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State of California—Health and Human Services Agency
California Department of Public Health

May 13, 2020

Pregnant and/or breastfeeding women and obstetrical care providers

Guidance for Pregnant and Breastfeeding Women During the COVID-19 Pandemic

This document provides guidance for pregnant and/or breastfeeding women during the COVID-19 pandemic and basic guidance for obstetrical care providers. The California Department of Public Health will update this guidance as new information becomes available.

Key Points

  • Pregnancy: There is no evidence that pregnant women are at higher risk of severe illness from COVID-19 than the general population. Due to changes in pregnant women's bodies and immune systems, they are vulnerable to some respiratory infections.
  • Breastfeeding: The virus has not been detected in breast milk. The Centers for Disease Control (CDC) and the World Health Organization (WHO) state that mothers with COVID-19 can breastfeed. 

How can I reduce the risk of being infected with COVID-19? 

It is important that pregnant women take precautions to protect themselves against COVID-19 by taking these actions (see CDC Coronavirus Disease (COVID-19) and Breastfeeding) :

  • Stay at home as much as possible while the statewide shelter-in-place order is in effect.  This includes restricting visitors to your home. While it may be necessary to visit essential businesses like grocery stores or pharmacies, consider having family members or friends shop for you when possible.
  • When you do leave your house, wear a facial covering and practice physical distancing by maintaining at least 6 feet (2 meters) from others. When you return home, wash your hands. 
  • Wash your hands regularly with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer with at least 60 percent alcohol. 
  • Try not to touch your eyes, nose or mouth throughout the day. 
  • Clean and disinfect objects and surfaces you touch regularly by using a household cleaning spray or wipe that is bleach or alcohol based. Use hot, soapy water or a dishwasher to wash dishes and utensils.
  • Take care of your body to maintain good health. Try to eat healthy, well-balanced meals, exercise regularly, and get plenty of sleep.
  • Make time to unwind as stress can impact your ability to fight infection. Try to do some other activities you enjoy. Take deep breaths, stretch, or meditate at home.
  • Connect with others by phone or over the internet. Talk with people you trust about your concerns and how you are feeling.
  • Ask your healthcare provider about doing prenatal visits virtually.  Consult with your provider about changes in the delivery hospital's policy on who can attend the birth.

What should I do if I feel sick? 

Call your healthcare provider if you have symptoms, such as fever, cough, shortness of breath, chills, headache, muscle aches, sore throat or loss of sense of smell or taste.  Also call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

I am pregnant and I do not feel safe continuing to work. What can I do? 

Talk about your concerns with your employer as well as options to work from home. If working from home is not an option, consider the following:

  • If you have sick leave, you may use your sick leave to stay at home. 
  • If you do not have sick leave, you may be covered under the Family Medical Leave Act (FMLA). FMLA is unpaid leave that allows you to keep your job if you miss work to care for yourself or a family member who is sick. For further information on FMLA and COVID-19 please visit US Department of Labor.  For further information on paid family leave in California please visit Employee Development Department.
  • You may be protected under the California Pregnancy Disability Leave law, if: 
    • 1) your employer has more than five employees and 
    • if you can show proof from your health care provider that due to the condition of pregnancy you are not able to work without putting your health or the health of your baby at risk.

Check with your healthcare provider to see if your health situation qualifies. Employee Development Department Pregnancy FAQs.

Pregnant women working in health care 

Pregnant women working in health care should follow the CDC risk assessment and infection control guidelines for health care personnel exposed to patients with suspected or confirmed COVID-19. Following recommended infection prevention and control practices is an important part of protecting all healthcare personnel in healthcare settings.

How does COVID-19 affect my baby? 

We still do not know if a pregnant woman with COVID-19 can pass the virus to her fetus during pregnancy or at the time of delivery.  In a few documented cases where newborns were infected, it appears the infection was not transmitted during pregnancy (see CDC COVID-19 If you are Pregnant, Breastfeeding, or Caring for Young Children). Currently, there is not enough data on COVID-19 to provide guidance or information about the risk of miscarriage or birth defects. Data from another coronavirus epidemic, the Severe Acute Respiratory Syndrome (SARS-CoV), suggest no increased risk of fetal loss or birth defects associated with infection early in pregnancy (See SMFM: Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Needto Know (PDF)). However, problems such as preterm birth, have been reported among infants born to mothers positive for COVID-19 during pregnancy. Note, this information is based on limited data and it is not clear that these outcomes were related to COVID-19.

If you are positive for COVID-19 and are preparing to give birth, talk to your healthcare provider and follow their recommendations on how best to protect your newborn.

If I am positive for COVID-19, can I breastfeed my infant? 

In limited studies on women with COVID-19 the virus has not been found in breast milk. Breastfeeding is encouraged and is an important source of antibody protection for the infant. The Centers for Disease Control (CDC) and the World Health Organization (WHO) say that mothers with COVID-19 can breastfeed (see ABM Statement on Coronavirus 2019 (COVID-2019)).

A mother with COVID-19, or who has symptoms of COVID-19 or may have been exposed to someone with the virus should take precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a mask, if possible, while feeding at the breast.   Ideally, all people, including new mothers, who are sick with COVID-19 should be isolated (separate bedroom and bathroom if at all possible) from other household members. The decision to isolate a COVID-19 infected mother from her infant should be made on a case-by-case basis.  The decision should be made jointly by the mother and the healthcare provider.

If the mother chooses to express her breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts. She should follow recommendations for proper pump cleaning after each use. If possible, consider having someone who is well care for and feed the expressed breast milk to the infant (See ABM Statement on Coronavirus 2019 (COVID-2019)).

When I bring my newborn home, is it ok to have visitors over? 

While we are in the COVID-19 pandemic, visitors should not be in your home. We know that people can have COVID-19 and spread the disease even before they are aware of any symptoms. Only those living in the household should be around and caring for the newborn.

For more information for California families:

CDPH: COVID-19 Women & Families 

For more information for California obstetrical providers:

CDPH: COVID-19: Family & Reproductive Health Professionals

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