As new moms know, a new child often means visitors.

Grandparents, excited relatives, neighbors, and friends look forward to sharing key moments in the journey: from pregnancy announcements to baby showers to sonograms to the newborn reveal. And after the birth, many of those people will hope to see, touch, or hold your new baby.

In the midst of the coronavirus pandemic, you may be wondering whether that closeness is too much of a risk for your child.

The pandemic continues to rage on – at press time, there is a rise in COVID-19 infections due to the Delta variant, as well as concerns regarding other emerging COVID-19 variants. As a result, there remains a heightened insecurity about what is safe and unsafe for newborns and toddlers.

“Opinions abound – from pediatricians, well-meaning relatives, and strangers on the Internet – and many new parents remain unsure how to protect their families while enjoying a bit of post-quarantine freedom,” according to an article in the Washington Post.

“For some people, the residual newness of COVID-19 means they do not want to [treat COVID-19 like other diseases]. They may worry about the unknowns – could there be unexpected impacts of COVID-19 infection a decade from now? – and no amount of current data will help with this,” according to a Parent Data newsletter by Emily Oster, Brown University Economics professor and author of pregnancy and parenting books Expecting Better and Cribsheet. “If this is your take, you may want to continue taking precautions which are greater than those you would take in the face of existing disease.”

All this uncertainty may lead to another unwelcome visitor: anxiety. Constant worry or fear – or incessant thoughts about certain fears – are symptoms of anxiety. Talking to a healthcare provider is a good first step to help with anxiety. Here are a few other actions you can take to help.

1. Minimize safety concerns by understanding the risk

Even in non-pandemic times, parents worry about their newborns’ vulnerabilities. With COVID-19, those vulnerabilities have grown, and many parents may limit the number of people who have close, physical contact with their babies.

Richard Godwin writes in The Guardian of the major differences between how his first child, born in 2014, was exposed to the world versus his second child born in 2020. While his older child had many visitors upon return from the hospital, went to parties at two weeks old, and rode on buses, subways, escalators and airplane in his early months, his youngest lived his first eight months primarily in isolation.

“A baby is usually a magnet for human touch,” Godwin writes. “I’d guess around 300 people had held [child #1] by the time he was eight months old. Perhaps 20 have made physical contact with [child #2].”

Parents of newborns and toddlers may share this concern and wonder if the sanitized experience of babies born during the pandemic could create socialization problems for their child.

“What sort of mark will this strange period leave on [our newborn child]? How much are babies missing out on? And can what is lost be regained?” writes Godwin in The Guardian article.

Parents are in the unenviable position of whether to risk their child’s socialization issues against the risk of exposing their newborns and toddlers to COVID-19, especially with the emerging variants of the virus. Which risk are parents of newborns willing to take?

“While most children who contract COVID-19 have mild symptoms, it is possible for them to get severely ill and require hospitalization, intensive care or a ventilator,” according to University of Chicago Medicine. “In addition, children under age 1 or with the following underlying medical conditions may be at increased risk of severe illness:

• Asthma or chronic lung disease
• Diabetes
• Genetic, neurologic or metabolic conditions
• Sickle cell disease
• Heart disease since birth (congenital heart disease)
• Weakened immune system
• Multiple chronic conditions that affect many parts of the body or are dependent on technology and other significant support for daily life
• Obesity”

Further, Dr. Heather Haq, assistant professor in the Department of Pediatrics at Baylor College of Medicine and the chief medical officer for the Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) at Texas Children’s Hospital, wrote on Twitter:

“After many months of zero or few pediatric COVID cases, we are seeing infants, children, and teens with COVID pouring back into the hospital, more and more each day. These patients ranged in age from 2 weeks old to 17 years.”

“So, we are on the front end of a huge COVID surge. But the difference this time compared to previous surges is we are simultaneously dealing with an unheard-of summertime #RSV surge — creating a ‘surge upon surge’ situation.”

2. Take basic precautions when hosting visitors

Newborns’ immune systems are often fragile during the first few months of their lives.

“There is no magical number about how many visitors, and this is relevant with a newborn, before or during a pandemic and post-covid,” Jorge Perez, a neonatologist in Coral Gables, Florida, tells the Washington Post. “Since babies are unprotected when they are separated from the placenta, I recommend that households with an infant limit their exposure for two to three months. The flu, RSV or other viruses are dangerous to an infant who can’t fight them off.”

