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Suspected or confirmed COVID-19 after giving birth

Written by London Pregnancy Clinic on . Posted in Blog, Covid-19.

COVID-19 Guidance: Suspected or confirmed COVID-19 after giving birth

Risk to my baby

There is insufficient evidence to suggest that women with suspected or confirmed COVID-19 can pass on the virus to their babies. There has been some evidence of babies born to mothers with COVID-19, but in these few cases the babies are all well and seem to recover well from the virus. However, in most new case studies, babies born to symptomatic mothers were all well and tested negative for the virus. Uncertainty can always be unsettling, and the evidence is rapidly evolving, thus we recommend that you discuss any of your concerns with your healthcare team as they will be able to provide you with individualised advice and support.

Skin-to-skin contact and breastfeeding

After delivery, the healthcare team will examine you and your baby, after which you will be able to head home together. At this point if you have suspected or confirmed COVID-19 it will be your choice whether you wish to have skin-to-skin contact with you baby. On one hand, some countries are advising to isolate from your baby for 14 days; however, the Royal College of Obstetricians and Gynaecologists highlight that this time spent away from your baby can hinder feeding and bonding. Every case is different, which is why it is important to have a conversation with your healthcare team regarding your situation.

There is insufficient evidence to suggest that the virus can be passed on in breastmilk. Furthermore, the well-documented benefits of breastfeeding, including the building of the baby’s immune system, outweighs the risk of the virus, with the evidence that we currently have. The main risk of transmission to your baby would be the close contact. If are worried about this, there are a few precautions you can take in order to reduce the risk:

  • Wash your hands before touching the baby or anything in the baby’s environment (such as the breast pump),
  • Try to avoid coughing and sneezing while the baby is feeding,
  • Some women have been wearing masking while breastfeeding, if available,
  • ensure that you follow the recommendations for pump cleaning as well as sterilisation guidelines regardless if you are using formula or expelled milk (Sterilisation guidelines: https://www.nhs.uk/conditions/pregnancy-and-baby/sterilising-bottles/)
  • Consider asking an asymptomatic household member to feed the baby with the breastmilk you have pumped.

We understand that caring for your child, especially if you have suspected or confirmed COVID-19 can be incredibly stressful. There has been no evidence to suggest that women who have recently had a baby to be at an increased risk of contracting the virus or being seriously unwell from it. Ensure that you take care of yourself and stay well hydrated and nourished. As every case is different, it would be beneficial to have a conversation about caring for your child if you have suspected or confirmed COVID-19. Your healthcare team will be happy to answer any of your questions and reassure you wherever possible.

References:

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

https://www.nhs.uk/conditions/pregnancy-and-baby/sterilising-bottles/

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30365-2/fulltext

https://www.newscientist.com/article/2237352-coronavirus-what-we-know-so-far-about-risks-to-pregnancy-and-babies/

COVID-19 Guidance: Suspension of IVF and Fertility Treatments

Written by London Pregnancy Clinic on . Posted in Blog, Covid-19.

What is happening?

Following many recent requests from patients we have reviewed main official documents referring to the IVF treatment at this time.

As the COVID-19 pandemic continues to escalate in the UK, many NHS services are being downsized or suspended. Unfortunately, it has been announced that all fertility treatment (NHS and private) will be as stopped as of 15 April 2020. We understand that this must be incredibly disheartening to hear for those beginning, continuing, or planning to undertake fertility treatment.

In accordance to the Directions, clinics plan to stop treatments over the next three weeks, so that patients are able to complete any cycle they have started. As of now, it is not known how long these Directions will remain in force, as this is dependent on Government guidance on restrictions. We understand that this uncertainty may add additional stress and anxiety to an already challenging situation. Please look under the sub-heading: Additional Support for resources intended to provide support and guidance for managing this challenging time for you.

Moving forward, any decisions to re-open fertility clinics will be evaluated by UK professional fertility societies, such as The British Fertility Society and The Association of Reproductive and Clinical Scientists. They will have to evaluate the impact re-opening would have on NHS services and ensure that clinics are able to operate safely to protect the health of their patients and staff.  The Human Fertilisation and Embryology Authority (HFEA) is working on an exit strategy so that fertility treatment can resume as soon as possible when Government restrictions on travel and contact are lifted.

In line with the Directions to suspend fertility treatments, it has also been requested that all centres have put measures in place to keep patients informed of any changes to treatment plans, the reasons for these, as well as some mechanism of support for patients who have concerns or require support. Furthermore, we recommend you do try to maintain contact with your fertility clinic in order to understand the changes to your treatments and to be contactable when treatment can resume.

Dr Marta Jansa Perez, Director of Embryology at The British Pregnancy Advisory Service (bpas) commented in a statement that the decision to close fertility services was to “enable fertility professionals to deal with the current pandemic, to reduce the spread of the infection, and to avoid unsafe care due to staff shortages rather than because of any concerns about the impact of the virus on pregnant women and their babies. There is no evidence that Coronavirus presents a specific harm to pregnancies, and there is no evidence to suggest that becoming pregnant during this time would be unsafe.”

See Dr Marta Jansa Perez’s full statement here: https://www.bpas.org/about-our-charity/press-office/press-releases/bpas-comment-on-the-suspension-of-fertility-services/

Lastly, many women may be worried about how the pandemic will affect the funding that has been put in place for their fertility treatment. If your clinic does not contact you about this, we recommend that you contact your local commissioning group for more information: https://www.nhs.uk/service-search/other-services/Clinical-Commissioning-Group/LocationSearch/1

Additional support

Linked below, is an open letter to fertility patients, written by Sally Cheshire CBE, the chair of the HFEA

https://www.hfea.gov.uk/about-us/news-and-press-releases/2020-news-and-press-releases/an-open-letter-to-fertility-patients-sally-cheshire-cbe-chair-hfea/

Furthermore, the UK Fertility Network is offering support lines, which is open from 10am-4pm Monday, Wednesday, and Friday. They have also moved all support groups online and provide general support and guidance on their website.

https://fertilitynetworkuk.org/coronavirus-covid-19/

References

1 https://www.hfea.gov.uk/treatments/covid-19-and-fertility-treatment/coronavirus-covid-19-guidance-for-patients/

2 https://fertilitynetworkuk.org/coronavirus-covid-19/

3 https://www.hfea.gov.uk/media/3092/2020-03-23-general-direction-0014-version-1.pdf

4 https://www.arcscientists.org/

5 https://www.bpas.org/about-our-charity/press-office/press-releases/bpas-comment-on-the-suspension-of-fertility-services/