To date, most cases in pregnant women have been mild - mirroring the experience in the general populations. Symptoms are fever, cough and breathing difficulties.
There are currently no data suggesting an increased risk of miscarriage in relation to COVID-19.
Labour:
- Continuous electronic fetal monitoring in labour is recommended for women with COVID-19.
- Induction of labour and caesarean section should be deferred if possible for women with COVID-19.
- If Entonox is used then the breathing system must contain a filter to prevent contamination with the virus. There is no evidence that epidural is contraindicated in the presence of coronaviruses.
- Vaginal delivery or caesarean section can occur in women with COVID-19. Care should be individualised.
- Given a lack of evidence to the contrary, delayed cord clamping is still recommended following birth, provided there are no other contraindications. The baby can be cleaned and dried as normal, while the cord is still intact.
- Given the current limited evidence we advise 24 that women and healthy infants, not otherwise requiring neonatal care, are kept together in the immediate post-partum period.
Breastfeeding:
It is reassuring that in six Chinese cases tested, breastmilk was negative for COVID-19; however, given the small number of cases, this evidence should be interpreted with caution. The main risk for infants of breastfeeding is the close contact with the mother, who is likely to share infective airborne droplets.
In the light of the current evidence, we advise that the benefits of breastfeeding outweigh any potential risks of transmission of the virus through breastmilk. The risks and benefits of breastfeeding, including the risk of holding the baby in close proximity to the mother, should be discussed with her. This guidance may change as knowledge evolves.
For women wishing to breastfeed, precautions should be taken to limit viral spread to the baby:
- Hand washing before touching the baby, breast pump or bottles;
- Try and avoid coughing or sneezing on your baby while feeding at the breast
- Consider wearing a face mask while breastfeeding, if available
- Follow recommendations for pump cleaning after each use;
- Consider asking someone who is well to feed expressed milk to the baby
For women bottle feeding with formula or expressed milk, strict adherence to sterilisation guidelines is recommended.
Where mothers are expressing breastmilk in hospital, a dedicated breast pump should be used.
Be informed by reliable sources – Check the HSE and HPSC websites for up to date information. These FAQs from HPSC are very helpful!
https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/frequentlyaskedquestions/
