Baby dies after mom with COVID-19 goes into premature labor: What we know about how susceptible infants are and how they’re treated

The American Academy of Pediatrics has also issued new guidelines.

April 6, 2020, 4:11 PM

A newborn baby in Louisiana has died in after being born premature to a COVID-19 positive mother. The death is believed to be the first of its kind in the state, according to a local health official.

The baby's mother, who was not identified, was admitted to a Baton Rouge hospital and tested positive for COVID-19, the illness caused by the novel coronavirus. The woman was placed on a ventilator and then went into premature labor, according to East Baton Rouge Parish coroner Beau Clark, M.D.

The baby did not survive "because of the extreme premature [birth]," according to Clark. Although there is no way to know for sure why this patient went in to premature labor, her doctor believes COVID-19 may have played a role.

"Had [the mother] not been COVID-19 positive, had not required ventilator support, had not had the shortness of breath, the hypoxia that is associated with the virus, likely she would not have gone into preterm labor and there would have been a different outcome," Clark said in a press conference Monday, adding that the baby "as of now has not tested positive for COVID-19."

Earlier this month, a 6-week-old Connecticut baby who later tested positive for COVID-19 was brought to a hospital in an unresponsive state and couldn't be revived, according to Connecticut Gov. Ned Lamont. A Chicago infant under the age of 1 who tested positive for COVID-19 also died, according to public health officials in Illinois.

The news of the infants' deaths, along with several other reports of infants testing positive for COVID-19, the illness caused by the virus, has given the parents of newborns and infants another worry -- that their baby could contract the virus, which has to date resulted in more than 10,000 deaths in the U.S.

The American Academy of Pediatrics (AAP) has also issued new guidelines for the care of infants as doctors learn more about the impact of the coronavirus on the youngest among us.

Here is more information from experts on infants and COVID-19, including more details on the AAP's new guidelines.

What we know about infants and COVID-19

Experts have long said the older population remains at a higher risk for COVID-19. Data from China, where the virus was first detected, indicates that the oldest of those affected were more likely to be hospitalized during the recent outbreak, and the oldest of the old were less likely to survive the severe respiratory illness that results from the infection.

The number of diagnosed COVID-19 cases around the world has now surpassed 1.3 million, meaning more people, including infants, have and will get the virus, experts say.

"This is a virus that’s never been in the human population before so literally everyone in the world is susceptible to it except for those who have already had it," Dr. David Kimberlin, professor and co-director of the Division of Pediatric Infectious Diseases at the University of Alabama-Birmingham, told "Good Morning America." "When the numbers get that large, in terms of people affected, then you will see those very rare and unusual situations."

The fact that more infants have not so far tested positive for COVID-19 shows that young people are not as affected by the virus as older people, according to Kimberlin.

"If it was going to be a common phenomenon, I think we would have already seen it," he said of infants and children testing positive. "Not to say it can’t happen, but it does not appear to be a likelihood."

It is too early on in the pandemic to know why coronavirus appears to affect older people more severely than it does the young, according to Kimberlin.-

"Children normally would be in many situations predisposed to having more severe disease, especially very young children, and yet with this particular outbreak and this particular virus, right now it doesn’t appear that they are," he said.

Both Kimberlin and Dr. Rachel Thornton, an associate professor of pediatrics at Johns Hopkins Medicine, said parents should also remember that common late winter and spring viruses are going around, as well as some flu activity.

"Not every fever, not every cough is going to be this new COVID-19 virus," said Kimberlin. "That said, the coronavirus is circulating widely and so it has to be on our radar and part of what we’re thinking. Pediatricians across the country are on heightened awareness with this."

New guidelines for care providers

The AAP's guidelines, issued on April 2, focus primarily on newborns who are born to women who have tested positive for COVID-19 or are being tested for the virus.

In those cases, doctors should use "standard procedural mask and eye protection, gown, and gloves" when coming in contact with infants, according to the APA.

Separating moms with COVID-19 or suspected of the virus from their newborn will help to minimize the risk of postnatal infection, according to the APA. The organization also recommends bathing infants "as soon as possible" after birth to remove any viruses on their skin.

