control (CDC) previously stated that “based on available information, pregnant people seem to have the same risk as adults who are not pregnant” but in late June the CDC updated its stance, explaining that “pregnant people might be at an increased risk for severe illness from COVID-19 compared to non-pregnant people.”

According to a new report by the CDC, “pregnant women were significantly more likely to be hospitalized, admitted to the intensive care unit, and receive mechanical ventilation than nonpregnant women.” The report also shows that Black and Hispanic mothers are disproportionately at risk for COVID-19 infections.

That seems confusing, but it’s a reflection of systemic racism in the health care system and the evolving science around this disease. It should be noted that the CDC has not found pregnant women to be more at risk of death due to COVID-19.

According to the American College of Obstetricians and Gynecologists (ACOG), “very little is known about COVID-19, particularly related to its effect on pregnant women and infants” and that “ACOG is aware of the CDC’s update and continues to update its practices during the “rapidly evolving” pandemic.

The CDC is not trying to scare pregnant women, it just wants people to have the facts they need to weigh risks when they need to.

“Understanding who is most at risk for severe illness helps people make the best decisions for themselves, their families, and their communities,” CDC Director Dr. Robert Redfield explained. “While we are all at risk for COVID-19, we need to be aware of who is susceptible to severe complications so that we take appropriate measures to protect their health and well-being.”

“Pregnant women should engage in usual preventive actions to avoid infection like washing hands often and avoiding people who are sick,” the CDC notes on its website.

The good news is you are probably already doing that, and the good news doesn’t end there.

If a pregnant person gets COVID-19, will the baby get it, too?

​A study published in The Lancet examined the health of nine babies born to moms during a COVID-19 infection. All of the babies had good Apgar scores, scoring in the 8-9 range at the one-minute mark and getting a 9-10 by 5 minutes. Additional research published in JAMA examined 89 babies between 1 month and 11 months old who did get COVID-19 (from living with an adult who had it). Of those babies 4 got a fever, 2 had respiratory symptoms and 1 had no symptoms at all. None of the 9 babies needed intensive care or ventilation because none of them had severe symptoms.

Since that study, there have been rare cases in the United States where babies have needed ventilation and very few infant fatalities due to COVID-19.

Can I get the COVID-19 vaccine while pregnant?

The American College of Obstetrics and Gynecology, the Centers for Disease Control and Prevention, and the World Health Organization (WHO) all agree the COVID vaccine is safe for those who are pregnant.

New research finds no evidence that the Pfizer-BioNTech or Moderna vaccines pose serious risks during pregnancy, to either mother or baby. The data, published in June in The New England Journal of Medicine, shows that mRNA vaccines are not correlated with an increased risk of miscarriage, stillbirth or birth defects when administered during pregnancy.

Remember: the COVID vaccine doesn’t contain a live virus.

Can I get the COVID-19 vaccine while breastfeeding?

The WHO recommends that breastfeeding people be vaccinated.

If you’re nervous about being vaccinated while nursing, try not to stress, mama.

Researchers have found no evidence of the presence of Pfizer or Moderna COVID-19 vaccines in human breast milk in a small study, published in the journal JAMA Pediatrics.

What does that mean? Well, researchers say it shows that the vaccines are safe to receive while breastfeeding and won’t alter your breastmilk.

Will the COVID vaccine affect my fertility?

According to Johns Hopkins Medicine, the COVID-19 vaccine will not affect your fertility.

“Women actively trying to conceive may be vaccinated with the current COVID-19 vaccines—there is no reason to delay pregnancy after completing the vaccine series,” says their website.

If I get COVID, how will I protect my baby?

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So far, there is no evidence that COVID-19 is transmitted through breastmilk, the CDC notes. Forms of antibodies that protect against coronaviruses have been found in breastmilk samples though, which is good news. That means mothers’ bodies are making antibodies and passing those (but not the virus) on to their infants.

If a mother does get COVID-19, they can follow the CDC’s Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation for COVID-19.

It states, in part: A mother “should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast. If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.”

As ACOG notes, the primary concern is not whether the virus can be transmitted through breastmilk, but rather whether an infected mother can transmit the virus through respiratory droplets during the period of breastfeeding.”

The bottom line about COVID-19, pregnancy + breastfeeding

COVID-19 is absolutely worth taking precautions for, and while this is certainly a stressful time too much stress isn’t good for anyone. If you feel like the worry is impacting your pregnancy, call your health care provider and if you are worried about symptoms you think may be COVID-19, do the same.

Experts suggest not going to the emergency room without calling ahead, so call your OB-GYN or midwife before going to any ER or clinic where sick people may be present.

Symptoms of COVID-19 include:

• Fever
• Cough
• Shortness of breath

The CDC recommends calling your “healthcare professional if you develop symptoms, and have been in close contact with a person known to have COVID-19 or if you have recently traveled from an area with widespread or ongoing community spread of COVID-19.”

Recommendations may change, so stay in contact with health authorities if you have questions regarding this virus.

[This article was originally posted March 2, 2020. It has been updated. Jamie Orsini also contributed to this post.]

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