Advice on corona for women who are pregnant or breastfeeding

Here you will find answers to the most common questions pregnant or breastfeeding women have related to the coronavirus.

Foto: Johnér © Corbis

Pregnancy and corona

What do we know about pregnancy and the coronavirus?

Pregnant women might be at increased risk of a more serious course of certain viral infections, for example in the case of influenza. We do not yet know if this is also the case for disease caused by the coronavirus. To protect you and others, the health care services are taking many precautions to reduce the risk of transmission and disease. Based on the available information so far on the global situation for corona, pregnant women seem to tolerate the coronavirus well. Pregnant women are not especially vulnerable to a serious course of the disease caused by the coronavirus.

The Norwegian Institute of Public Health (NIPH) also offers advice to pregnant women, children and adolescents.

Should I take special precautions?

To prevent infection, you should follow the same advice as the general population. Read more on how to prevent transmission (in Norwegian). 

All pregnant women who are in the 2nd or 3rd trimester are recommended to take the seasonal flu vaccine. If you are in the 1st trimester, and you have risk factors, the seasonal flu vaccine is also recommended. This is independent of infection by the coronavirus.

What should I do if I am pregnant and at risk?

If you have a chronic disease or pregnancy complications, you should discuss with your doctor whether there is a need to take additional precautions and if workplace adjustments are necessary. Sick leave is not required unless work adjustments are impossible. If you work as a healthcare professional and are pregnant, you should –based on the precautionary principle - arrange with your employer so that other personnel perform testing and treatment of persons with possible coronavirus (covid-19 disease), as far as possible.

Can the virus be transmitted from me to the baby prior to or during birth?

We do not know for sure whether the coronavirus can be transmitted from the mother to the baby prior to or during birth. Currently, it looks like you do not need to worry. Based on present knowledge, transmission via the placenta has not been detected. Nor has transmission from mother to baby during birth been detected. This means that you can give birth the normal way.

Should I follow my normal pregnancy check-up routines?

Service activity for pregnancy check-up routines should be maintained as normal at the local health centre. We recommend you contact your midwife/doctor when you find out that you are pregnant and follow the recommended pregnancy check-up routine. Read more about antenatal appointments. We also recommend you follow your scheduled appointments with your midwife/doctor. If you are worried about your own or your unborn baby's health, you should contact your midwife/doctor even if you do not have an appointment.

What can I do myself?

You can optimize your pregnancy and reduce the risk by refraining from alcohol, tobacco and other drugs. Consult with your doctor if you are on medication. Starting to take folate (folic acid) as early as possible during pregnancy is beneficial, preferably already while planning your pregnancy.  Other vitamin and mineral supplements may also be needed, such as vitamin D, iodine, and omega 3 fatty acids. You will find more information on diet during pregnancy here (in Norwegian).

What should I do if I suspect that I am infected or feel sick?

If you have symptoms of respiratory infection, you suspect that you are infected by the coronavirus, or you have been in close contact with someone with a confirmed infection, it is important that you contact the health services before check-ups to discuss how these should be carried out. Typical symptoms of covid-19 are cough, fever and shortness of breath. If you are worried about your own health or your unborn baby, contact your midwife/doctor immediately.

Birth and corona

What happens when I go into labour?

If you are not sick or infected, births will proceed as normal.

Should a coronavirus infection be confirmed just prior to or during birth, you will be given a separate room, the staff will be wearing protective clothing and there is a possibility that you will also be asked to wear a face mask. 

You can be with your newborn baby after birth unless you are seriously ill, or the baby is very premature or ill. Maternity and neonatal departments in Norway are prepared to receive both you and your baby and have established routines on how to best assist you.

Can family and friends come visit me at the hospital?

Yes, you can have visits under certain conditions. Visits to hospitals should be facilitated as far as possible. All visits should be assessed and arranged for in advance, and they must be registered.

The need of each individual person to receive visitors should be assessed relative to the risk of spreading the infection, the individual risk of a more severe progression of covid-19, the local infection situation and the capacity at the institution for welcoming visitors. All visits must be in line with the national recommendations for infection control.

