COVID-19 in Babies and Children

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In early April, the Centers for Disease Control and Prevention (CDC) published an update on what we know about COVID-19 in children and babies. We still do not know for certain if the virus can be passed from a mother to a baby before birth. There has been no evidence of the virus in amniotic fluid. Although a few cases of babies testing positive for COVID-9 have occurred soon after birth, the American College of Obstetricians and Gynecologists says that it is unlikely these infants were infected before or during birth.

COVID-19 is Less Severe in Children

The CDC report says that children may have less severe symptoms from COVID-19 and that when they do have symptoms, they are less likely to need hospital treatment. Severe, life threatening infections in children are very rare. The main danger from children with COVID-19 is that they may spread the infection to others.

Here are some key findings from the CDC report.

  • As of early April, 2020, less than 2 percent of Americans who tested positive for COVID-19 were under age 18.
  • Infants under age one accounted for 15 percent of these infections, with the highest rate of infection occurring in ages 15 to 17.
  • Less than 20 percent of children needed to be treated in the hospital, and less than 2 percent needed intensive care. Infants were more likely to be admitted to the hospital than older children.
  • Close to 80 percent of children who needed hospital admission had a medical condition that put them at higher risk from COVID-19, including asthma, another lung disease, or heart disease.

COVID-19 Symptoms in Children

It is difficult to know how many children have had COVID-19 without showing any symptoms, since children without symptoms are not being tested. According to the CDC, available evidence suggests that when children do have symptoms, they are usually milder than in adults. The American Academy of Pediatrics (AAP) says that the most common symptoms are fever, cough, and shortness of breath.

Although children are less likely to have severe symptoms, they may be more likely to spread the virus to others because they may have more virus in the nose and throat than in the lungs. Children sneezing and coughing, may be shedding infected droplets into the air and infecting others.

There is also evidence that the virus can be shed in stool. This may be another way a young child who is not toilet trained or who is not reliable at washing hands after using the toilet may spread virus through this route.

Preventing COVID-19 in Children

The CDC and AAP advise these ways to protect children:

  • Wash hands.
  • Reduce close contacts.
  • Avoid playing outside with children from other homes.
  • Teach children to sneeze or cough into a tissue or their arm.
  • Clean and disinfect surfaces that get lots of touching.
  • Frequently wash stuffed animals.
  • Follow your local guidelines for social distancing or sheltering at home.

CDC advises that children over age 2 should wear a face mask when they are in a community setting and may come into contact with others. This is not to protect your child from the virus, but to prevent spreading the virus. CDC makes this recommendation because children may spread the virus without having symptoms or only having mild symptoms.

AAP says that children – like adults – can become frightened and overwhelmed by all the media attention to COVID-19. You should explain the virus to your child and the reason from taking precautions, but filter out frightening details and limit exposure to TV and social media. Although this virus may have started in China, it is important for children to know that people of Asian descent are not responsible for the virus or more likely to spread it.

If your child has fever, cough, or is old enough to complain of feeling short of breath, call ahead to your doctor about a possible office visit.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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