Mommies and expecting mommies are you worried about Coronavirus?

Hey mommies and mommies-to-be, I’m sure, you have tons of questions re COVID-19 and your children or your pregnancy. I teamed up with my favourite place, Burlington Health and the Paediatric Place, with an awesome group of doctors (Obstetrician and Paediatricians) who care for my precious Jordan to give you some answers.

This was so helpful to me, so I hope you find it useful too!

Let’s start with the disclaimer that with COVID 19 being a novel virus there is still a lot for us to understand about it. Much is still not known about the Novel Coronavirus and its pathogenesis (how disease process evolves).

However, these are the best-known answers to date.

For expecting mommies

Is it easier for pregnant women to become ill with the virus?

Doc:     Pregnancy alters the immune system in a fascinatingly complex way to accommodate the growing fetus/baby. There is a delicate balance between tolerance of the fetus (a foreign organism) and maternal immunity (ability to fight infection). These changes occur at different stages of the pregnancy and include a reduction in the number of Natural Killer cells and a reduction in T-cell mediated immunity. Hormonal changes also contribute to the immune response as Progesterone, which is present in very high levels during pregnancy, is thought to be a natural immune suppressor.

Once these alterations occur there is a greater predisposition and sensitivity to pro-inflammatory conditions and any viral infection.  

My interpretation: So, basically, our body changes with pregnancy which alters our immune system. So, yes, a pregnant woman may be more susceptible to viruses like the flu or COVID 19.  

So, does that mean that if a pregnant woman becomes infected, she will be sicker than other people?

Doc:     There is no evidence to suggest that she will become more ill. However, some pregnant women enter pregnancy with comorbidities (illnesses they have prior to pregnancy). These women may have a greater degree of sickness. With more pregnancies occurring in women with advanced maternal age (over 35 years) the comorbidities are more prevalent (eg.pre-gestational Diabetes, Hypertension). Then there are others with cardiac disease and asthma who have the propensity to have severe outcomes when the respiratory system is challenged.

Can COVID-19 cause problems for a pregnancy?

Doc:   There is no evidence, at this time, that COVID-19 increases miscarriages or neonatal deaths. (Although this was demonstrated in other related coronavirus infections such as SARS). However, any high fever (from any source) in pregnancy can increase the risk of certain birth defects. Pregnant women should, therefore, take all possible precautions to prevent infection.

Can COVID-19 be passed from a pregnant woman to the fetus or newborn?

Doc:     There is no evidence at this time that it is transferred to the fetus. In two reports including a total of 18 pregnant women with suspected or confirmed COVID-19 pneumonia, there was no laboratory evidence of transmission to the fetus. However, two neonatal cases of infection have been documented. One diagnosed at 17 days of age was attributed to close contact with infected adults; the source and time of transmission in the other case were unclear. 

It is unknown whether the virus can be transmitted through breast milk. The only report of testing found no virus in the maternal milk of six patients.  However, droplet transmission could occur through close contact during breastfeeding.

Thus, mothers with confirmed COVID-19 or symptomatic mothers with suspected COVID-19 should take precautions to prevent transmission to the infant during breastfeeding (including assiduous hand hygiene and use of a facemask). Alternatively, to minimize direct contact, the infant can be fed expressed breastmilk by another caregiver until the mother has recovered. Please note, we do not recommend that you stop breastfeeding.

For Mommies

Are children more susceptible to Coronavirus than adults?

Doc:     What is known thus far is that while children are less likely than adults to have a severe manifestation of Covid-19, they are still vulnerable to being infected with the virus. They do not appear to have a higher risk of acquiring the virus, however. 

Though children may have a milder form of the illness, there is a small percentage, especially infants who can become severely ill. The infection rate may be comparable to adults. However, due to the milder form of presentation, few children are being tested, hence there is limited information on their susceptibility.

Are the symptoms the same as in adults? What signs should I look for?