The hospital has a responsibility to reduce the risk for you and your baby, for other women giving birth, for newborns and for personnel who need to be at work. Refer to your hospital's website for further information.

Can I bring a birth companion?

Yes, you may. It is important to facilitate the presence of a partner or someone close to you during birth and postpartum.

Breastfeeding and corona

What do we know about breastfeeding and the coronavirus?

Breastfeeding is recommended even if you are infected or you are sick from being infected by the coronavirus. Coronavirus has not been detected in breastmilk from women with coronavirus infection, where this has been studied. Relatively few infants have been reported with confirmed coronavirus infection. Those that have had an infection have had a mild course of the disease.

Can the virus be transmitted from the mother to the baby during breastfeeding?

We do not yet know if the coronavirus can be transmitted from the mother to the baby. What we do know is that breastfeeding protects the baby from disease after birth as well as later in infancy and childhood. Breastfeeding protects against infection by transferring antibodies from mother to baby. Breastmilk also contains components that are beneficial for the development of the child's immune system. Breastmilk and breastfeeding have several positive health benefits both for the child and for you who are breastfeeding.

What advice applies to me who is breastfeeding?

If you are healthy and without symptoms of respiratory infection nor diagnosed with covid-19, you should follow:

If you have a respiratory infection and/or are diagnosed with covid-19:

If you have a respiratory infection and/or are diagnosed with covid-19, you should follow the same general advice listed above for breastfeeding and infection prevention, and in addition the following advice that applies specially to breastfeeding:

  • Keep a good hand hygiene whenever you are in close contact with the baby. You should always wash your hands thoroughly prior to breastfeeding and prior to touching your breasts.
  • Try to avoid touching your breasts just like you are advised to avoid touching your face, to avoid transmission from your hands to your breast (and further to your baby). When required, your breasts can be washed with soap and water; alcohol should not be used.
  • If you receive breastfeeding guidance from a health care provider, ask if he or she can show or explain without touching your breasts.
  • Avoid coughing or sneezing directly onto your baby, for example by keeping some distance (when not breastfeeding). If you cough or sneeze while breastfeeding, you should cough or sneeze away from the baby and into tissue paper that you then dispose of.
  • Clean your home frequently, including washing/disinfection of surfaces that you are in contact with, such as door handles, mobile phones etc.

If you/the mother is seriously ill and cannot breastfeed the baby directly, it will be of great benefit if you/the mother can get help to express / pump breastmilk for the baby while still following recommendations to prevent infection.

Breastfeeding if you are healthy and sent home early from the hospital after birth

If you have returned home from the hospital before breastfeeding has properly started, it is important that you contact your local health centre to quickly get guidance should you need it. Due to the challenging situation, it is recommended that home visits are replaced with consultation at the health centre, with an interpreter if needed (helsedirektoratet.no).

Ammehjelpen, the Norwegian Mother-to-Mother Breastfeeding Support Group, provides practical advice and support on breastfeeding by volunteer mums via Ammehjelpen.no or their Facebook-group.

It is important and beneficial if you breastfeed as much as possible after giving birth. Give the baby as much breast milk as possible and nothing else unless required. For most babies, colostrum (the first yellow milk produced) is enough during the first few days. Colostrum comes in small quantities and is continuously being produced. It is therefore important to let the baby feed as often as he or she wants to. The more you breastfeed, the more your baby's sucking will stimulate your supply and the more milk you'll make. It is quite normal for newborns to breastfeed 8-12 times a day and sometimes more.

Once your milk production has started (after 2–4 days), there are certain signs you can follow to make sure your baby gets enough milk.

When should I contact the health services?

If you find that your baby is not eating well, that he or she does not swallow milk during breastfeeding, if the diapers are dry and/or the baby seems tired and apathetic, the baby might not be getting enough milk/fluid. 

You must then contact the health centre (possibly your doctor hospital) immediately, at the same time as you try to get the baby to take breast milk, alternatively infant formula. 

Infant formula

If you have tried to breastfeed and have received good breastfeeding councelling without succeeding, or if you are not well enough to breastfeed or express / pump breastmilk, the baby must be given infant formula. Pay extra attention to the hygiene.