Does COVID-19 affect pregnancy and breastfeeding?

If you are trying to get pregnant or are already pregnant, you may be wondering if COVID-19 affects pregnancy or breastfeeding. But there is so much information online, that it can be confusing to understand and follow advice. In this article, we review recommendations from different organisations on this topic, so you can make an informed decision.

Royal College of Obstetricians and Gynaecologists (UK)

In the UK, the RCOG says studies from the UK show that pregnant women are no more likely to get seriously unwell from coronavirus but pregnant women have been included in the list of people at moderate risk as a precaution. It also says that the majority of pregnant women experience only mild or moderate symptoms. This advice is based on a study that included information about the outcomes of 427 pregnant women admitted to hospital with coronavirus and their babies during the pandemic, and was published on 11 May 2020.

Key advice for pregnant women during the pandemic includes:

• Following socially distance recommendations, wearing face coverings. This general guidance may vary depending where you live (England, Scotland, Wales or Northern Ireland).
• Keep mobile and hydrated.
• Regular exercise and healthy diet, with folic acid and vitamin D supplementation.
• Attend all pregnancy scans and appointments unless advised otherwise.
• If you have symptoms:
• call NHS 111 online/NHS 24 for advice
• inform your midwife/maternity team
• if symptoms get worse, contact maternity team, GP or call NHS 111 online/NHS 24

The UK is continuing to monitor the impact of COVID-19 with a few surveillance initiatives, including the UK Obstetric Surveillance System (UKOSS); and the PAN-COVID from Imperial College London. Any new evidence published from this and other studies will be used to update our guidance.

NHS (UK)

NHS recommendations are aligned with those mentioned above by the RCOG, saying “there's no evidence that pregnant women are more likely to get seriously ill from coronavirus. But pregnant women have been included in the list of people at moderate risk (clinically vulnerable) as a precaution. This is because pregnant women can sometimes be more at risk from viruses like flu."

Key advice for pregnant women during the pandemic includes:

• Wash hands regularly
• Stay at home and follow advice on social distancing
• Stay away from anyone who has symptoms
• Attend pregnancy scans and appointment unless advised otherwise
• If you have symptoms:
• Self-isolate
• Book a test
• Speak to your midwife or maternity team
• There is no evidence coronavirus can be passed on to your baby in breast milk, so the benefits of breastfeeding and the protection it offers outweigh any risks.

World Health Organisation

WHO says “pregnant women or recently pregnant women who are older, overweight, and have pre-existing medical conditions such as hypertension and diabetes seem to have an increased risk of developing severe COVID-19. When pregnant women develop severe disease, they also seem to more often require care in intensive care units than non-pregnant women of reproductive age."

Key advice for pregnant women during the pandemic includes:

• Wash hands frequently
• Keep social distance
• Wear a face mask when it is not possible to keep physical distance
• Avoid touching eyes, nose and mouth
• Cover your mouth and nose with your bent elbow when coughing or sneezing
• If you have symptoms, seek medical care early.
• If you have COVID-19 and are breastfeeding, you can do so safely, wearing a medical mask, washing hands before and after touching your baby and keeping surfaces clean.

The reality is that the medical community is still learning a lot about coronavirus and its impact on pregnancy. Even though there seems to be some conflicting views on whether pregnant women are at low, moderate or high risk, the key advice on what to do seems to be similar: follow guidance to prevent infection, like the rest of the population. If you are pregnant and develop symptoms, get it touch with your medical team as soon as possible. 

This article was written on 30th January 2021. Please read current advice from medical sources when making decisions.

References

[1] https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

[2] https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/pregnancy-and-coronavirus/#:~:text=There%27s%20no%20evidence%20that%20pregnant,this%20happens%20with%20coronavirus.

[3] https://www.acog.org/womens-health/faqs/coronavirus-covid-19-pregnancy-and-breastfeeding

[4] https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

[5] https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-pregnancy-and-childbirth