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| The CDC says: Not everyone needs to be tested for COVID-19. Here is some information that might help in making decisions about seeking care or testing.
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| Each community and state is setting their own guidelines for testing based on their availability of tests, and guidelines change frequently. For example, testing may be done more frequently in a community until it has been determined that “community spread” is already occurring, at which time testing may be re-prioritized for health care workers and sicker patients. PRIORITY is given to those who have exposure, are showing symptoms, and have additional risk factors. |
| Have you had contact with anyone with confirmed COVID-19 in the last 14 days?
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| Have you had any of these symptoms in the last 14 days?
Are you currently experiencing fever over 100°F, difficulty breathing or cough? Do you have a history of a chronic respiratory condition or current symptoms of a respiratory illness? Chronic Obstructive Pulmonary Disease (COPD), bronchitis, asthma, bronchopulmonary dysplasia (BPD) in infants - especially preterm infants
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| Is there a rising number of confirmed COVID-19 cases reported in your social network and community due to significant "community spread" ? CDC: Cases in U.S. updated daily |
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| Understand if You Are at Higher Risk The Centers for Disease Control (CDC) says that the early information out of China, where COVID-19 first started, shows that some people are at higher risk of getting very sick from this illness. This includes:
Those with serious chronic medical conditions like:
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| Help protect the people who protect us. Healthcare workers are on the frontline during a pandemic. That's one of the reasons why it's important not to buy or hoard the supplies that our medical and home healthcare communities need. It's also a good reason to prioritize their testing and treatment. If we support social distancing and limit community spread we reduce the risks of having too few healthy providers to care for too many vulnerable patients. “The risk to our health-care workers is one of the great vulnerabilities of our health care system in an epidemic like this. Most ERs and health-care systems are running at capacity in normal times." - Liam Yore, a board member of the American College of Emergency Physicians |
| The National Perinatal Association and National Association of Neonatal Nurses issue a joint statement. Caring for Mothers with COVID-19 and Their Newborn Infants May 11, 2020 |
| From the American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Academy of Family Physicians, and Society for Maternal-Fetal Medicine A joint, public statement on the safety of birth in hospitals and birth centers March 30, 2020 |
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| Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)
AWHONN is committed to supporting nurses during the pandemic with updates on AWHONN’s efforts related to practice, advocacy, meetings, and organizational messages as well as general resources of interest and links to valuable self-care tools. |
| American College of Obstetricians and Gynecologists (ACOG)
Coronavirus (COVID-19), Pregnancy, and Breastfeeding: A Message for Patients
Coronavirus (COVID-19) and Women’s Health Care: A Message for Patients Practice Advisory: Novel Coronavirus 2019 (COVID-19) The American College of Obstetricians and Gynecologists (ACOG) is closely monitoring the outbreak of a respiratory illness caused by a novel coronavirus (COVID-19) that was first detected in Wuhan City, Hubei Province, China, and continues to expand. Imported cases of COVID-19 infection in travelers have been detected in the United States, and person-to-person spread of COVID-19 also has been seen among close contacts of returned travelers from Wuhan. However, it is critical to note that at this time, for the general public in the United States, the immediate health risk from COVID-19 is considered low. Novel corona virus disease (COVID‐19) in pregnancy: What clinical recommendations to follow? PDF There appears to be some risk of premature rupture of membranes, preterm delivery, fetal tachycardia and fetal distress when the infection occurs in the third trimester of pregnancy. However, there is no evidence suggesting transplacental transmission based on very limited data, as the analysis of amniotic fluid, cord blood, neonatal throat swab, and breast milk samples available from six of the nine patients were found to be negative for SARS‐COV‐2. Whether virus shedding occurs vaginally is also not known. Whether COVID‐19 increases the risk of miscarriage