Short Term Neonatal Outcomes of Colocating and Breastfeeding Infants of Mothers Who Tested Positive for SARS-COV-2

Background: There is a paucity of data on the neonatal outcomes of maternal SARS-COV2 infection which has emerged as a pandemic spreading rapidly across the world Further, conflicts in current guidelines exist on whether to routinely separate infants from infected mothers in the hospital, to utilize shared decision-making to regulate care or to encourage exclusive breastfeeding and standard feeding guidelines for these infants At our hospital in New York City which has been the epicenter of the infection in the US, shared decision-making between the mother and clinical team was utilized Mothers who elected to room-in were encouraged to initiate skin-to-skin care and follow routine breast-feeding practices while following strict hand washing and use of masks Infected mothers who were restricted from NICU and mothers of isolated infants were encouraged to provide pumped breastmilk We aimed to elucidate the outcomes of the infants born to mothers with COVID-19 infection following these practices Methods: We identified all neonates born to mothers who were tested positive for SARS-CoV-2 from March 19 to April 22, 2020 at Elmhurst Hospital (Table Presented) Center All infants were tested by nasopharyngeal PCR swabs Data regarding demographic, epidemiologic, clinical features, breastfeeding practices and short-term outcomes including outpatient follow up through telemedicine or in-person visits were obtained by retrospective chart review of medical records Results: Among 118 mothers tested during the study period, 45 (38%) of mothers tested positive of which 18(40%) were asymptomatic All the infants were screened for SARS-CoV-2 and none were positive 3 infants initially tested positive for SARS-CoV-2 on a screen at <24 hours of age, but tested negative on 2 repeated screens and were considered false positives All the infants were asymptomatic for COVID-19 in the hospital Demographic characteristics are described in Table 1 33 babies were roomed with the mother while 7 required NICU admission 5 newborns were isolated from the mother at birth due to maternal request 31 infants were breastfed directly, 9 received expressed breastmilk and 5 did not receive any breastmilk 41 babies were discharged to the same household as mother, one is still in the hospital and 3 were discharged to a different household (Table 2) During follow up, there was a 93% adherence to the initial in-person newborn visit while there was a 100 % compliance to the tele-medicine visit around 14 days All infants were asymptomatic at follow up visits and none had COVID-19 related emergency department visits or subsequent hospital admissions Conclusion: We report no short term adverse neonatal outcomes to skin-to-skin care, rooming-in or breastfeeding in infants of SARS-CoV-2 positive mothers in our population Although this data is preliminary, it could help decide best practices for these infants