As more Americans receive COVID-19 vaccinations, many activities people have avoided over the last year will likely become less risky. For parents of newborns, there’s the hope that they may feel safe introducing their babies to more loved ones.
“I recognize it is very hard to parent without your village. This past year has been very difficult for parents of newborns,” said Jaime Friedman, a San Diego-based pediatrician and director of marketing at Children’s Primary Care Medical Group.
“Luckily we now have vaccines that are very effective so that more and more family and friends can begin to visit or help out,” she added. “As our vaccine access and eligibility improves, it will be easier for families to surround themselves with other vaccinated adults.”
Recent promising data has suggested that vaccinated people may not transmit the virus and that vaccinated mothers likely can pass COVID-19 antibodies to their babies through the placenta and breast milk, which may provide protection to newborns.
Still, as we remain cautiously optimistic, it’s important to make wise choices when it comes to newborn babies. Below, pediatricians share what you need to know about interactions with newborns in the age of COVID-19 vaccinations.
Newborns are vulnerable to infections
“Newborns are particularly vulnerable to any infections because they do not yet have fully developed immune systems,” said Belinda Mills, a primary care physician at Nationwide Children’s Hospital in Columbus, Ohio. “Because of this, parents should be cautious of anyone who is around the baby, especially if they have a cold. It is particularly important for those babies who have underlying conditions as they might be at higher risk for severe illness.”
While children generally have milder COVID-19 symptoms, infants can be more vulnerable to severe disease, particularly in their first few months of life.
“Although most infants who have been infected with COVID-19 don’t have severe disease, it is still risky,” said Hansa Bhargava, a pediatrician and senior medical director of WebMD in Atlanta. “It’s best to avoid contact with others in the newborn period.”
Infants’ immune systems strengthen over time, particularly after they get their first routine vaccinations and boosters for a variety of serious diseases. They remain at risk, though, for complications of COVID-19 as there is currently no vaccine for babies and children.
Vaccinations make interactions with adults less risky
“As with pre-COVID times, anyone around babies should be up to date on all routine vaccines,” Mills noted. “Especially now that the vaccines are becoming more widely available, I do recommend COVID-19 vaccine for all eligible newborn parents and those who come into close contact with newborns, such as grandparents, close relatives, caregivers, etc.”
For two-dose vaccines like Pfizer and Moderna, she advised having both doses to provide as much immunity as possible. It’s also best to wait for two weeks after your final shot (or your only shot, if it’s Johnson & Johnson), as that’s when you’re considered fully vaccinated. This helps form what the CDC calls “a circle of disease protection around the baby” as their immune system develops.
“When my daughter was born way before the pandemic, I required family members to have Tdap and the flu vaccine before visiting her to prevent pertussis and flu, which can be severe in newborns,” said Candice W. Jones, an Orlando-based pediatrician. “So I prefer visitors to be fully vaccinated against COVID-19 during the pandemic before they visit a newborn.”
Precautions are still important, even after vaccinations
“Even if people are vaccinated, they should wear a mask, wash their hands when they come into the home, and most importantly, not come around if they’re having any symptoms of illness,” Mills said.
Limiting the number of visitors reduces the risk of exposing your newborn to COVID-19 or other serious infections in the first few months.
“If someone is fully vaccinated against COVID-19, it is less likely they will transmit the virus to the newborn or the family,” Bhargava said. “But the vaccine may not protect fully against some variants. Additionally, a person could still transmit another non-COVID virus or infection to the newborn.”
She noted that she was very careful when her children were newborns and limited unnecessary exposure to others until they were 4-6 months of age.
“In the pandemic, it is best to be extra careful and try to limit this until they are even a bit older,” Bhargava said. “If people would like to visit, make sure they are vaccinated, masked and remain socially distanced. Safety and prevention is the best way to prevent your baby from getting sick.”
Interactions with unvaccinated people are possible
When it comes to people who are not yet vaccinated, it’s important to consider the risks to your baby and any other high-risk individuals. Your vaccination status as a parent also makes a difference.
The CDC has advised that fully vaccinated people can visit indoors with unvaccinated people from a single household who are at low risk for severe COVID-19 without wearing masks or physical distancing. Multiple unvaccinated households mixing is still not recommended, but if you choose to go this route, there are extra precautions you can take to reduce risk.
“In this scenario, visitors could lower risks by quarantining and testing prior to the visit,” Jones said. “Of course, observing all safety precautions, such as hand hygiene, mask, social distancing, sanitizing surfaces, lowering numbers of visitors, being outside, and excluding anyone who is sick will also help.”
Others echoed this advice, stressing the importance of limiting interactions with unvaccinated people to outdoor venues and abiding by social distancing guidelines. This is particularly true with children, who are not eligible to be vaccinated and may be exposed to COVID-19 if they’re attending school or camp.
“Unvaccinated visitors should only be seen outdoors, distanced at least 6 feet apart and while they are wearing a mask. Never put a mask on a baby,” Friedman said.
“I always caution parents about visitors who smoke as well,” she added. “During the pandemic, parents need to consider the health of their newborn as well as the health of the visitor. Don’t forget, new parents and their babies are returning home from the hospital.”
Ultimately, it’s up to parents to make the informed choices that are best for their families. And when in doubt, you can always ask your doctor for guidance.