Abstract

Early reports of COVID-19 in pregnancy described management by caesarean section, with strict isolation of the baby from the mother and formula feeding. This study aimed to estimate the risk of the baby becoming infected with SARS-CoV-2 by examining the type of delivery and the type of infant feeding and looking at mother-infant interaction. Two databases of publications on COVID-19 were searched and all case reports or case series of pregnant women with confirmed COVID-19, where neonatal outcomes were reported, were included. 49 studies had all the information needed about the type of delivery, infant feeding and infant infection status. 4% infants tested positive after birth, and more tested positive after Caesarean delivery than after vaginal birth. Of reported breastfed babies 5% tested positive compared with 5% for reported formula fed ones, and more infants who were isolated from their mothers tested positive. We concluded that COVID-19 infection is uncommon in infants and that it is rarely symptomatic. The rate of infection was no greater when the baby was born vaginally, breastfed or remained with the mother. The practices early on in the pandemic of separating infants from their COVID-19-positive mothers and advising against breastfeeding could not be justified.