Having a Baby During a Pandemic? Part Two: Pediatric Visits, Early Visitors, and Mental Health

This post is a continuation of thoughts on the pregnancy and delivery experience during the pandemic. Did you miss Part One?

If you need advice for your first days at home with a new baby during a pandemic, you are in the right place. 

The first visit to the pediatrician.

By the time your baby is born, I hope you have found a pediatrician you love. (Here’s my 5 questions to ask a pediatrician during your interviews, if you need some direction.) During the pandemic, all pediatric visits remain essential visits, especially in the first few weeks of life. 

A baby’s physiology is changing rapidly during the first few days after birth. Heart defects, metabolic issues, growth failure, and high jaundice levels are just a few significant issues that may not be detected until well beyond early hospital discharge. Follow-up appointments with a pediatrician are crucial during these early days to discover and manage these problems. 

Rest assured that pediatric offices across the country have modified office procedures to allow safe newborn visits. Be sure to call your pediatrician to arrange follow-up before you leave the hospital, and expect to visit the pediatrician’s office more frequently if directed to do so.

I have been disappointed to hear of pediatric offices doing newborn visits virtually. However, I understand in some geographic areas there are severe barriers to seeing children inside the office. You may inquire with your prospective pediatrician about their plans to serve their families throughout the pandemic and prioritize clinicians who plan to safely continue in-person visits. 

Vaccines. 

Keeping your child up-to-date on vaccinations remains critically important during this pandemic. Although it may “feel” safer to delay vaccines at times of uncertainty, lethal viral and bacterial diseases can still be spread through asymptomatic carriers and vaccine-preventable illnesses are still circulating. Your infant’s best defense against preventable illness continues to be routine vaccines. Hepatitis B should be offered prior to leaving the hospital. Baby’s first set of vaccinations should occur between 6-8 weeks of life. Your baby’s pediatrician will have a safe way to get to the office and get vaccinated on time, just give a call to find out your options.

Visitors.

It may seem to make sense that if an entire family has been isolating for weeks and is feeling well, a quick visit to another person’s home to meet a new baby might be okay, but the short story is, maybe not. Pre/asymptomatic infection spread remains a significant gap in our medical knowledge of COVID-19, and a new parent or infant catching the virus from a visitor is a concern that remains.

Allowing visitors is based on very individualized factors like the health of your own family, who you want to visit and if they have risk factors for illness, what you want the visit to look like, and how long the visit might last. This is all under the umbrella of the level of illness in your local community.

To figure this out, you want to lean into your experts – local and national. Offer details to your medical team about the type of visit your family desires, and allow them to blend your goals with local insight. Ask your OB’s opinion as he or she is preparing your family for your delivery. Ask the pediatrician who is discharging you from the hospital. It’s also important to be familiar with and understand current guidelines from the CDC and from your community health department. Blending all of that information together should help you make the right decision for your family.

Data has been consistent that the population at greatest risk of death and dying from COVID-19 are aged 65+ years (read: grandparents). For this special group, it’s important to highly consider continued physical distancing for their health and safety. The decision to keep people from visiting the new baby is tough, but we must stand firm in the goal of protecting one another until it is deemed to be safe.

Finally, know that even if you can’t be with each other IRL, there are ways for baby to safely interact and meet new people like Zoom hangouts, FaceTime, voice recordings, and personal picture books. I know these alternatives are not ideal, but they can be helpful ways to connect until in-person visits are safe. 

If you believe the benefit to early newborn visits exceeds your family’s risk, safer visits would be after a mutual two-week self-quarantine, take place outside, and be short in duration. Any visitor must thoroughly wash up prior to holding the baby and should wear a facial covering. Of course, this is assuming that everyone is feeling well and has had no recent symptoms of illness. 

Early development. 

Infants do not need “social time” for many weeks after birth. Early infant development is entirely dependent on interaction and attachment to parents. Although isolation is, well, isolating; don’t stress about how a lack of visitors or interaction with other children could be negatively affecting early cognitive and social development for your newborn. Tummy time, high-contrast cards and toys, getting outside to take a walk with appropriate distancing (babies should not wear a mask or facial covering when outside), singing and talking with your baby, reading stories – these are things that all infants need for secure early development and attachment. The good news is that all these things can be done at home and without any fancy devices, tricks, or toys.

If mom or dad are sick.

If a parent becomes symptomatic with any illness suggestive of COVID-19, immediately isolating from other members of the household is suggested to prevent transmission. Since this virus is affecting individuals differently, it will be important to stay in touch with your doctor to discuss individualized plans for the care and feeding of your new infant should a parent become ill. Having a discussion with a friend or family member who might be willing to step in and help may be valuable. 

Maternal mental health.

Especially during these days of unexpected and sustained stress, I urge new parents to begin addressing mental health from before the infant is born through the early months. We know that maternal anxiety and stress have been shown to affect infants in the womb, so learning self-directed methods to reduce stress and anxiety should begin today. In addition, preparing for postpartum mental health support should be part of every parent’s birth plan. This would include open dialogue between partners regarding expectations for support and infant care, discussion with your OB regarding medical plans should your mental health suffer after the baby is born, and connection with local therapists in your area who specialize in postpartum support. Most therapists are still offering virtual appointments and group classes from the comfort of your home. You will be thankful to have these support anchors in place, should help be urgently needed in the first few weeks after birth.

Worried you may be experiencing peripartum mental health issues? Take a quiz here and get connected here. 

Where to turn for more help

Choosing to receive information and advice from reputable sources is critical as news is shifting quickly. Up-to-date information for pregnant people and newborns can be found at cdc.gov, healthychildren.org, and acog.org. Connect with these sources routinely, but be equally mindful of the needless stress that continuous connection with the news may bring. Take breaks from the news when needed and allow yourself to connect with your baby and partner, distraction-free, as much as you are able.

Need more? Resources and references on COVID-19 in kids, newborn feeding plans, and what to expect at the hospital can be found in Part One of this series. 

A version of this post was originally published on US World and News Report’s parenting blog.