Babies born to mothers with COVID-19 should undergo immediate testing of the nasopharynx, placenta and cord blood, as a case of a COVID-19-positive newborn illustrates in CMAJ (Canadian Medical Association Journal). 

A mother with COVID-19 gave birth 5 weeks before the due date to a baby boy who was subsequently found to be COVID-19-positive after a nasopharyngeal swab and testing of the placenta.

As the baby was born by cesarean and protocols to limit infection were employed, it is suspected that he was infected in the womb rather than during birth. Placental tissue tested positive for the virus.  

“This represents a probable case of congenital COVID-19 in a newborn,” says Dr. Prakesh Shah, Pediatrician-in-Chief with Sinai Health, and the University of Toronto, Toronto, Ontario. “The baby was born by cesarean and was not in contact with vaginal secretions, the membranes were intact at birth, and there was no skin-to-skin contact with the mother until after he had a first nasopharyngeal swab.”

The authors recommend testing of newborns as soon as possible rather than waiting 24 hours as recommended by the American Academy of Pediatrics. This can help establish the prevalence of COVID-19-positive babies born to infected mothers and determine whether they were infected in utero, during or after birth. Early testing will also ensure proper precautions are followed and help with resource management if babies test positive.   

After a few minor issues in its first few days, the baby recovered and is thriving.