At-home antigen tests are common tools for quickly screening for COVID-19, leading many parents to wonder if they can be safely and accurately used on infants. While many rapid tests are authorized for pediatric populations, using them on an infant requires strict adherence to specific instructions for safety and reliability. Successful home testing requires verifying the test kit’s authorization and mastering the gentle, shallow sample collection technique required for a small nasal passage.
FDA Authorization and Age Limitations
Verify the Emergency Use Authorization (EUA) granted by the Food and Drug Administration (FDA) for the test kit before attempting to test a baby. The FDA authorizes at-home antigen tests based on clinical trials that establish performance in specific age groups. Many common over-the-counter antigen tests are authorized for use in individuals aged two years and older when the sample is collected by an adult.
Locate the age restrictions printed on the test kit’s instructions, as authorization varies between manufacturers. Most rapid at-home antigen tests are not officially authorized for infants and children under two years of age. If a baby under two requires testing, consult a healthcare provider for guidance. They may recommend a laboratory-based molecular test, the gold standard for accuracy, or a professionally administered test.
Safe Sample Collection Techniques for Infants
If your child is within the authorized age range, or if a healthcare provider advises using the kit, the nasal swab technique differs from that for an adult. The primary concern is protecting the child’s small nasal passages and avoiding injury. Swabbing an infant requires gentleness and caution to ensure a safe and sufficient sample is collected without causing trauma.
Instead of deep insertion, the swab should only be placed into the anterior nares, the shallow, front part of the nose. For a child under two years, the recommended insertion depth is typically only about one centimeter, or until slight resistance is met. This is much shallower than for older children. Gently rotate the swab against the inside wall of the nostril for the time specified in the instructions (often five to fifteen seconds) to ensure the swab is fully saturated with sample material.
It is recommended to have a second caregiver present to assist with safely restraining the baby. A secure hold, such as the “bear hug” position, keeps the baby’s head and arms still, preventing sudden movements that could cause injury or result in an inadequate sample. Inadequate sample collection due to a wriggling child is a common reason for inaccurate test results.
Interpreting Results and When to Contact a Pediatrician
Interpreting the results of an at-home antigen test on a baby requires understanding the test’s limitations. A positive result is reliable, meaning the virus proteins were detected, and you should immediately contact your pediatrician to discuss next steps. Even a faint second line on the test cassette indicates a positive result and must be treated as such.
A negative result from a rapid antigen test is less certain because these tests are not as sensitive as laboratory-based molecular tests, particularly early in an infection. A negative result does not definitively rule out COVID-19, especially if the baby is symptomatic. If the first test is negative and symptoms persist, perform a repeat test 48 hours later (serial testing) to catch a potential infection later in its course.
Regardless of the test result, parents must monitor their baby for specific symptoms that warrant immediate medical attention. Call your pediatrician if your infant, especially one under 12 weeks old, has a fever of 100.4°F (38°C) or higher, as this requires immediate medical evaluation. Other urgent signs include difficulty breathing, fast or shallow breathing, bluish lips or face, excessive fussiness, or poor feeding and lethargy. Home testing serves as a supplement to, not a replacement for, professional medical supervision for infants.