and stillbirth is unknown. Concerns have been expressed by experts in the media about women undergoing termination of pregnancy for fear of congenital infection and teratogenicity. However, information on the effect of COVID‐19 on the course and outcome of pregnancy in the first and second trimesters is not available yet. March 5, 2020 Novel coronavirus infection and pregnancy PDF In summary, based on the available clinical and research data, the clinical characteristics of patients with COVID‐19 infection presenting from mid‐trimester onwards are similar to those of non‐pregnant adults. Currently, there is no evidence that pregnant women are more susceptible to COVID‐19 infection and that those with COVID‐19 infection are more prone to developing severe pneumonia. There is also no evidence of vertical mother‐to‐baby transmission of COVID‐19 infection when the maternal infection manifests in the third trimester. Our opinions are in line with the recommendations of the Centers for Disease Control and Prevention. COVID‐19 infection should not be the sole indication for delivery; rather, the patient should be duly assessed, and management, timing and mode of delivery should be individualized, dependent mainly on the clinical status of the patient, gestational age and fetal condition. Ongoing collection of clinical data and research is underway with the aim of answering questions in relation to the risk of congenital infection and the optimal intrapartum management, and timing and mode of delivery. Lastly, we would like to pay tribute to all frontline medical professionals who are working tirelessly to bring the COVID‐19 epidemic under control. March 5, 2020 EXPERT REVIEW: Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know video PDF Sonja A. Rasmussen, MD, MS; John C. Smulian, MD, MPH; John A. Lednicky, PhD; Tony S. Wen, MD; Denise J. Jamieson, MD, MPH Published: February 24, 2020 Emerging infectious disease outbreaks: Old lessons and new challenges for obstetrician-gynecologists (2006) PDF Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome (2003) |
| Society for Maternal-Fetal Medicine (SMFM)
COVID-19: Changes in Pregnancy and Maternity Care Advice for Women and Their Families
UPDATED Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Need to Know SMFM partners with Baby Center to create Coronavirus (COVID-19) Pregnancy FAQs: Medical Experts Answer your Questions |
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| American Journal of Obstetrics & Gynecology MFM: Guidance for COVID-19 This document addresses the current COVID-19 pandemic for maternal-fetal medicine (MFM) practitioners. The goals the guidelines put forth here are two fold- first to reduce patient risk through healthcare exposure, understanding that asymptomatic health systems/healthcare providers may become the most common vector for transmission, and second to reduce the public health burden of COVID-19 transmission throughout the general population.
March 19, 2020 |
| Society for Obstetric Anesthesia and Perinatology (SOAP)
Interim Considerations for Obstetric Anesthesia Care Related to COVID-19 |
| World Health Organization (WHO)
Q&A on COVID-19, pregnancy, childbirth and breastfeeding WHO Rooming-In Guidance: Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected |
| Centers for Disease Control and Prevention (CDC) 
Frequently Asked Questions and Answers: Coronavirus Disease 2019 (COVID-19) including:
Frequently Asked Questions and Answers: Coronavirus Disease 2019 (COVID-19) and Pregnancy WEBINAR: Coronavirus Disease 2019 (COVID-19) Update - Information for Clinicians Caring for Children and Pregnant Women Key Points
Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation For COVID-19 Coronavirus Disease 2019 (COVID-19): Print Resources |
| Foundation for Opioid Response Efforts
WEBINAR: Caring for Pregnant and Parenting Women with OUD During the COVID-19 Pandemic
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| MotherToBaby The MotherToBaby Podcast: COVID-19 in Pregnancy & Breastfeeding
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Should Infants Be Separated from Mothers with COVID-19? First, Do No Harm by Alison Stuebe, MD, MSc
© Alison Stuebe, 2020; Published by Mary Ann Liebert, Inc. Infographic created under Creative Commons. |
FEATURED RESOURCES: SHARED DECISION-MAKING: Determining a Need for Infant Separation from United States Lactation Consultants Association (USLCA) |
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FEATURED PRINTABLES:
| FREE Posters
| Praeclarus Press, LLC
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| Centers for Disease Control and Prevention (CDC)
Key Points
Interim Guidance on Breastfeeding for a Mother Confirmed or Under Investigation For COVID-19 |
| The Academy of Breastfeeding Medicine’s (ABM)
