Yesterday, I posted a tweet saying it was uncertain whether the novel virus could be transmitted vertically from mother to child, but I was proven wrong today:
On February 2, a top-tier hospital in Wuhan delivered a baby for a mother infected with the novel coronavirus. Her baby underwent a nucleic acid test for the novel coronavirus 30 hours after birth, and the result was positive!
After receiving the results, the hospital immediately transferred the newborn to Wuhan Children's Hospital, where he was admitted to the dedicated ward for newborns of confirmed and suspected COVID-19 cases. Zeng Lingkong, chief physician of the Neonatal Department at Wuhan Children's Hospital, cautioned that the possibility of mother-to-child vertical transmission should be considered.
The baby currently has no symptoms such as fever or cough, but has developed rapid breathing, abnormal liver function, and a chest X-ray showing signs of lung infection. Although vital signs are temporarily stable, close observation and supportive treatment are still necessary.
Zeng Lingkong also stated, "The newborns admitted to the neonatal ward for confirmed and suspected COVID-19 cases all had mothers who were COVID-19 patients, but the vast majority of the infants tested negative for nucleic acid. However, COVID-19 is a completely new virus, and our understanding of it is still insufficient. Current data shows that newborns are not exempt from infection. This reminds pregnant mothers to avoid contact with COVID-19 patients, and if they are infected before delivery, the newborn needs to be monitored for possible infection."
In short, this news scared me half to death. The novel coronavirus has gone from being less susceptible to children and more susceptible to pregnant women to now potentially being transmitted from mother to child. It's like it's constantly lowering our "limits".
Infants and young children have weak immune systems, and newborns primarily obtain their immune factors from breast milk.
So, if the mother is infected with the novel coronavirus, do uninfected babies have no choice but to stop breastfeeding? What should be done for infected newborns?
Based on the latest national management plan for 2019-nCoV and in light of the actual situation, the Working Group of the Perinatal Neonatal Novel Coronavirus Infection Prevention and Control Management Plan of the Editorial Board of the Chinese Journal of Contemporary Pediatrics has proposed the "Perinatal Neonatal Novel Coronavirus Infection Prevention and Control Management Plan (First Edition)" (hereinafter referred to as the "Plan").
The contingency plan states that if a mother is infected with COVID-19, breast milk from infected mothers should be avoided to reduce risk, and the mother should be immediately isolated for 14 days postpartum. Breastfeeding can be considered after the mother recovers from isolation treatment. Donated breast milk can also be used, but it must be pasteurized before use.
If a newborn is confirmed to be infected, the contingency plan recommends:
All suspected or confirmed neonatal cases should be admitted to the neonatal ward for monitoring and treatment as early as possible. Clinical treatment should focus on symptomatic and supportive care, maintaining internal environmental balance, and minimizing airway manipulation. Effective single-room placement and implementation of contact and droplet isolation measures should be adopted, and airborne isolation measures should be implemented when performing procedures that may generate aerosols.
Treatment of severe neonatal cases: In addition to symptomatic treatment, prevention and treatment of complications, and effective organ function support are crucial. For infants with severe acute respiratory distress syndrome presenting with "white lung," high-dose pulmonary surfactant, nitric oxide inhalation, and high-frequency oscillatory ventilation (HFOV) may be effective. In particularly critical cases, continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO) may be necessary.
For family members who wish to visit the newborn, it is also recommended to take precautions.
Newborns can be discharged from the hospital once they meet the following criteria:
Asymptomatic infection: Collect upper respiratory tract specimens (nasopharyngeal swab + pharyngeal swab) every 2 days to test for 2019-nCoV, and get two consecutive negative results (at least 24 hours apart).
Upper respiratory tract infection: Body temperature has returned to normal for more than 3 days, symptoms have improved, and two consecutive upper respiratory tract secretion specimens (nasopharyngeal swab + pharyngeal swab) collected at least 24 hours apart have tested negative for 2019-nCoV.
Pneumonia: Body temperature returns to normal for more than 3 days, respiratory symptoms improve, lung imaging shows significant absorption of inflammation, and two consecutive tests (at least 24 hours apart) of upper respiratory tract specimens (nasopharyngeal swab + throat swab) and lower respiratory tract specimens (sputum) are negative for 2019-nCoV.
The fight against the coronavirus seems far from over. All we can do is continue to pray and urge everyone, young and old, to take precautions and remember: wash your hands frequently, wear masks, and stay home as much as possible!
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