Newborns/Infants and (Un)Vaccinated Visitors!

Shannon M. Clark, MD
May 13, 2021
Newborns/Infants and (Un)Vaccinated Visitors!

Welcome home, baby!

But wait...are those people coming to visit vaccinated? And what about older siblings in the home who can’t get vaccinated? Who can hold baby? Is it best to visit indoors or outdoors?

You might have a lot of questions and very little information on what do to now that people can get the COVID-19 vaccine, and we can finally start seeing our family members!

Vaccinated and unvaccinated visitors

Today, I’m sharing guidance for vaccinated and unvaccinated visitors coming in to the home to see newborns/infants. Click here to watch the very important discussion I had with Neonatologist, Dr. Prem Fort, @thenicudoc!

Clark-Fort Live Discussion

In this live discussion we address the following:

  • the definition of newborn, infant, toddler and preschooler
  • are they considered high risk when considering COVID-19 exposure
  • definition of being fully vaccinated
  • guidelines for vaccinated and unvaccinated people visiting newborn/infant
  • effect of the pandemic on postpartum support
  • face masks/shields on children
  • testing newborns for antibodies
  • having other unvaccinated siblings who are in school

The age ranges for babies and young children and who is considered "high risk"

Newborn is from 0 up to 3 months, infant is from 0-1 year, toddler is from 12 months to 3 years, and preschoolers are from 3 to 5 years. Newborns are high risk when considering COVID-19 exposure. 0-3 months is considered a high risk person, and it applies to infants up to 1 year of age as well. The younger the baby, the higher the risk. If a baby was born premature, that baby will be considered even more high risk. Premature babies usually reach immune development at 2 years old adjusted age.

Why are newborns and infants up to 1 year considered high risk?

Your immune system is very low when you are born since the “infection fighting cells”, or white blood cells, are developing. Once born, the baby’s immune system is getting exposed to the outside world, but the response is not immediate immune development. The immune system development takes time. Therefore, babies don’t respond as strongly to exposure to COVID-19 as an older child or healthy adult would. If an infant or newborn gets exposed, they can get sick very quickly with more likelihood of needing hospitalization. If the baby is premature and has lung disease, the baby is at higher risk than other infants at the same age. In addition, a baby is at risk for dehydration. For a 4 month old, who needs to be eating/drinking every 4 hours but gets sick and doesn’t want to feed for 8 hours versus a 4 year old who gets sick and doesn’t want to eat for 8 hours, the 4 month older is much more likely to get dehydrated. This poses severe consequences to a young baby.

A few guidelines for visiting infants and toddlers

If you have a healthy 12 month to 2 year old, and you are considering allowing a vaccinated grandparent or other person visit the child, you have to consider if the psychosocial and emotional benefits of that visit outweigh the risk of exposure. It is best if the vaccinated visitors use a mask, wash hands before and after contact, and physically distance if indoors. However, the parents can decide if the vaccinated visitor can hold the baby rather than physically distance. Either way, direct facial contact is not recommended.

If you have a child under 1 year old, but there are older children or other family members in the home who are not vaccinated, those individuals who are not vaccinated should ideally wear a mask when being in close contact with the newborn/infant, especially if these individuals are potentially getting exposed via outside contacts.

If you have questions or if your child might be considered high risk for medical reasons, ask your pediatrician. They can help you determine the best way to handle vaccinated visitors, as well as other children in the home who cannot get vaccinated and may be in school or daycare.

Some other consideration to keep in mind

  • A healthy child over age 2 is not considered high risk
  • Children age 2 and under are not recommended to wear masks or face shields
  • Avoid having multiple households gather indoors when there is a high risk individual present

Postpartum support from outside visitors

There are many reasons why having support during the postpartum period with a newborn is necessary, and this often means having support from someone outside the household, including a close family member or friend. A vaccinated person can go into the home to help the new parent as long as they are wearing a mask, washing hands and physically distancing to the comfort level of the parent when around the newborn/infant. It is not recommended for an unvaccinated member to come into the household to help. The risk of exposure is too great with an unvaccinated person.

As a new parent, you don’t have to explain why or accept being told that you are wrong if an unvaccinated person is wanting to see you and your baby and you say. "No". You have the right to protect the health of your child to the best of your ability. As a parent, you’re making the best decision for your family.

Antibodies In Babies

Be sure to watch the whole discussion here to get even more information, and also follow Dr. Prem Fort on IG @thenicudoc!

I hope this discussion helps you welcome your baby home with a little more peace of mind. Having a baby can continue to be a joyous occasion, and having the right information can help that happen!

Shannon M. Clark, MD

Shannon M. Clark, MD

Shannon M. Clark, MD, MMS is a double board certified ObGyn and Maternal-Fetal Medicine Specialist, and founder of Babies After 35. In her roles as a clinician, educator and researcher at UTMB-Galveston, she focuses on the care of people with maternal and/or fetal complications of pregnancy. Dr. Clark has taken a special interest in pregnancy after the age of 35, which according to age alone, is considered a high-risk pregnancy.

Follow Shannon on TikTok @tiktokbabydoc, Facebook @babiesafter35, and Instagram @babiesafter35.

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