Consequences of Early Separation of Maternal-Newborn Dyad in Neonates Born to SARS-CoV-2 Positive Mothers: An Observational Study

Abstract

As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues its spread all over the world, data on perinatal management of the maternal-infant dyad are urgent. We performed an observational study to describe the effects of the early separation of the maternal-infant dyad, in case of maternal SARS-CoV-2 infection. We reported the medical records for 37 neonates born to 37 SARS-CoV-2 positive mothers in a setting of separation of the dyad after birth. Data on neonatal infection, clinical condition, and breastfeeding rate were recorded until the first month of life. No maternal deaths were recorded; 37.8% of women had at least one pregnancy-related complication. We reported a high adherence to recommended safety measures after discharged with 84.8% of the mothers using at least one personal protective device and 51.5% using all the protective devices. We reported one case of vertical transmission and no cases of horizontal transmission. However, the separation of the dyad had a negative impact on breastfeeding because only 23.5% of the newborns received exclusively human milk during the first month of life. Despite early separation of the dyad protecting the newborns from possible horizontal transmission of SARS-CoV-2, it negatively affects breastfeeding during the first months of life.

Immune Response of Neonates Born to Mothers Infected With SARS-CoV-2

“…All mothers with SARS-CoV-2 infection were separated from their newborns immediately after birth and during their entire hospital stay owing to the shortage of health care workers and for space optimization. 25 At hospital discharge, the dyad was reunited, and medical staff encouraged infant care and breastfeeding consistent with the Italian National Institute of Health COVID-19 safety guidelines, including handwashing and use of personal protective equipment when caring for the infant.…”

Neonates and COVID-19: state of the art

“… 43 , 44 Despite the fact that early separation of the father can protect the newborns from possible horizontal transmission of SARS-CoV-2, it is not effective at preventing antenatal and intrapartum vertical transmission. 9 , 45 , 46 It is also associated with increased maternal stress, risk for traumatic childbirth, further maternal psychiatric morbidity 47 – 49 and can negatively affect breastfeeding and mother−neonate bonding. 45 , 46 Protected rooming-in is an evidence-based preventive measure for neonates born to mothers with SARS-CoV-2 infection.…”

“…9 , 45 , 46 It is also associated with increased maternal stress, risk for traumatic childbirth, further maternal psychiatric morbidity 47 – 49 and can negatively affect breastfeeding and mother−neonate bonding. 45 , 46 Protected rooming-in is an evidence-based preventive measure for neonates born to mothers with SARS-CoV-2 infection. It is based on overall clinical context and is preceded by an educational program, including handwashing, use of surgical face masks during breastfeeding or caring for the infant, and otherwise physical distancing (2 m) from the infant, strict adherence to sterilization guidelines policies while expressing breastmilk, infection control and prevention practices at home.…”

Does COVID-19 Policy Affect Initiation and Duration of Exclusive Breastfeeding? A Single-center Retrospective Study

“… 27 Only limited studies, including this study, have explored the consequences of temporarily mother-newborn separation on breastfeeding. 28 , 29 Our study shed light on the effect of the COVID-19 policy on EBF initiation and duration during the first six months postpartum. We observed variation in the EBF prevalence at different times during the postpartum period.…”