Perez recommends following the same sort of precautions used pre-pandemic when visiting a newborn: wash hands before touching the newborn and avoid kissing the infant. He also recommends to mask up regardless of vaccination status, and if possible, meet the baby outside.

“Six feet apart, outside and vaccinated would be better,” Perez tells The Washington Post.

3. Focus on developing the parent-baby bond

“Infancy is the period during which children are biologically predisposed to form close relationships with important caregivers,” says Sarah Schoppe-Sullivan, an Ohio State University child psychology professor in an article in The New York Times.

Yet, Dr. Schoppe-Sullivan clarifies that newborns develop a capacity for forming relationships with more than just their parents, even if only the parents were able to bond with them during the pandemic.

“The theory says that when infants form secure attachments, they’re also forming the capacity for relationships in the future. That means the bonds parents have built with their babies during coronavirus-induced isolation may help those babies connect with relatives who live far away — whenever they finally visit,” according to The New York Times article.

Family members should focus on proper hygiene when around a newborn, such as washing hands. Some believe young children may consider wearing a mask around a newborn because they are less likely to practice proper hygiene than adults, according to the Washington Post article.

4. Follow safety recommendations when taking newborns into public

Concern for providing newborns with variety, stimulation and opportunities for learning is a valid reason for wanting to take them outside. It is also important for parents to get out in the fresh air and interact with nature and other people.

“Taking walks and outdoor activities are OK if you practice social distancing from other people, wear protective clothing and avoid direct sun exposure on the baby,” according to Johns Hopkins All Children’s Hospital weekly series On Call for All Kids. “If other people have to interact with the baby, wearing a mask may help reduce spread of germs to the baby.”

The CDC provides recommendations for the best ways to protect infants and other unvaccinated family members from contracting the COVID-19 infection:

1. “Get vaccinated yourself.” With a vaccine, you reduce your own risk of getting COVID-19 and possibly being too ill to care for your child. Also, according to the CDC, getting the vaccine can reduce your risk of spreading it to others.
2. “Get everyone in your family who is 12 years or older vaccinated against COVID-19.”
3. “Wear a mask.” This is recommended especially for indoor spaces but is suggested as an option under some outdoor situations when dealing with those with fragile immune systems, such as most infants. The CDC advises that masks should not be put on children younger than 2 years old.

5. Take steps to address your mental health

The unprecedented levels of uncertainty that the pandemic has brought about may result in even higher levels of mental health struggles for new moms, according to Paige Bellenbaum, Licensed Master Social Worker (LMSW), of The Motherhood Center of New York, in Parents Magazine.

“Existing risk factors for new and expecting moms to develop a perinatal mood and anxiety disorder – isolation, not having access to a support network, and managing high levels of stress and anxiety – are now the new normal,” she says.

Whether you are dealing with anxiety and depression driven by being a new mom during a pandemic or by the hormonal changes that occur post-partum, it is important to  communicate with your doctor about any emotional ups and downs that you may have, according to psycom.net.

“Without treatment, there’s no telling how long [post-partum depression] will last, but it will not necessarily go away on its own or by wishing it would, and it can have serious consequences for mom and baby,” according to psycom.net.

According to an article in Greater Good magazine, “there are science-tested steps new parents can take to mitigate the impact of the pandemic on their relationship with children, and even adapt to the circumstances they face.”

According to the magazine article, parents should consider:

1. “Practice mindful parenting techniques
2. Get physically active
3. Find support where you can
4. Cultivate positive relationships with your parenting team”

However, if you continue to feel emotional upheaval in the face of being a new parent in the pandemic, consult with your healthcare provider who may recommend medication, therapy or participating in a support group.

“Taking care of yourself is the foundation of taking care of your baby and your family,” according to  Mental Health America. “Work with your loved ones, doctors, and community supports to determine which treatment path is best for you and how to make it a reality.”

If you’d like to learn more about anxiety and depression post-partum and other parental mental health struggles read these GeneSight blog posts:

• https://genesight.com/blog/patient/postpartum-depression-when-its-not-just-the-baby-blues/
• https://genesight.com/blog/patient/life-changes-women-and-depression/
• https://genesight.com/blog/patient/what-to-do-when-your-child-receives-a-depression-or-anxiety-diagnosis/