Healthy infants need to be kept away from infected moms for as much time as possible until the mom has been without a fever for 72 hours without medication and seven days have passed since symptoms first appear, or until the mom has negative test results from at least two tests done more than 24 hours apart, according to the APA.

How infants are diagnosed, treated

One of the top points for parents of infants to remember amid the coronavirus pandemic is that in most cases infants should continue to go to their regularly scheduled pediatrician appointments, especially to receive their vaccinations, according to Thornton.

"A big part of our job is helping keep babies healthy, making sure that newborns are growing and developing properly and getting their routine vaccinations to prevent infections from other illnesses that can be severe in children," she said. "It's really important to still make sure that we’re doing the preventive care that keeps babies safe from other types of infections."

PHOTO: A nurse in protective suit attends to a baby with COVID-19 in an isolation ward of Wuhan Children's Hospital in Wuhan, China, in a photo taken on March 16, 2020.
A nurse in protective suit attends to a baby with COVID-19 in an isolation ward of Wuhan Children's Hospital in Wuhan, China, in a photo taken on March 16, 2020.
China Daily via Reuters, FILE

If a baby is showing symptoms, especially a fever, Thornton and Kimberlin say parents should call their pediatrician first.

"Call the pediatrician’s office and the doctor or their staff will be able to sort through what symptoms the baby is having, whether they need to be seen in the office or whether they need to go to the emergency room," said Kimberlin. "They will use the symptoms' information with what they know is already circulating in the community."

The pediatrician will also help determine whether your baby's symptoms are severe enough to be tested for COVID-19, which would include a nasal swab, according to Thornton.

In mild cases, treatment for COVID-19 in babies would focus on lowering the fever, explained Kimberlin. Other treatments would be needed only in severe cases that involve hospitalization.

Symptoms to watch for in babies

The most important thing to watch for in a baby is a fever, which would be a temperature of 100.4 degrees Fahrenheit or higher, according to Thornton.

"Call [your pediatrician] if you notice your baby has a fever, regardless of whether they have other symptoms," she said.

Other symptoms to watch and note to your pediatrician include how well your baby is feeding, how alert they are and their hydration level (Are they making tears when they cry? Are their diapers wet?), according to Thornton.

Also, pay attention to your baby's breathing.

"We get concerned when babies are working hard to breathe, like if their neck is bobbing up and down or they seem to be putting extra effort into breathing," said Thornton. "And any change in the color around their mouth, severe coughing episodes, those would potentially signal to us something a little more severe that would warrant medical attention."

How to keep your baby protected from COVID-19

Parents should follow CDC guidelines to socially distance, stay home, sanitize surfaces and wash hands, according to both Thornton and Kimberlin.

"The things that parents can do to protect their children are the same things they can do to protect themselves and their parents and so forth," said Kimberlin. "Social distancing, washing hands, wiping down surfaces, those kinds of things are going to be what protect not only infants but also the people who are even more at risk, the grandparents and parents who have other chronic conditions."

PHOTO: Emergency medicine physician Thomas Krajewski wears a mask as he holds his baby Cal with his wife Genevieve after finishing his shift amid an outbreak of coronavirus disease in New Orleans, March 27, 2020
Emergency medicine physician Thomas Krajewski wears a mask as he holds his baby Cal with his wife Genevieve after finishing his shift amid an outbreak of coronavirus disease in New Orleans, March 27, 2020.
Kathleen Flynn/Reuters, FILE

The American Academy of Pediatrics (AAP) also offers these tips for parents on its website.

1. Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer. Look for one that is 60% or higher alcohol-based.

2. Reduce close contact with others by practicing social distancing. This means staying home as much as possible and avoiding public places where close contact with others is likely.

3. Keep your kids away from others who are sick or keep them home if they are ill.

4. Teach kids to cough and sneeze into a tissue (make sure to throw it away after each use!) or to cough and sneeze into their arm or elbow, not their hands.

5. Clean and disinfect your home as usual using regular household cleaning sprays or wipes.

6. Wash stuffed animals or other plush toys, following manufacturers' instructions in the warmest water possible and dry them completely.

7. Avoid touching your face; teach your children to do the same.

8. Avoid travel to highly infected areas.

9. Follow local and state guidance on travel restrictions.

What to know about coronavirus:

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