We know many people who are going to give birth over the next few months may have concerns about what COVID-19 means for them. If you have questions or concerns, it’s important for you to talk with your health care provider and the hospital or birthing center you have chosen for the birth. Different facilities have different policies based on their current situation.
There have been efforts nationally to limit the number of people in all health care settings to protect our healthcare providers. Talk to your facility about their policies related to the number of support persons who can be present during birth.
The World Health Organization has a good FAQ on pregnancy and breastfeeding that addresses concerns about people who are pregnant and may have COVID-19.
You also will want to talk to your providers, as they know the most about you and can provide the best guidance about giving birth and breastfeeding during the COVID-19 pandemic.
Pregnancy during the COVID-19 pandemic
Am I at higher risk of COVID-19 if I’m pregnant?
Pregnant people are at higher risk of severe illness from COVID-19 and may be at increased risk for other adverse outcomes, such as preterm birth, if they do become infected. If you are sick or have been exposed to COVID-19, you should contact your health care provider. Pregnant people are not at higher risk for contracting COVID-19. See the CDC website for more information.
What precautions should I take to avoid getting COVID-19?
Due to the high risk of severe illness, pregnant people are strongly encouraged to stay at home at all times, except when they need necessary medical care. There is no way to ensure zero risk of infection, so it is important to understand the risks and know how to be as safe as possible. In general, the more people you interact with, the more closely you interact with them, and the longer that interaction, the higher your risk of getting and spreading COVID-19. If you work in a setting where you interact with others, see information below about how to work with your employer to identify ways to limit your exposure. See the CDC website for preventive steps you and people you live with can take.
What if I’m worried about exposure to COVID-19 at my workplace?
As a pregnant individual, you are at risk of severe illness due to COVID-19 and cannot be compelled to work for any business or government function during this pandemic. Based on your pregnancy, you may make a request (written or verbal) to your employer to identify reasonable accommodations to limit your exposure to COVID-19. As outlined in Public Health Order 20-36, employers must provide reasonable work accommodations, such as telecommuting. Employers are also strongly encouraged to provide reasonable work accommodations for individuals who live with you. See this document for more information for employers on reasonable accommodations. You may ask your medical provider to provide documentation to support you in that request.
How will the COVID-19 pandemic affect my birth experience?
For concerns about your birth, it’s important for you to talk with your health care provider and the hospital or birthing center you have selected for birth. Different facilities have different policies based on their current situation.
The World Health Organization has a good FAQ on pregnancy and breastfeeding that addresses concerns about people who are pregnant and may have COVID-19. The CDC website has more information on many of the questions listed below.
What should I do if I’m worried about going into the office/clinic for appointments?
It is important that you continue to receive care throughout your pregnancy. Ask your health care provider how you will continue your appointments throughout your pregnancy, even if you are not going to appointments in person. Health care providers and facilities have changed office visits to limit the number of people coming into the office. Some health care providers are doing visits through telephone or video calls.
Can I get the COVID-19 vaccine while I’m pregnant?
Based on current knowledge, experts believe that mRNA vaccines (like the Pfizer and Moderna vaccines) are unlikely to pose a risk for people who are pregnant. mRNA vaccines are not live vaccines, so a person cannot get a COVID-19 infection from the vaccine. The virus mRNA creates a reaction in the body's immune system to fight the virus, creating antibodies, and the mRNA is quickly destroyed. Pregnant people were not included in any of the clinical trials for currently authorized COVID-19 vaccines, therefore, no data is currently available on the safety of the vaccines in pregnant people.
If pregnant people are part of a group that is recommended to receive a COVID-19 vaccine (e.g., healthcare personnel), they may choose to be vaccinated. A conversation between the patient and their health care team may assist with decisions regarding the use of vaccines approved under Emergency Use Authorization for the prevention of COVID-19. While a conversation with a healthcare provider may be helpful, it is not required prior to vaccination.
When making a decision, pregnant people and their healthcare providers should consider the level of COVID-19 community transmission, the patient’s personal risk of contracting COVID-19, the risks of COVID-19 to the patient and potential risks to the unborn baby, the efficacy of the vaccine, the side effects of the vaccine and the lack of data about the vaccine during pregnancy.
The COVID-19 vaccine should not be given simultaneously with any other vaccines you may get during pregnancy. Wait a minimum of 14 days before and after the administration of other vaccines before getting the first and second dose of COVID-19 vaccine.
There is no recommendation for routine COVID-19 testing before getting a COVID-19 vaccine. Those who are trying to become pregnant do not need to avoid pregnancy after COVID-19 vaccination.
