Care in the NICU during the COVID-19 outbreak

Having a baby requiring specialized care in the Neonatal Intensive Care Unit (NICU) is stressful under any circumstances. But if your baby is being cared for in  the NICU during the current COVID-19 outbreak, you may have even more questions and concerns than usual.

To address these worries, we spoke with Dr. Kristen Leeman, associate medical director of the NICU at Boston Children’s Hospital. Dr. Leeman provides answers to some of the most common questions she’s been hearing from parents in the NICU.

Are you taking new precautions in the NICU to help prevent the spread of COVID-19?

We have many infection prevention strategies already in place as part of our routine standards of care. We also have a few additional precautions that have been implemented given the COVID-19 outbreak:

• Visitors in the NICU are now limited to two identified and consistent adult caregivers. Children under age 18 are not permitted to visit unless they are a parent. We’re also requiring all visitors to wear masks and encouraging thorough hand washing with soap and water at regular intervals during the visit.
• All of our staff are now wearing masks throughout the day and appropriate personal protective equipment (PPE) for all patient care. We’re using evidence-based recommendations and science to guide what PPE to wear during specific clinical scenarios.
• We’re advising all families and staff to practice social distancing when not at the hospital to avoid exposure in the community. We recommend you review the latest guidelines from the Centers for Disease Control and Prevention (CDC) on how to prevent the spread of COVID-19.

Are you screening parents and staff?

Yes, we are screening all parents, visitors, and hospital staff each time they enter the hospital by asking a series of questions about symptoms.

If they are symptom free, they are given a mask to wear in the hospital. If they have symptoms, they are not permitted in the hospital and are advised to seek medical care.

Have you limited visiting hours in the NICU?

No, parents can still visit at any time. We strongly support family-centered care and view parents as essential partners with the health care team. The presence of parents in the NICU helps support infant and parent bonding and a sense of psychological security.

Are parents concerned about how COVID-19 could affect their infants?

Many parents are worried that if their child catches the virus they won’t be strong enough to fight it off. But, most parents have also said that they feel very safe in the hospital, and appreciate the extra precautions that have been put in place.

Many have also said they appreciate the transparency and open discussions our team is having with them about COVID-19 and our infection control measures. We’ve also reassured families that based on current epidemiologic data, children with COVID-19 tend to have had milder symptoms than adults.

We let families know that while we may not know everything about the COVID-19 virus, we are using all available evidence to ensure the safety of our patients, families, and staff while still providing the highest quality of care.

Have there been any changes to care in the NICU since the outbreak started?

The use of PPE has been the biggest change in the NICU. Our staff has used simulations to practice procedures using COVID-19 precautions to optimize key steps in how we care for each child and ensure the highest degree of safety for both your child and our staff.

Otherwise, our approach to patient care is very much the same. Family-centered care remains a high priority and we are working with families to include them on rounds, bedside check-ins, or videoconferencing updates to make sure they are included in decisions about their baby’s care.

What happens if a new mom or dad has COVID-19?

If a mom or dad has a positive COVID-19 test, they are strongly encouraged not to visit and to self-quarantine for 14 days. After that period they can visit the hospital as long as they are symptom free. If a mom or dad is sick with any symptoms, they are not permitted to visit the hospital.  

If parents can’t be there in person with their baby, we can use video conferencing so that they can see and speak to their baby — and also communicate with care team members for updates.

Can a new mom who has COVID-19 breastfeed her infant?

Yes, she can provide breastmilk. No studies have found COVID-19 in breastmilk, and in fact, breastmilk may contain antibodies to COVID-19. 

If a nursing mother has COVID-19, she can pump milk for her baby and send it to the hospital with a healthy caregiver. We can instruct nursing moms on how to follow strict infection control guidelines, such as thorough handwashing and pump cleaning.

Is your team offering any additional support for families during the COVID outbreak?

Our social work team is putting together a list of emergency resources for families who are dealing with job loss or financial strain related to the outbreak, including virtual wellness resources, tips for dealing with stress and emergency food sources.

Get answers about Boston Children’s response to COVID-19.