Statement on Coranovirus 2019 (COVID-19) The choice to breastfeed is the mother’s and families. If the mother is well and has only been exposed or is a PUI (person under investigation) with mild symptoms, breastfeeding is a very reasonable choice and diminishing the risk of exposing the infant to maternal respiratory secretions with use of a mask, gown and careful handwashing is relatively easy. If the mother has COVD-19, there may be more worry, but it is still reasonable to choose to breastfeed and provide expressed milk for her infant. Limiting the infant’s exposure via respiratory secretions may require more careful adherence to the recommendations depending on the mother’s illness. |
| United States Breastfeeding Committee (USBC)
*updated March 17, 2020 |
| United Stated Lactation Consultant Association (USLCA)
SHARED DECISION-MAKING: Determining a Need for Infant Separation Guidelines for Healthcare Facility Management of Perinatal Care of Persons with COVID-19 or Suspected COVID-19 Compiled by: Bryna Sampey, IBCLC |
| International Lactation Consultant Association's (ILAC)
All international world health guidelines agree: Breastfeeding should continue and be supported during the COVID-19 epidemic, with appropriate precautions. Breastfeeding protects infants and young children, particularly against infectious disease. When a person is lactating and becomes ill with a virus, they develop antibodies to fight the illness. Those antibodies are then conveyed to the infant through breastmilk, helping to protect the infant from illnesses to which the parent has been exposed. |
| La Leche League International (LLLI) The novel Coronavirus (COVID-19) currently in the news is a rapidly evolving global medical situation with limited information available at this time. La Leche League International (LLLI) respects the efforts of international health and medical organizations and associations to maintain up-to-date information and recommendations as understanding of the virus is developed. LLLI will continue to track the development of the current global health crisis. |
| United Nations Population Fund
Breastfeeding women who become ill should not be separated from their newborns, the statement adds. There is no evidence that the illness can be transmitted through breastmilk. However, breastfeeding mothers who are infected should wear a mask when near their baby, wash their hands before and after feeding, and disinfect contaminated surfaces. If a mother is too ill to breastfeed, she should be encouraged to express milk for the baby, while taking all necessary precautions. * Mental health and psychosocial support should be made available to affected individuals and their families. |
| Human Milk Banking Association of North America (HMBANA)
The Human Milk Banking Association of North America (HMBANA) is closely monitoring the evolving situation regarding the outbreak of the 2019 Novel Coronavirus. As always, HMBANA remains dedicated to providing safe donor human milk to infants in need. Screening criteria for milk donors are rigorous, and designed to protect the incoming milk supply. For more details, please read HMBANA's full statement on milk banking and COVID-19. |
| COVID-19: Overview and Evaluation - Pediatric Collection Open Access As a trusted pediatric publisher of peer-reviewed research, clinical references, patient education and coding & payment resources, the American Academy of Pediatrics is dedicated to providing AAP members, physicians, and health care providers with the latest open access research and guidance recommendations related to COVID-19. As the world responds to the pandemic, we are committed to fast-tracking COVID-19 research articles and publishing them free to read in this collection. The latest research will pre-publish on pediatrics.org and be deposited to PubMed upon final publication. |
| American Academy of Pediatrics (AAP)
Tips for Coping with a New Baby During COVID-19 Cloth Face Coverings for Children During COVID-19 AAP's WEBSITE: Healthy Children 2019 Novel Coronavirus (COVID-19) Talking to children about COVID-19
COVID-19: Information for Families of Children and Youth with Special Health Care Needs Epidemiology of COVID-19 Among Children in China Yuanyuan Dong, Xi Mo, Yabin Hu, Xin Qi, Fang Jiang, Zhongyi Jiang, Shilu Tong Pediatrics. Pre-publication release. March 16, 2020 AAP offers response and updates for members on COVID-19 With news of the first possible instance of community spread of coronavirus has come raised anxiety, myriad questions and a need for guidance from a public health perspective. In response, the American Academy of Pediatrics is reassuring members of the steps they can take now and offering continued support as the outbreak evolves. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case We describe the case of a 6-month-old infant admitted and diagnosed with classic Kawasaki disease (KD), who also screened positive for COVID-19 in the setting of fever and minimal respiratory symptoms. The patient was treated per treatment guidelines, with intravenous immunoglobulin (IVIG) and high-dose aspirin (ASA), and subsequently defervesced with resolution of her clinical symptoms. May 8, 2020 |