Are there other vaccines I should get while I’m pregnant?
Getting other recommended vaccines during pregnancy can help protect you and your baby from other respiratory illnesses that have similar symptoms to COVID-19. This includes getting vaccinated against the flu and whooping cough (Tdap). Others living in your household should also get vaccinated to protect themselves and you.
If I’m pregnant and contract COVID-19, will my baby get COVID-19?
Based on current research, it appears unlikely that pregnant people will transmit COVID-19 to their baby before or during birth. COVID-19 has not been detected in amniotic fluid, breastmilk, or other maternal samples. However, after birth a newborn can contract COVID-19 from the birth parent or other people. See the CDC website for more information.
How many people can be present in the room during my birth?
The CDC has advised hospitals to limit the number of people allowed in hospitals, including visitors and non-essential staff, to reduce exposure of patients and health care workers to COVID-19. During labor, hospitals have generally made exceptions to allow a support person as long as they are not experiencing symptoms associated with COVID-19.
Talk to your facility or health care provider about the policies where you are going to deliver your baby and if the facility is allowing any exceptions on a case-by-case basis. Decide in advance who your primary support person would be and identify a secondary person who can be available if your primary support person is experiencing symptoms of COVID-19. You can also make plans with your provider about connecting with additional support people through platforms such as FaceTime, Google Hangouts, or Zoom.
If I have COVID-19 at the time of my birth, will my baby be able to stay with me?
Hospitals are taking precautions when caring for people who have tested positive or are suspected of having COVID-19 at the time of their birth to prevent spreading the infection to the baby. The choice of whether to have your baby in your hospital room with you should be made by you and your health care team. Your providers will talk with you about a plan to protect your baby from getting COVID-19 that may include hand washing, wearing a mask, and physically distancing yourself from your baby. You have a right to actively participate in the conversation with your health care provider in your preferred language and ultimately decide how to care for your baby. See the CDC website for more information.
Is it safe to go to a hospital that is taking care of people with COVID-19?
The labor and birth units in hospitals around the state are functioning normally during the pandemic with hospital beds reserved specifically for labor and birth. Hospitals are treating people with COVID-19 in separate areas of the hospital and are taking precautions with all staff, patients and support people to limit exposure. Labor and birth units are taking special precautions to care for people in labor with COVID-19 separately from laboring people without COVID-19.
What can I do if I am worried about my emotional health during this pandemic?
Pregnancy, birth, and the postpartum period can be an emotionally difficult time under the best of circumstances. Having a baby during the current pandemic can heighten normal worries and concerns for the safety of you and your baby. If you or someone you are close to is experiencing symptoms of depression or anxiety, it is important to ask for help. For additional support and resources in Colorado go to www.postpartum.net/colorado or www.postpartum.net/ayuda (for Spanish) or reach out to your health care provider. There are a number of virtual services available to help support you through this time. If you or someone you know is in immediate danger, please call 911. For additional safety information, contact the National Suicide Prevention Hotline at 1-800-273-8255 or Colorado Crisis Services at 1-844-493-8255.
For additional breastfeeding guidance, visit the CDC’s Pregnancy and Breastfeeding website.
Is it safe to breastfeed my baby if I have or think I may have COVID-19?
Breast milk is the best source of nutrition and protects babies from getting sick. The limited studies available suggest breast milk does not transmit COVID-19. Breastfeeding helps strengthen your baby’s immune system because breast milk contains antibodies and other important components. However, your baby could get the virus from contact with you or other caregivers. The CDC recommends breastfeeding or feeding expressed breast milk to your baby while taking precautions to avoid spreading the virus to your baby.
If you are sick or experiencing symptoms, you should take all possible precautions to protect your baby, including washing your hands before and wearing a face mask when you touch your baby. You may breastfeed directly at the breast or express breast milk for a healthy caregiver to feed to your baby.
Can COVID-19 be given to my baby through breast milk?
The limited studies on breastfeeding people with COVID-19 show that breast milk is not likely to transmit the virus to your baby. The main concern is the parent or caregiver infecting the baby through respiratory droplets. Precautions should be taken to keep your baby healthy, including washing hands before touching and feeding your baby and wearing a face mask if you are experiencing symptoms or confirmed positive with COVID-19.
Can COVID-19 be given to a caregiver by handling breast milk?
The limited studies do not indicate any risk of exposure to COVID-19 through breast milk for both the baby and caregivers. Breast milk is protective against sicknesses because it contains antibodies and other important components that help keep breastfed babies healthy. Caregivers should wash their hands before and after handling bottles, no matter if the bottle was prepared at home or at a child care facility.
