COVID-19 in Babies: What Parents Need to Know About Symptoms and Transmission

Here's what to know about the common symptoms of COVID-19 in babies, plus what to do if your infant gets infected with the virus.

Since the start of the coronavirus pandemic, experts have been researching how the virus affects little ones. The majority of newborns who test positive tend to have mild or no symptoms, but infants may have a higher risk of hospitalization than older children, according to the Centers for Disease Control and Prevention (CDC). Certain factors—such as prematurity, congenital heart disease, and genetic, neurologic, or metabolic conditions—raise the risk of severe illness even more.

One way to protect your baby during the pandemic? Getting vaccinated. Children under 6 months old aren't eligible for vaccination yet, but CDC data published in February 2022 found that vaccinated parents can pass some antibodies to their babies in the womb. Vaccinated family members also have a lower chance of transmitting the illness to the baby. Other precautions, such as limiting COVID exposure and washing your hands regularly, can help prevent infection as well.

Staying informed is key to keeping your family safe, so we've compiled a guide to COVID-19 in babies and newborns. Keep reading to learn more about coronavirus symptoms, prevention methods, transmission, and more.

How Do Babies Get COVID-19?

Some newborns become exposed to COVID-19 during or after childbirth. If this happens, parents can typically still room-in with the baby during hospital stays unless the parent is severely ill. There have also been reports of infants getting COVID-19 across the placenta in the womb, although this appears rare.

After heading home from the hospital, babies can be exposed to COVID-19 through parents, relatives, and caregivers—but you can reduce the risk by following safety precautions, like wearing a mask in public indoor spaces. Note that the virus likely does not spread through breast milk, which might be a relief for parents who are breastfeeding or pumping.

Parents and Crying Baby At Home
Uber Images/Shutterstock

COVID-19 Symptoms in Babies

According to the CDC, those under 1 may be more likely to suffer from severe coronavirus infection than older kids. Even so, many American infants have asymptomatic or mild cases. Baby COVID-19 symptoms might include the following:

  • Fever
  • Cough
  • Runny nose
  • Vomiting
  • Diarrhea
  • Breathing difficulties or rapid breathing
  • Decreased feeding
  • Lethargy

These symptoms usually show up within two to 14 days of exposure to the virus. Babies with symptomatic COVID-19 usually get better within two weeks, but if they experience any complications,the road to recovery could be a bit longer. Some young people also develop "long COVID," which happens when symptoms linger for weeks or months after infection.

According to the CDC, babies with medical complexity, congenital heart disease, or genetic, neurologic, or metabolic conditions might be more likely to suffer severe illness. Preterm infants (less than 37 weeks gestational age) may also have a higher risk of COVID-19 complications.

To find out if your baby has COVID-19, ask your pediatrician about testing the child. Your doctor might also diagnose your child based on their exposure history and symptoms.

COVID-19 Complications in Babies

Research is advancing how much we know about infants and COVID-19, but little ones appear to have a higher risk of complications. Take an April 2020 report from the CDC, which looked at 2,500 COVID-19 cases in children 18 and under. Among 95 infants in the study, 59 of them (62 percent) were hospitalized. Five of these infants were admitted to the ICU. In comparison, less than 14 percent of children ages 1 to 17 were admitted to the hospital.

These statistics have changed with the emergence of new variants, but a similar trend remains. For example, research published in March 2022 looked at children ages 0 to 4 years old who were infected during the Omicron surge. They were "hospitalized at approximately five times the rate of the previous peak during Delta variant predominance," according to the CDC report, and those under 6 months had the highest rates of hospitalization.

One possible (but rare) COVID-19 complication is multisystem inflammatory syndrome in children, or MIS-C. This mysterious illness can cause inflammation in certain body parts, including the heart, lungs, gastrointestinal organs, eyes, skin, brain, or kidneys. Most children who get it can be treated, but some cases are serious or deadly. The CDC states that its cause is still unclear—but remember that MIS-C is a rare condition.

Besides MIS-C, other COVID-19 complications in babies might include pneumonia, myocarditis (inflammation of the heart muscle), respiratory distress, and more.

Can Babies Transmit COVID-19?

Research has shown that children can carry a high viral load of the virus whether they show symptoms or not. That means babies might unknowingly spread the coronavirus to their caregivers. These "silent cases" may be particularly worrisome for grandparents and caregivers with compromised immune systems.

A study by a Canadian public health agency, published August 2021 in JAMA Pediatrics, found that younger children are more likely to spread COVID-19 at home, as compared to teens and older kids. This makes sense, considering that parents give plenty of hands-on care to babies and toddlers. (And that little ones are home more often, as older children tend to be in school.)

My Baby Has COVID-19 Symptoms: Now What?

If you suspect your baby has the coronavirus—or if they've been exposed to it—call the doctor right away. They'll determine if your baby needs testing based on any symptoms, risk factors, and potential exposure. The protocol for COVID-19 infection depends on the situation. Health care providers will help you decide on the proper course of treatment, which can include rest and plenty of fluids; your doctor may also suggest pain-relieving medication.

It's also important to know the red flags for COVID-19 in infants. Seek medical help immediately if your baby has breathing or feeding difficulties, an inability to wake, blueish lips, or other worrisome symptoms.

Aside from treatment, preventing the spread of COVID-19 is also important. Babies diagnosed with COVID-19 (and their primary caregiver) should stay away from other family members and take measures to prevent household transmission. They should remain home until they're no longer contagious. Check out the latest CDC guidelines for quarantine and isolation here.

How to Prevent COVID-19 in Babies

COVID-19 mainly spreads through respiratory droplets emitted when an infected individual coughs, sneezes, talks, or breathes. Young babies can't receive the COVID-19 vaccine, and anyone under 2 years old shouldn't wear a face mask. Therefore, to keep little ones safe, it may be best to rely on other precautions such as hand washing, keeping the space sanitized, limiting exposure to others indoors, and masking in public indoor spaces.

Also, parents, caregivers, and household members over 6 months old should receive the COVID-19 vaccine when eligible. Vaccination helps create a "bubble of protection" around your newborn, because vaccinated individuals have less risk of getting and spreading the virus.

It's also important to get vaccinated while pregnant or trying to conceive, if you haven't done so already. Data from the CDC found that infants (under 6 months old) had a 61 percent lower risk of COVID-19 hospitalization when their parent completed a two-dose mRNA primary vaccine series while pregnant. Effectiveness was 32 percent if the vaccine was taken in early pregnancy, and 80 percent if taken later in pregnancy. Talk to your doctor for more information about receiving the COVID-19 vaccine.

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