In the UK especially, it is widely accepted that physical contact between mother and baby from birth onwards is immensely beneficial for both. Supported by UK Baby Friendly Initiatives standards in 2018-19 by UNICEF (2019), skin-to-skin contact assists with the regulation of the baby's temperature, heart rate, breathing as well as other benefits. But how has the global pandemic impacted this practice? Mothers who have contracted SARS-CoV-2 should still be given the opportunity to bond with their baby and practice skin-to-skin contact however in a safe manner.
In response to this, the Royal Collge of Midwives developed a rapid review - ‘Optimising mother-baby contact and infant feeding in a pandemic’ - which sheds light on the effects the virus has had on mother-baby contact and general maternity care. The review, authored by Renfrew et al (2020), details how the pandemic has altered how mothers interact with their babies which in turn affects breastfeeding, bonding and more. It has also presented other issues that were not necessarily present prior to the pandemic, such as families being excluded from the birth; visiting one's baby at the neonatal unit; as well as fear and isolation during a time when mothers need the most support.
When looked at as a whole, such drastic changes “pose a risk to immediate, close and loving contact between the mother and newborn infant and with the other parent and the wider family, to the initiation and continuation of breastfeeding, and to future individual and family well-being and public health” (Renfrew et al, 2020). The concern is the knock-on effect this may have in the future and how well mother and families are able to adjust post-birth.
While there is currently no evidence suggesting that vertical transmission of SARS-CoV-2 is possible, it is important to monitor and review the situation on a case-by-case basis. Renfrew et al (2020) have provided guidelines for midwives to assist with putting measures in place during the pandemic, and while have stressed the importance of remaining diligent during this outbreak, they have also highlighted how crucial it is to try and keep mother-baby contact as normal as possible. Such recommendations include (Renfrew et al, 2020):
- All parents and carers should be encouraged to observe strict hygiene measures
- Suspected or confirmed COVID-19 positive infants and infants who have been in contact with suspected or confirmed COVID-19 positive mothers, but who are otherwise well, should not be cared for in neonatal units where the risk of infecting caregivers and immune-compromised infants is high
- Minimising the number of caregivers the infant is exposed to is essential to reduce the infection risk both for the infant and for the caregivers.
Although it is important not to downplay the severity of possible vertical transmission of the virus despite little evidence to support it, we must also not downplay the importance of mother-baby contact and the proven positive effects such bonding has for both.