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Care of asymptomatic newborn Covid PUIs


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Hi all

I am looking for protocols  for the care of asymptomatic newborns born to mothers with suspected Covid. One question that has come up in my unit is whether an isolette 6 feet away  ( that is turned off to avoid air circulation) should be used as an ideal physical barrier to  protect the baby from the mother and other caregivers. I did see this recommendation briefly at some  site online but unable to find it now!

Thanks for your help

Mike

Mike Sukumar MD

Rockville MD

USA

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Hi ,

The chinese expert group has given a consensus statement on Perinatal and Neonatal management for prevention and control of 2019 nCOV infection in Feb 2020 in Annals of Translational Medi Here is the link to the said article. http://atm.amegroups.com/post/view/chinese-expert-consensus-on-the-perinatal-and-neonatal-management-for-the-prevention-and-control-of-the-2019-novel-coronavirus-infection-first-edition.

Regards

Dr Satyen

Jaipur, Rajasthan, India

 

 

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20 hours ago, msukumar said:

Thank you for your response, Dr. Satyen. I did read that publication but it does not address my question about using the incubator as a physical barrier

Best regards

Mike Sukumar

Hi Kindly see the page no 6 of the article under subheading of Isolation . It is mentioned that suspected or confirmed cases are suggested to be kept in Incubator. I have highlighted this for you in the attached article.

atm-08-03-47.pdf

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The Swedish national guideline also recommends incubator in this situation.

here you can download the latest version (5 April), but of course in Swedish... https://neo.barnlakarforeningen.se/wp-content/uploads/sites/14/2020/03/Rekommendation-om-handläggning-av-gravida-och-barn-till-kvinnor-med-verifieradelsannolik-Covid-19_ver-2_200405.pdf

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10 hours ago, Stefan Johansson said:

The Swedish national guideline also recommends incubator in this situation.

here you can download the latest version (5 April), but of course in Swedish... https://neo.barnlakarforeningen.se/wp-content/uploads/sites/14/2020/03/Rekommendation-om-handläggning-av-gravida-och-barn-till-kvinnor-med-verifieradelsannolik-Covid-19_ver-2_200405.pdf

WIll have to learn sweedish to go through that . That seems more simple than managing COVID 19 in neonates 😃

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Is the mother severely sick? If the baby is healthy and the mother can care for her baby, why should the baby be isolated? I thought it is conses that mother and baby should not be separated and the mother should breastfeed her newborn. If mum is severely sick the baby should be discharged to the father. 

 

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Nice informative articles

Of course everything changes so fast - Always check online for updates

 

Neonatal Resuscitation and Postresuscitation Care of Infants Born to Mothers with Suspected or Confirmed SARS-CoV-2 Infection (https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0040-1709688 ) ( Full test access is free

Also some nice resource - updated continuously ( https://www.allthingsneonatal.com/category/covid19/ )

Keep checking online - things get outdated within days in this Pandemic

 

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Dear Satyan and Mike Sukumar ,

What decides the separation and care of the Neonate in the Neonatal Unit would be in 2 situations (1) If the baby is unwell / or the (2) Mother is unwell . In all other situations irrespective of the COVID ( Suspect or confined) status of the other , the baby may be roomed in with the mother 6 feet apart and cared by a NON-Covid Attender who can also feed  EBM / or the Mother may feed with recommended drops;let and Contact precautions .

As far as the baby who comes to Neonatal unit for his sickness , on admissions all the neonates will be suspect ( irrespective if they are born to COVID positive or Suspect Mother , so they are cared in the suspect area . They only move away from this area to Positive area when the results of neonates are positive and mother is positive ( that again is a rarity) , hence positive / suspect not possible at admission. As the Neonate other wise not on Vent/ CPAP do not generate the aerosol / the Incubator makes no sense amnd can be cared as other babies are cared . Only the hoods of various seizes can be used for aerosol generating procedures egg, Intubation / suction etc 

Some of these are prepared indigenously ( attached Photographs) 

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