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Avoiding Newborn Illnesses

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You really, really don’t want your newborn to get sick in the first eight or so weeks of life. Not necessarily because, well, you don’t want her to suffer, but more importantly, because you want to avoid a long/expensive/scary trip to the ER. In the middle of the COVID-19 pandemic, this feels all the more true. 

You see, when newborns (0-8 weeks old, give or take) appear sick (spike a fever, say), medical professionals respond swiftly and seriously — because if something really is wrong, things can deteriorate quickly. All in all, newborns are both more susceptible to germs as well as to being medically intervened upon.

A sick newborn sets in motion a chain of events that all parents want to avoid. But the weird thing is that, compared to parents who gave birth before COVID, you already have a leg up on avoiding illness right now (hopefully).

More on that in a minute, but first, here’s how Dr. Kathleen Pope explains what happens if and when a newborn gets sick (i.e., why you want to prevent that from happening in the first place): 

The first two months of life are a high risk time for the more serious kinds of infections. There are some big, bad bacteria and viruses that can infect the child at birth, but don’t start showing symptoms until up to seven-eight weeks after delivery.

Newborns don’t run fevers as quickly or easily as an older child, in general, so seeing a fever in a young infant is a red flag that there could be something more serious going on than, say, a cold virus.

This is why when your little one (under two months old) has a fever over 100.4 F (38 C) it’s considered an emergency. The child needs to be seen right away (usually in the ER), to be tested for more severe infections such as blood infection (sepsis), urinary tract infection, or meningitis.”

At this age, the standard of care for a fever is a full ‘rule-out-sepsis,’ as we call it in the pediatrics world, even if the child is well-appearing. This includes checking blood, urine, and spinal fluid. This also includes the dreaded spinal tap, which I know strikes fear in the heart of every parent.

Thankfully, they are not that technically difficult and certainly not as “dangerous” as most parents imagine they must be. I performed a spinal tap just about every ER shift I worked in this age group of infants.

In addition to sending cultures for bacteria from blood, urine, and spinal fluid, a child under eight weeks with a fever will be admitted to the hospital for 48 hours of intravenous (IV) antibiotics until the cultures are negative for 48 hours. In the event that a bacteria grows in the culture, this generally means a longer course of IV antibiotics and longer hospital stay.

Even though any parent who has to go through this is going to feel like the world is ending and their worst nightmares have come true, the “rule-out-sepsis-admission” is extremely commonplace in pediatrics. At any given moment there is at least one and probably more than one infant admitted to pretty much any pediatrics unit in any hospital in the country for this reason. It is only after the 48 hours of the culture not-growing-anything-of-concern that the declaration “the fever is probably just due to a cold virus” can be made for a child under two months old.

And everyone can finally breathe a sigh of relief.

Playing it Safe

Generally, doctors recommend keeping babies away from large crowds of people during the first two months (especially in the winter months when colds and flus are running rampant) and requiring hand washing before handling babies. 

In the age of COVID, we’re all already familiar with these and other basic rules of thumb for preventing infection (and the risks of airborne transmission):

  • Avoid indoors;
  • Hand-wash, hand-wash, hand-wash;
  • Social distance — Johns Hopkins explains that “minimizing interactions with adults and other children is always best” to avoid newborn illness (meaning, try to keep interactions within your immediate family as much as possible);
  • Wear face masks when visiting with others, and whenever you go out in public, so as to avoid bringing anything home (note — it’s not recommended that babies wear masks) — and yes, even family members should mask up to visit newborn babies during the pandemic.

If you do bring your baby out in public, Michigan’s Health Department recommends wearing your baby in a carrier and covering the carrier with a light blanket. 

Or, you know, get your walking pod on… Anyone?

sick baby -- avoid with a pod?!
whaaat????

The Big Questions 

Some people are saying that you should put off having anyone meet your baby until “after the pandemic.” This is understandable advice, but may be unrealistic for some — given that we are months in and months away from that actually happening. And most new parents feel like they need, you know, some social support. Yes, it’s totally against how we’ve evolved to be isolated for any extended amount of time, especially after bringing a child into the world.

In reality — everyone is going to feel differently about this. Some parents may actually be more comfortable being out in public with their baby, given mask mandates and general social sensitivities these days, while others may not. 

The same goes for meeting grandparents and other family members. The NYT wrote a thoughtful piece discussing the decision, including some advice for how to visit safely. *Remember that testing is getting better — so you can use that to your advantage (especially if you have visitors traveling from “away”). 

All of this said, it’s not the end of the world if your newborn does get sick. Please don’t feel like you have to hole-up in a bunker. It’s important to get out; even just going outside briefly can be a great mood booster. Just also keep in mind that everything you know about preventing the spread of COVID applies twice over with a newborn. 

This sucks, friends. There’s no way around it.  We’re sorry.

Eventually, I promise you, there will come a time when you are not terrified of germs anymore. I remember taking my baby out to dinner with us when she was about a month old (imagine!). An older kid came over to admire her in the stroller, then sneezed RIGHT on top of her. I totally flipped out (on the inside). Then, when I had my second baby, that stuff didn’t phase me one BIT. Trust me: you’ll be like, “OH well.” LOL. 

Eventually

For now, remember to be good to yourself; you’re still right in the thick of adjusting to this new life. In a pandemic. 


Related:

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