If you have COVID-19 and a baby at home, you can safely continue caring for your infant with a few key precautions: wear a mask during close contact, wash your hands before every touch, and keep breastfeeding if you’re able to. You do not need to separate from your baby entirely. The current guidance from both the CDC and the American Academy of Pediatrics supports staying in the same room as your infant as long as you’re well enough to provide care.
You Can Stay in the Same Room
Early in the pandemic, the AAP recommended physically separating COVID-positive mothers from their newborns. That guidance has since been revised. The AAP now recommends rooming-in with your baby unless you are too sick to provide care. A study of 120 mother-infant pairs at a New York City hospital found that when mothers wore surgical masks near their newborns and practiced hand hygiene before skin-to-skin contact and feeding, transmission rates remained very low.
When you’re not actively feeding or holding your baby, try to keep about six feet of distance. If another healthy adult is available, they can handle diaper changes and soothing while you rest. But if you’re the sole caregiver, staying close to your baby with a mask on is far safer than leaving your infant without adequate care.
Breastfeeding Is Still Recommended
Keep breastfeeding. COVID-19 has not been shown to pass through breast milk, and your milk actually works in your baby’s favor during this time. When your body fights the virus, it produces antibodies that transfer directly into your breast milk, giving your infant a layer of immune protection. If you’ve been vaccinated with an mRNA COVID vaccine, your milk likely contains additional antibodies as well.
Before each feeding, wash your hands thoroughly with soap and water for at least 20 seconds. If soap isn’t available, use hand sanitizer with at least 60% alcohol. Wear a mask while nursing or bottle-feeding. If you’re pumping, wash your hands before touching the pump or any parts, and clean and sanitize all pump components and bottles after every use.
If you feel too sick to nurse directly, have a healthy caregiver feed the baby expressed milk from a bottle. Try to pump on your regular feeding schedule so your supply stays up. Even if your baby catches COVID, continuing to breastfeed is recommended because of the protective factors in the milk.
Hygiene Steps That Matter Most
The virus spreads primarily through respiratory droplets and contaminated hands, so the two most important things you can do are masking and handwashing. Wear a well-fitting mask (KN95 if you have one, surgical mask otherwise) any time you’re within arm’s reach of your baby. Wash your hands or use sanitizer before every interaction: feeding, holding, diaper changes, burping, all of it.
Other household members who may have been exposed should also mask around the baby and stay six or more feet away when possible. Regularly wipe down surfaces you touch frequently, like doorknobs, countertops, and your phone. Change your shirt or place a clean cloth over your chest before holding your baby if you’ve been coughing.
What COVID Looks Like in Babies
More than 40% of newborns who contract COVID-19 remain completely asymptomatic or develop only mild symptoms. When symptoms do appear, the most common ones are low-grade fever, cough, runny nose, vomiting, and diarrhea. These look a lot like any other mild infant illness, which makes monitoring important.
In more symptomatic babies, you may notice rapid breathing, fussiness, or feeding difficulties. Neurological symptoms like seizures are rare. Most infants recover without complications, but babies under one year are considered higher risk than older children simply because their immune systems are still developing.
Warning Signs That Need Emergency Care
While most babies handle COVID mildly, certain breathing symptoms require immediate medical attention. Call 911 or go to the emergency room if your baby shows any of these signs:
- Grunting with each breath
- Nostril flaring while breathing
- Chest pulling inward at the collarbone or ribs with each breath
- Rapid or noisy breathing at rest, including wheezing or raspy sounds
- Inability to cry or feed, which in infants can signal serious respiratory distress
Also watch for signs of dehydration: fewer than the usual number of wet diapers, no tears when crying, or a sunken soft spot on the head. A rectal temperature of 100.4°F or higher in a baby under three months old always warrants a call to your pediatrician, whether or not you suspect COVID is the cause.
Getting Help When You Feel Too Sick
COVID can hit hard, and caring for a baby while you’re feverish, exhausted, and short of breath is genuinely difficult. If you have a partner, family member, or friend who isn’t sick, ask them to take over as much hands-on baby care as possible. You can still stay in the same room and maintain your breastfeeding relationship through pumped milk.
If you’re on your own, prioritize rest during every moment your baby sleeps. Prepare bottles and supplies in advance so you don’t have to scramble when your energy dips. Keep water, snacks, diapers, wipes, clean masks, and hand sanitizer within arm’s reach of wherever you feed and hold your baby. Accepting that the house will be messy and routines will slip for a few days is completely fine. Your only real jobs right now are keeping yourself hydrated, keeping your baby fed, and following the hygiene precautions above.
When You Can Relax Precautions
The CDC’s guidance for ending isolation applies to caregivers as well. You can generally stop masking and distancing from your baby once at least five days have passed since your symptoms started, your symptoms are improving, and you’ve been fever-free for at least 24 hours without using fever-reducing medication. Some people remain contagious a bit longer, so continuing to wash your hands carefully around your baby for a full 10 days is a reasonable extra step.
If your baby does test positive, keep up breastfeeding and watch for the warning signs listed above. Most infected infants recover within a week or two with nothing more than extra fluids, rest, and close attention from a parent who, by that point, is probably starting to feel better themselves.