As COVID-19 numbers rise in many states across the country, several children too are getting infected with the virus. In Karnataka, for example, 88 patients are infants and toddlers, while 122 patients are between the ages of 5 and 10.
Many parents are worried and ask what happens if a mother (usually the primary caregiver in India) and child, both or either one test positive for coronavirus. Will they be allowed to stay together in the hospital, the same ward or the same room, is the question often posed.
According to Dr P Shravan Kumar, Superintendent of Gandhi Hospital in Hyderabad and the Telangana Coordinator for measures to tackle COVID-19, “The mother and child, even if one of them is positive, can be in the same room. However, physical distancing should be maintained, and the mother should wear personal protective equipment (PPE).”
The state-run Gandhi Hospital, which has designated wards for COVID-19 patients, follows the guidelines of the World Health Organisation (WHO) when it comes to handling cases where mothers or young children who are dependent on caregivers, are diagnosed with COVID-19.
“A four-year-old child or a newborn cannot be separated from the mother. In such cases, independent rooms will be given to the mother and children, where beds will be at two different corners. The attendee or caregiver should take all precautions in such a situation. Make sure masks are worn when handling the child,” explained Dr Shravan.
Dr Sajith Kumar R, Head of the Infectious Diseases Department at Kottayam Medical College, which has a COVID-19 care ward, said that it does not follow specific protocols but allows mothers and children to stay together, for practical reasons and on humanitarian grounds.
“It will be difficult for the hospital staff to handle a four-year-old without her/his mother. Some children may throw tantrums and not wear masks. So, in many instances, we allow them to be together,” Dr Sajith told TNM.
However, he warned that there is a risk of the healthy person contracting the virus if they stay together. “We cannot guarantee their safety. We explain these risks to the parents, and if they are willing, we will let them be together,” he said, elucidating with a recent case.
“Last month, we had a case where both the parents were diagnosed with COVID-19 and did not have any caregiver to look after the child at home. After they understood the risk, we let the child stay with the parents in the same room for almost three weeks. Fortunately, the child tested negative,” he said.
On Wednesday, a 20-year-old COVID-19 patient gave birth to twins at Gandhi Hospital. The samples of the twins have been sent for testing and the results are still awaited, although the hospital officials said the babies are healthy.
“As per protocols, we test a newborn soon after its birth and then five days later. If the baby tests positive, the normal treatment protocols will be followed. It usually takes 15 days for recovery. The mother can continue breastfeeding the child until then,” said Dr Shravan.
There is currently no evidence to show that mothers with COVID-19 can transmit the virus through breast milk. “The risks and benefits of breastfeeding, including the risk of holding the baby in close proximity to the mother, should be discussed with her,” the Federation of Obstetric and Gynaecological Societies of India (FOGSI), an organisation of practising obstetrics and gynaecologists, has said.
Bengaluru-based obstetrician Dr Hema Divakar, who is part of FOGSI, said that a mother who has tested positive for SARS-CoV-2 should, in fact, continue to breastfeed the child. “A mother's milk essentially provides the baby with the antibodies or immunity s/he needs. This should not be discontinued as it can be detrimental to the development of the child’s own immunity,” she said.
The United Nations Population Fund (UNPF), a United Nations organisation, recommends breastfeeding with good hygiene practices, including washing hands before and after touching the baby, wearing a mask and not sneezing near the baby during breastfeeding.
“If the mother is particularly anxious about coming in direct contact with the child, we encourage them to express milk using a breast pump,” said Dr Hema, adding that some precautionary measures, including washing hands and wearing a mask, should be followed in this procedure as well.
International organisations like UNDP and WHO say that an ill mother or newborns/infant/toddler should not be separated from each other.
“Immediate and continued skin-to-skin care, including kangaroo mother care, improves thermoregulation of newborns, enables early initiation of breastfeeding, which also reduces neonatal mortality, and it outweighs the potential risks of transmission and illness associated with COVID-19,” the WHO has said.
In such cases, all protocols and preventive measures are adopted, such as wearing masks, gloves, frequent hand washing and using hand sanitisers.