What Does COVID-19 Mean for Pregnancy, Breastfeeding, and Fertility?

Robin Berzin, MD
April 2, 2020

If you or someone you love is currently pregnant, breastfeeding, or planning to conceive, it’s likely that you’re concerned and unsure about what the COVID-19 climate might mean for the health of you and your baby. At Parsley Health, we’re here to help navigate you through the noise and explain what we currently do and do not yet know.

For new, about-to-be, and future moms, the good news is that current data on COVID-19 is reassuring and thus far, shows very little impact of COVID-19 infection on otherwise healthy pregnant and breastfeeding women and their babies.

With that in mind, current information on the novel coronavirus is still regularly changing and staying informed is one of the best things you can do to equip yourself with the knowledge and tools needed to feel most at ease during your pregnancy, birth, and postpartum experience.

What is the risk to pregnant women of getting COVID-19?

Changes in the immune system , heart, and lungs during pregnancy can increase the risk of infection for pregnant women—from any type of virus. Specifically, women have shown to have a higher risk of developing common viral respiratory infections such as the flu and even from viruses from the same family as COVID-19, like the common cold. Fortunately, though, according to the report by the World Health Organization (WHO) the current data does not show that pregnant women have any greater risk of contracting COVID-19 than any other group.

Among the research included in the WHO report , a study based in China that looked at 147 pregnant women found that only 8% had severe symptoms and only 1% became critically ill. The large majority of women experienced only mild or moderate symptoms. While promising, because research is limited and our understanding of COVID-19 continues to change, out of an abundance of caution it’s recommended to consider pregnant women an at-risk population.

What about transmission of COVID-19 to newborns?

Newer studies suggest that COVID-19 may cross the placenta—the protective organ that typically blocks harmful viruses and bacteria from reaching the fetus. However, despite finding antibodies in the newborns that recognized the virus, the babies were largely unaffected by the exposure and experienced only mild symptoms, if any at all. More research is warranted to help understand if COVID-19 is in fact passing to newborns in utero.

For infants born to women infected with COVID-19, according to a study of nine babies in China, all were either asymptomatic or developed only mild symptoms and none of them experienced severe complications. Instead, they had low-grade fevers, a cough, or other mild respiratory symptoms that they recovered from.

While current findings are positive, it is too soon to know the potential long-term consequences for exposed COVID-19 babies. For now, the current trends indicate the risk of severe illness for newborns is low and after recovery of mild symptoms, COVID-19 does not appear to affect the infant’s immediate health.

What about breastfeeding and COVID-19?

The biggest concern about breastfeeding and COVID-19 is ensuring an infected mother won’t pass along COVID-19 to her baby through breast milk. In early findings on women with COVID-19 , the virus has not been present in breast milk. What we do know about breast milk is that it is a living fluid that contains antibodies that strengthen immunity and helps seal the newborn’s gut against potentially harmful bacteria, viruses and allergens. Because of this, there are few scenarios when breastfeeding is not recommended for a symptomatic mother as even breastfeeding women with the flu are still encouraged to continue breastfeeding or to feed their babies expressed milk while sick.

The most important thing to do if you continue breastfeeding while symptomatic is to take all the necessary precautions to prevent spreading the virus to your baby. This includes ensuring to wash your hands before touching your infant and wearing a face mask or mouth and nose covering while feeding. If you manually express your breast milk or use a breast-pump, wash your hands before touching the pump or bottle parts and thoroughly disinfect the pump after each use. If you feel more comfortable, you could also consider having a trusted family member who is well feed the baby expressed milk with a bottle.

What if I’m trying to conceive?

If you’re currently trying to conceive naturally, there appears to be little concern in doing so if you and your partner are overall healthy and uninfected by or fully recovered from COVID-19—although studies have not yet been done to see if having COVID-19 could make it harder to get pregnant. Bigger challenges to conception at this time may be navigating the high stress and anxiety that accompanies the current COVID-19 situation and the barrier to having limited access to in-person medical care if needed.

If you were considering undergoing fertility treatment, discussion with your doctor is encouraged as some treatments—including initiation of ovulation induction, intrauterine inseminations (IUIs), in vitro fertilization (IVF), and retrievals and frozen embryo transfers—have been temporarily suspended .

How can pregnant women protect themselves from getting COVID-19?

Whether pregnant, breastfeeding, or planning to conceive, it’s important to take all the necessary precautions to protect yourself from contracting COVID-19. This includes actively engaging in prevention behaviors recommended to the general public including cleaning your hands often using soap and water or alcohol-based hand sanitizer and avoiding people who are sick.

Women in these populations should also continue to take a high quality daily prenatal vitamin that contains methylated B-vitamins, well sourced ingredients, and appropriate levels of key nutrients like DHA fatty acids which are important for baby’s brain development. A prenatal vitamin also helps provide essential nutrients that support strong immunity.

While there are no herbs or supplements known at this time to prevent or treat COVID-19, vitamin C, vitamin D and zinc, are all considered safe while pregnant and breastfeeding and can help support immune function. However, high doses are not recommended during pregnancy but if appropriately included at recommended amounts by your physician, they may be helpful.

Ultimately, it is important to avoid taking any other antivirals or supplements unless they have been explicitly approved by your doctor for use.

What do I do if I start having symptoms?

If you do start to experience hallmark COVID-19 symptoms—including fever, dry cough, or shortness of breath—it’s important to let your doctor know immediately and self-isolate at home if your symptoms are mild and manageable. Recovering from a mild case of COVID-19 is similar to how you’d treat a bad cold or flu—plenty of fluids, ample rest, and proper nutrition.

It’s particularly important to monitor your fever while pregnant, as there may be some risk of fever in pregnancy causing birth defects—although research is controversial . The greatest risk of higher fevers (above about 102°F) appears to be in beginning of pregnancy; during the first trimester. While you should avoid overuse of fever-reducing medications during pregnancy, for those women that do spike high fevers, using Tylenol to help reduce fever for short-term use while sick is encouraged.

To help with symptoms, teas such as chamomile, echinacea, ginger, and lemon balm can help soothe aches and aid in digestion and above supplements for immune support can may help to reduce the severity of symptoms if approved to add into your regimen by your physician.

While many cases of COVID-19 are mild, if your symptoms worsen such that you experience difficulty breathing at rest, severe pressure in the chest, become difficult to wake up, or appear to have blue-colored lips or face, you should seek immediate medical care from your nearest emergency room. Call ahead for safe arrival instructions, opt to have a trusted friend or family member drive you, and to protect yourself and others, wear a mask if possible.

Since information on COVID-19 is regularly changing, we recommend staying up to date with the latest guidelines from the CDC on information regarding pregnancy and breastfeeding in the current climate. If you’re a Parsley Health member, our doctors are here for you through messaging or virtual visits to help guide you through specific recommendations, screening, and testing as needed.

Robin Berzin, MD

Dr. Robin Berzin is the Founder and CEO of Parsley Health, America's leading holistic medical practice designed to help women overcome chronic conditions. She founded Parsley to address the rising tide of chronic disease in America through personalized holistic medicine that puts food, lifestyle, and proactive diagnostic testing on the prescription pad next to medications. Since founding Parsley in 2016, Dr. Berzin has seen 80% of patients improve or resolve their chronic conditions within their first year of care, demonstrating the life-changing value of making modern holistic medicine accessible to everyone, anywhere. Parsley is available online nationwide.

Dr. Berzin attended medical school at Columbia University and trained in Internal Medicine at Mount Sinai Hospital in New York City. Her book, Prescription for Happiness: How to Eat, Move, and Supplement for Peak Mental Health, was published by Simon Element in January 2022.

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