New study COVID-19 and babies

Published on Tuesday, 10 November 2020

As we head into the second week of our November national lockdown, this week also sees the publication of the first national study to analyse the impact of COVID-19 on newborns in the journal The Lancet Child and Adolescent Health. The study was commissioned by the government, and is what's known as a 'rapid response' study – when information is needed urgently to support giving women and babies the best care. A pandemic is, of course, just such a situation.

The findings should allay fears for families around the consequences for newborn babies who contract COVID-19 infection around the time of birth and supports not separating mother and baby after birth, even if one or other has the infection.

The study traced babies less than 29 days old across the UK who needed to be admitted into hospital with COVID-19 during the first peak of the pandemic from the start of March this year to the end of April. Researchers found 66 babies needed hospital treatment for COVID-19 infection during this time; that's the equivalent of 1 in 1785 births, or 0.06 per cent of births. This means that contracting the infection is thankfully rare for newborns.

“Parents and expectant parents are understandably worried about their babies becoming ill with COVID-19,” says Dr Chris Gale, co-lead author of the study from Imperial College London's School of Public Health. “This study will hopefully provide some reassurance, as it suggests severe COVID-19 infection in newborns is very rare. Most babies only developed mild symptoms when infected with the virus and made a full recovery. This research also supports UK and international guidance to keep mother and baby together even when the mother is known or suspected to have COVID-19.

“Although this study did show that six babies may have contracted COVID-19 in hospital, this data was from the beginning of the pandemic, and infection control measures on neonatal and paediatric units have improved dramatically over the past six months.”

Only 14 babies, who were born to mothers with confirmed COVID-19 infection, developed an infection in the first seven days, and seven of these babies developed COVID-19 despite being separated from their mother for other reasons immediately after birth. This supports UK and international guidance to keep mother and baby together even when the mother is suspected or known to have COVID-19.

None of the babies died from COVID-19 (although one baby sadly died, this was not linked to the infection). Out of 17 of the babies, whose mother had COVID-19, two of these babies may have contracted COVID-19 in the womb. This means if it happens at all, it's rare.

When the data were analysed nearly 90 per cent of the babies had fully recovered from the infection and gone home. The small number of babies still on neonatal units were almost certainly receiving on-going care because they were more premature, but we are still awaiting follow up information.

The study suggests that, while 1 in 3 newborns who develop COVID-19 will need intensive care or breathing support compared to 1 in 7 older children, severe infection in babies is still very rare and the babies may have required breathing support because they were premature rather than ill from COVID-19.

There is further research to be done, however, to understand why nearly half of the babies who developed severe infection were from Black, Asian or minority ethnic groups. And around one in four of the babies were born before 37 weeks. These are both higher than would be expected from the UK birth population.

“As in our recent study of pregnant women with COVID-19, and the general population, we found a higher than expected proportion of the babies were from Black, Asian and ethnic minority backgrounds, which clearly needs further investigation,” says Professor Jenny Kurinczuk, co-lead author and director of the Policy Research Unit for Maternal and Child Health (PRU-MNHC).

“In the meantime, we hope parents may find some reassurance that severe COVID-19 infection, even in the first wave of the pandemic, was rare in babies from Black, Asian and minority ethnic communities.”

For families, the main symptoms of COVID-19 infection to look out for in babies are high temperature, poor feeding, vomiting, a runny nose, cough and less active or alert than usual

If you are supporting women and families with questions around COVID-19 and newborns we've created some FAQs, we hope you'll find useful:

Read the full story: Characteristics and outcomes of neonatal SARS-CoV-2 infection in the UK: a prospective national cohort study using active surveillance