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Infographic: Early Cases of MIS-C: Multi-System Inflammatory Syndrome in U.S. Children
Centers for Disease Control and Prevention (CDC)
Frequently Asked Questions and Answers: Coronavirus Disease-2019 (COVID-19) and Children Evaluation and Management Considerations for Neonates At Risk for COVID-19 Well child checks and lactation servicesWEBINAR: Coronavirus Disease 2019 (COVID-19) Update - Information for Clinicians Caring for Children and Pregnant Women Preparedness measures urged in anticipation of more COVID-19 cases in U.S.: CDC Infographic: Early Cases of MIS-C: Multi-System Inflammatory Syndrome in U.S. Children (see the full graphic)
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| Atypical presentation of COVID-19 in young infants Here we describe our experience of COVID-19 in five young infants. In the pandemic context, infants younger than 3 months with isolated fever should be tested for SARS-CoV-2. Although infants might initially present signs of severe infection, our experience is that the youngest children tolerate and rapidly improve from COVID-19, in contrast to adults admitted to hospital with COVID-19. However, because little is known about SARS-CoV-2 infection in infants,4, 6 close monitoring is required for at least 2 weeks after the diagnosis. All of the infants' parents showed mild signs of viral infection (ie, rhinitis, or cough or fever, or both, for <1 week), which could be related to undiagnosed COVID-19. April 27, 2020 |
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| Families First Coronavirus Response Act Medicaid and CHIP Provisions Explained The Families First Coronavirus Response Act was signed into law (P.L. 116-127) on March 18, 2020. The law is the second piece of legislation enacted by Congress in response to the coronavirus pandemic and negotiations are currently underway on a third, much larger economic stimulus package. The Families First legislation covers a broad range of programs affecting children and families, including the Supplemental Nutrition Assistance Program (SNAP), the Women, Infants and Children’s program (WIC), school lunch, family and medical leave, unemployment insurance, emergency paid sick leave, and Medicare. The following explainer brief focuses on the provisions impacting Medicaid and the Children’s Health Insurance Program (CHIP). |
| Enroll for Health Insurance at HealthCare.gov HealthCare.gov is a health insurance exchange website operated under the United States federal government under the provisions of the Patient Protection and Affordable Care Act, which currently serves the residents of the U.S. states which have opted not to create their own state exchanges. |
| The Children's Health Insurance Program (CHIP) If your children need health coverage, they may be eligible for the Children's Health Insurance Program (CHIP). CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers pregnant women. Each state offers CHIP coverage, and works closely with its state Medicaid program. |
| Continuation of Health Care Benefits You can keep your coverage for as long as 18 months under the federal law known as the Consolidated Omnibus Budget Reconciliation Act (COBRA). But only if you’re willing to pay as much as the total amount of your premium (monthly fee) — both what you normally pay and what your employer had contributed toward your premium. Though particular circumstances vary, COBRA coverage tends to be more expensive than coverage in the Obamacare marketplaces. It may be a particularly desirable option for anyone in the middle of treatment for an acute or chronic condition because it will allow you to keep seeing the same doctors. Your employer may also be willing to subsidize some of the monthly cost for a period. - from the New York Times article How to Get Health Insurance if You’re Worried About Coronavirus or Have Lost Your Job: There are more options for getting coverage than in past economic crises. March 25, 2020 |
| Supplemental Nutrition Assistance Program (SNAP) The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition assistance program. SNAP provides benefits to eligible low-income individuals and families via an Electronic Benefits Transfer card. This card can be used like a debit card to purchase eligible food in authorized retail food stores. To be eligible for SNAP, most households must meet certain bank balance limits. |
| Women, Infants, and Children (WIC) The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. |
| The National Diaper Bank Network (NDBN) Directory NDBN connects and supports the country’s more than 200 community-based diaper banks that collect, store and distribute free diapers to struggling families. The Network serves nearly 280,000 children throughout the country each month. |