Can I get the COVID-19 vaccine while I’m breastfeeding?
Based on what is known about how mRNA vaccines work, the COVID-19 vaccines are not believed to be a risk to breastfeeding individuals or babies. It is important to continue breastfeeding. Currently there are no data on the safety of authorized COVID-19 vaccines for breastfeeding individuals, as they were not included in initial clinical trials.
The Academy of Breastfeeding Medicine recommends that lactating individuals who get the vaccine continue breastfeeding their babies after being vaccinated. Breast milk contains antibodies and other components that can boost babies’ immune systems and protect babies from getting sick. Early research has shown COVID-19 antibodies are present in breast milk. It is believed that antibodies created after a breastfeeding individual receives the vaccine may also transfer into breast milk and could provide some protection to the baby.
Breastfeeding individuals who are healthcare workers, or part of other groups recommended to receive the COVID-19 vaccine, may choose to be vaccinated. The American College of Obstetricians and Gynecologists recommends that COVID-19 vaccines be offered to lactating individuals similarly to non-lactating individuals when it is their turn in the phased distribution plan of the vaccine.
Discuss the risks and benefits of vaccination with your healthcare provider. While a conversation with your healthcare provider is helpful, it is not required to receive a vaccine.
What precautions should I take to feed my baby expressed breast milk?
If you are sick or choose to express breast milk to feed your baby, you can do so with hand expression or a breast pump (manual or electric). Be sure to use proper hand washing before touching any pump or bottle parts and before expressing breast milk. Follow recommendations for proper pump cleaning after each use and thoroughly clean all parts that come into contact with breast milk. Clean the pump after each pumping session according to the pump manufacturer’s instructions.
If possible, or if you are too sick to feed your baby, have another healthy person feed your expressed milk to your baby. Be sure everyone feeding your baby follows proper hand hygiene and wears a face mask if experiencing symptoms. To establish and keep your milk supply, it is important to express your milk from the breast as often as your baby eats every day, typically 8-12 times a day for newborns or every 1.5 to 3 hours.
If I am separated from my baby after birth due to COVID-19, can I breastfeed?
If you are temporarily separated from your baby after birth because you are sick with COVID-19 and you intend to breastfeed, you should request lactation support from your hospital and an electric breast pump to help you establish and maintain your milk supply. Expressed breast milk should be fed to your baby by a healthy caregiver. Breast milk protects babies from getting sick and helps strengthen your baby’s immune system.
Do I need to clean breast milk storage containers (bottles, bags, etc.)?
The CDC does not recommend disinfecting breast milk containers after pumping or before feeding a baby. It is unnecessary and unsafe to apply chemical disinfectants to milk storage containers. If a hospital is concerned, follow guidance from the Human Milk Banking Association of North America (HMBANA) and use a simple Bottle Transfer Technique.
What if I need help with breastfeeding?
Seek help with breastfeeding, counseling or psychological support, or practical feeding support from appropriately trained health care professionals, lactation consultants, Women, Infants and Children (WIC) Program staff, La Leche League, and community-based peer breastfeeding counselors. You can find breastfeeding support resources, including virtual support groups and counseling sessions, through the hospital where you delivered or any nearby hospital with maternity services (you did not have to deliver at a hospital to get lactation support there). For online breastfeeding resources, visit BreastfeedColorado.com or the Colorado Breastfeeding Coalition.
If I am separated from my baby and need a breast pump, how can I find one?
Breast pumps can be very useful tools to help establish and increase your milk supply and are often a necessity if you are separated from your baby, whether due to illness like COVID-19 or due to work or school. Insurers are required to provide coverage for breast pumps as part of the Affordable Care Act (ACA). Ask your health insurance provider to determine what pumps are available and how to receive them. If you are on Medicaid or uninsured, you may be able join the Colorado Women, Infants and Children (WIC) program to receive a breast pump and related breastfeeding support, including peer counselors, access to expert lactation support, as well as nutritious food and more - sign up to be contacted by WIC or visit ColoradoWIC.com.
How do I keep my breast pump clean, especially if I have to pump while at work?
In Colorado, all employers are required by law to provide a private space that is not a toilet stall, and paid or unpaid break and/or meal time for employees to express breast milk at work. Always wash your hands well before touching any pump or bottle parts. If soap and water are not available, use a hand sanitizer with at least 60% alcohol. When at work, wear a mask while expressing breast milk. If you are using a shared, multi-user breast pump at work, wipe the pump (including dials, power switch and countertop/table) before and after each use with a disinfectant wipe. Follow the CDC recommendations for keeping your pump and pump parts clean.