Ahmed Afifi, MBBCH, MSc, David Corcoran MD, Allison C. Walker, MD, Alexandra Adamczak, M.D., T. Allen Merritt, MD, Jan Mazela, MD, PhD, Thomas A. Clarke, MD

The COVID-19 pandemic has brought unprecedented contemporary challenges to the delivery of health care to pregnant women and their infants. The World Health Organization (1), and the Centers for Disease Control and Prevention (2), and the American Academy of Pediatrics (3) have issued guidelines regarding mother-infant-postpartum care if a mother is COVID-19 positive and emphasize the importance of a model of shared decision making between mother, health care providers, and family members regarding the need for separation of mothers and infants while they are in the hospital. The guidelines from the American Academy of Pediatrics have been undergoing revision with the latest update provided on May 21, 2020. Key guidance focuses on the use of delayed-cord clamping and that “there is no reason why the infant should not have the benefits of delayed cord clamping and skin-to-skin contact after delivery.” The amended guidance acknowledges that “experts are divided” regarding rooming-in for mothers. “While difficult to separate mother and infant, this is the safest action, at least temporarily,” as they may provide the mother time to become less infectious,” and the goal is not to separate a family from its newborn.” The American Academy of Pediatrics strongly supports breastfeeding as “to date, breast milk is considered to be an unlikely course of transmission of SARSCoV-2 and encourages mothers who are COVID-19 positive to express breastmilk after appropriate hygiene which may be fed to the infant by an un-infected caregiver. If mothers prefer to nurse their infant, they should follow strict preventive precautions. Early hospital discharge is discouraged, and frequent post-discharge follow is recommended. Guidance for visitation to the NICU is that mothers and partners who are COVID-10 positive or persons under investigation should not enter the NICU until their status is resolved. (www.aapnews.org May 21, 2020).

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Disclosures: The authors do not have any disclosures.

The authors wish to acknowledge the special assistance of Thomas A. Clarke, MD, Retired Consultant, Rotunda Hospital, Dublin, Ireland, Co-Editor