Doc:     Symptomatic infection in children appears to be uncommon; when it occurs, it is usually mild, although severe cases have been reported. Younger children (if symptomatic, especially infants under 1-year-old) were reported in one study to be more vulnerable to severe infection. Most children do not require oxygen supplementation or ventilation and the infection runs a mild course.

However, you may look for symptoms of acute upper respiratory tract infection including:

• fever
• fatigue,
• myalgia (muscle pain),
• cough,
• sore throat,
• runny nose, and
• sneezing
• more rarely, you may also have fast breathing, shortness of breath and wheezing.

It is very difficult to differentiate these viral symptoms from every other viral infection that occur frequently in children and they seem to recover well.

Please remember that children (including the asymptomatic ones) do transmit infection easily to others (especially vulnerable adults) and this is where the major concern is.

You should look for all the symptoms above, but right now travel history and contact history are very important in deciding if a child has Covid-19. (This will become difficult as Community Spread occurs).

What should I do if I think my child has the virus?

Doc:    Stay calm. The virus appears to be milder in children. Contact your health care provider BUT do not go directly to the doctor’s office. Call ahead and follow the instructions given. You may also call the Ministry of Health and be sure to follow the instructions given.

If possible, isolate the child in a separate room from other children and adults, especially older adults such as grandparents with pre-existing conditions such as diabetes or heart conditions. If possible, have one parent exclusively care for the child.

If an ensuite bathroom is available to use only that bathroom. If the bathroom is shared, the child should be the last person to use the bathroom. Be sure to clean surfaces such as doorknobs tabletop and faucets with disinfectant, bleach or 70% alcohol. Use separate plates, cups and utensils for the child and wash thoroughly after use.

Take comfort in the fact that, most cases are mild and can be managed at home.

• Use only acetaminophen for pain and fever. Monitor temperature with a thermometer. 
• Encourage increase fluid intake.
• You may use saline nose drops for congestion and non-sedating antihistamines.
• Teach cough etiquette, cough or sneeze in a napkin or tissue or in the elbow.

If the child has worsening symptoms such as difficulty breathing, shortness of breath, persistent vomiting or lethargy call your health care provider or the Ministry of Health at once.

Remember, the child may remain contagious even after their symptoms improve.

How can I help to protect my child?

Doc:     Teach your child about the Coronavirus using simple terms or creative illustrations and explain to them the importance of doing things to stay healthy.

Encourage frequent and proper handwashing and/or use of hand sanitizers. Hands should be washed for 20 seconds or for the duration of the happy birthday or alphabet song.

If using a hand sanitizer remind them to count to 10 to let it dry. Explain that this will help to stop the virus from spreading to others.

Be a good role model for your child by washing your hands frequently or making handwashing a family activity. Supervise the use of hand sanitiser, especially in smaller children.

Frequently clean and disinfect high touch surfaces daily in household common areas using Lysol or other regular household cleaning sprays or bleach.

Teach them to practice social distancing and avoid people who are sick (coughing and sneezing) and infants (especially those younger than one) should be kept away from such individuals at all cost.

 Remind children to avoid touching their face.

Teach kids to cough and sneeze into a tissue or flexed elbow. Remind them to throw the tissue away after use.

Wash stuffed animals following the manufacturer’s instructions using the warmest water possible and dry them completely.

School is out, should I keep my child's playdates?

Doc: The short answer is No. However, with the internet, there are many alternatives. These include frequent voice calls and group video playdates. Teenagers are especially great with online games and there are a number of free apps which allow us to stay connected, even though we are apart.

Even though social interaction with other children should be limited, still encourage outdoor play by taking a walk with your children and allow them to ride their bikes. This is great for physical and mental health. Plus, the lack of playdates can serve as great bonding time for parents and children.

Major thanks to Dr.T.Tomlinson Morris and the team at Burlington Health and the Paediatric Place. Call them at 876-616-6816 or 876-853-3202. For some tips on how to talk with your children about COVID-19, check out UNICEF