Newborns coming home to almost post-pandemic world

BOSTON — Massachusetts sits just behind New Jersey and New York when it comes to the percentage of COVID-19 patients who didn’t make it. But these days, there’s a happier pandemic statistic to ponder: a big rush of new babies.

“It does seem just anecdotally that we are seeing a fair number of babies that have been born,” said Lloyd Fisher, MD, president of the Massachusetts chapter of the American Academy of Pediatrics.

Newborns do have vulnerabilities, Fisher said.

So, how to keep them safe in a not-quite post-pandemic world -- but one in which COVID has at least been quelled.

“Really what we need to do is go back to what we’ve always told parents, we’ve always recommended that parents of newborns do,” Fisher said. “And that is, of course, limit the number of total people who come in contact with their newborn, making sure that anybody with any signs of illness doesn’t come in close contact, doesn’t hold that newborn. And then of course everyone washes their hands.”

For the past year new parents haven’t had to make decisions about newborns and crowds. But with things opening up, that’s changed.

“I think where people have been craving social interaction there is going to be some pressure to maybe even have larger gatherings than they would before,” said Fisher. “And I think we still need to go back to what we’ve always known.”

One good reason to limit interactions between newborns and others is the variety of other bacterial and viral threats that haven’t changed because of COVID -- but have largely been absent from the scene because of COVID mitigation measures, such as masks.

Fisher said RSV or Respiratory Syncytial Virus, is one of the most important illnesses for those very young. It’s one of the more common causes of pneumonia, for example, in this age group.

“The majority of infants and young children who get RSV do just fine,” Fisher said. “However every year we do see a number of infants who do have severe disease.”

Those infants wind up hospitalized, with some even requiring intensive care.

While fatalities from RSV are rare -- they do happen.

“Most of the severe cases that lead to hospitalizations, intensive care is really during that first winter,” Fisher said. “So the first 6 to 9 months of life is when an infant is most at risk.”

Days ago, the CDC issued a health advisory regarding a sharp rise in the number of RSV cases nationwide -- but most especially in about a dozen Southern states. RSV infections had remained very low since March, 2020, largely because of mask use and social distancing.

Fisher said RSV and influenza will remain threats as the cooler months come.

So do masks need to be used around newborns? If someone is unvaccinated, the answer is yes. While COVID infections in infants tend not to be severe, no one can predict if a particular newborn might become quite ill.

But transmission of the virus from fully vaccinated individuals is unlikely,  Fisher said.

“If we have a vaccinated adult or a vaccinated teenager then I don’t think it is necessary for them to be wearing masks around infants,” Fisher said.

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