| Helping Women Period Girls Helping Girls Period PERIOD. The Menstrual Movement The number of families in the USA needing assistance from food pantries continues to increase every year. The lack of access to menstrual health products for people who are either homeless or low-income is appalling. These necessary products are not covered by SNAP or any other welfare program. Each month, this leaves countless people without the products many of us take for granted. |
| The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. COVID-19 and the Family and Medical Leave Act Questions and Answers |
| Legal Rights for Pregnant Workers under Federal Law If you are pregnant, have been pregnant, or may become pregnant, and if your employer has 15 or more employees, you are protected against pregnancy-based discrimination and harassment at work under federal law. You may also have a legal right to work adjustments that will allow you to do your job without jeopardizing your health. |
| Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status United States January 22–June 7, 2020 Summary: What is already known about this topic? Limited information is available about SARS-CoV-2 infection in U.S. pregnant women. What is added by this report? Hispanic and non-Hispanic black pregnant women appear to be disproportionately affected by SARS-CoV-2 infection during pregnancy. Among reproductive-age women with SARS-CoV-2 infection, pregnancy was associated with hospitalization and increased risk for intensive care unit admission, and receipt of mechanical ventilation, but not with death. What are the implications for public health practice? Pregnant women might be at increased risk for severe COVID-19 illness. To reduce severe COVID-19–associated illness, pregnant women should be aware of their potential risk for severe COVID-19 illness. Prevention of COVID-19 should be emphasized for pregnant women and potential barriers to adherence to these measures need to be addressed. June 26, 2020 |
| Atypical presentation of COVID-19 in young infants Here we describe our experience of COVID-19 in five young infants. In the pandemic context, infants younger than 3 months with isolated fever should be tested for SARS-CoV-2. Although infants might initially present signs of severe infection, our experience is that the youngest children tolerate and rapidly improve from COVID-19, in contrast to adults admitted to hospital with COVID-19. However, because little is known about SARS-CoV-2 infection in infants,4, 6 close monitoring is required for at least 2 weeks after the diagnosis. All of the infants' parents showed mild signs of viral infection (ie, rhinitis, or cough or fever, or both, for <1 week), which could be related to undiagnosed COVID-19. April 27, 2020 |
| Kawasaki Disease From COVID-19 in Kids: How Common? - Warnings out on inflammatory syndrome but many questions remain |
 | COVID-19 and Kawasaki Disease: Novel Virus and Novel Case We describe the case of a 6-month-old infant admitted and diagnosed with classic Kawasaki disease (KD), who also screened positive for COVID-19 in the setting of fever and minimal respiratory symptoms. The patient was treated per treatment guidelines, with intravenous immunoglobulin (IVIG) and high-dose aspirin (ASA), and subsequently defervesced with resolution of her clinical symptoms. May 8, 2020 |
| Centers for Disease Control and Prevention (CDC)
Frequently Asked Questions and Answers: Coronavirus Disease 2019 (COVID-19) including:
Frequently Asked Questions and Answers: Coronavirus Disease 2019 (COVID-19) and Pregnancy Frequently Asked Questions and Answers: Coronavirus Disease-2019 (COVID-19) and Children Coronavirus Disease 2019 (COVID-19): Print Resources |
| World Health Organization (WHO)
Coronavirus disease (COVID-19) advice for the public: Myth busters Coronavirus disease (COVID-19) outbreak VIDEO: Coronavirus Update with Anthony Fauci, MD March 2020 VIDEOS: Coronavirus disease (COVID-19) advice for the public When and how to use masks DATA: Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) (page 32) As opposed to Influenza A(H1N1)pdm09, pregnant women do not appear to be at higher risk of severe disease. In an investigation of 147 pregnant women (64 confirmed, 82 suspected and 1 asymptomatic), 8% had severe disease and 1% were critical. ...Severity (page 38) Continue to share information on patient management, disease progression and factors leading to severe disease and favorable outcomes Review and analyze the possible factors associated with the disease severity, which may include:
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MARCH and APRIL 2020 |
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February 2020 |
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