I may be late asking about this but have you all seen these
recommendations? About separation of mom and newborn infant? Are they acurate?
_http://www.cdc.gov/h1n1flu/clinician_pregnant.htm_
(http://www.cdc.gov/h1n1flu/clinician_pregnant.htm)
Infant feeding considerations
Infants who are not breastfeeding are more vulnerable to infection and
hospitalization for severe respiratory illness than infants who are
breastfeeding. Women who are not ill with influenza should be encouraged to initiate
breastfeeding early and feed frequently. Ideally, babies should receive
most of their nutrition from breast milk. Eliminate unnecessary formula
supplementation, so the infant can receive as much maternal antibodies as possible
Infants are thought to be at higher risk for severe illness from novel
influenza A (H1N1) infection and very little is known about prevention of
novel H1N1 flu infection in infants. If possible, only adults who are not sick
should care for infants, including providing feedings. The risk for novel
influenza A (H1N1) transmission through breast milk is unknown.
_http://www.cdc.gov/h1n1flu/masks.htm_
(http://www.cdc.gov/h1n1flu/masks.htm)
_http://www.cdc.gov/h1n1flu/guidance/obstetric.htm_
(http://www.cdc.gov/h1n1flu/guidance/obstetric.htm)
Pregnant Women With Confirmed, Probable, or Suspected H1N1 Illness
In general, guidance for control of novel H1N1 flu infection in obstetric
settings is consistent with that in other healthcare settings but also
includes special considerations for prevention of infection in the newborn.
Infants are known to be at higher risk of severe illness from seasonal
influenza virus infections. Based on this experience, infants are also considered
to be at higher risk for severe illness from novel influenza A (H1N1) virus
infection. Because very little is known about prevention of novel H1N1 flu
infection in infants, these recommendations are intended to minimize the
potential for exposure to novel influenza A (H1N1) viruses when an ill
pregnant women delivers her baby.
Special considerations in obstetric settings when a pregnant woman has
confirmed, probable or suspected novel H1N1 flu (adapted from recommendations
for seasonal influenza:
_http://www.cdc.gov/flu/professionals/infectioncontrol/peri-post-settings.ht_
(http://www.cdc.gov/flu/professionals/infectioncontrol/peri-post-settings.ht) m) include:
Initiate appropriate antiviral treatment as soon as possible.
Isolate the ill mother from healthy pregnant women as mentioned above.
Place a surgical mask on the ill mother during labor and delivery, if
tolerable, in order to decrease exposure of the newborn, healthcare personnel,
and other labor and delivery patients to potentially infectious respiratory
secretions.
Place the ill mother in isolation after delivery (_http://www_
(http://www/) .cdc.gov/h1n1flu/guidelines_infection_control.htm). The mother who has
influenza-like-illness (_http://www_ (http://www/)
.cdc.gov/h1n1flu/casedef.htm) at delivery should consider avoiding close contact with her infant until
the following conditions have been met: she has received antiviral
medications for 48 hours, her fever has fully resolved, and she can control coughs
and secretions. Meeting these conditions may reduce, but not eliminate,
the risk of transmitting influenza to the baby. Before these conditions are
met, the newborn should be cared for in a separate room by another person
who is well, and the mother should be encouraged and assisted to express
her milk. Breast milk is not thought to be a potential source of influenza
virus infections. As soon as all conditions are met, the mother should be
encouraged to wear a facemask, change to a clean gown or clothing, adhere to
strict hand hygiene and cough etiquette when in contact with her infant, and
begin breastfeeding (or if not able to breastfeed, bottle feeding). She
should continue these protective measures, both in the hospital setting and
at home, for at least 7 days after the onset of influenza symptoms
(_http://www_ (http://www/) .cdc.gov/h1n1flu/guidance_homecare.htm#c). If symptoms
last more than 7 days, she should discuss the symptoms with her doctor.
Protective measures might need to be continued until she is symptom-free for
24 hours. People who are once again well 7 days after getting sick are
thought to be at low risk for transmitting the virus to others.
Newborns of Ill Mothers
Because the risk for transmission of novel H1N1 flu from mother to fetus
is unknown, the newborn should be considered to be potentially infected if
delivery occurs during the 2 days before through 7 days after illness onset
in the mother. Infection control procedures developed for novel H1N1 flu
should be used for the newborn throughout the hospital stay (_http://www_
(http://www/) .cdc.gov/h1n1flu/guidelines_infection_control.htm). The newborn
should be closely monitored for signs and symptoms of influenza. If signs
or symptoms develop, testing should be performed, infection control measures
should be continued, and treatment with anti-influenza medications should
be considered (_http://www_ (http://www/)
.cdc.gov/h1n1flu/childrentreatment.htm). Oseltamivir is approved for prevention of influenza in patients 1
year of age and older; however, an emergency use authorization (EUA) has
been issued for oseltamivir for influenza treatment and prevention in patients
less than 1 year of age (_http://www_ (http://www/)
.cdc.gov/h1n1flu/recommendations.htm#C).
Chemoprophylaxis of infants less than 3 months of age is not typically
recommended, as there are very limited data available on the safety and
effectiveness of chemoprophylaxis for infants less than 3 months. However, in
situations which are judged to be critical, chemoprophylaxis with oseltamivir
can be considered.
Infant Feeding
Breastfeeding should be protected and supported at all times because of
the protection from respiratory infection that breast milk provides to the
infant. The mother with influenza-like-illness should be encouraged and
assisted to express her milk. During this time, the infant should be fed the
mother’s expressed milk by another person who is well.
Pat
Patricia Predmore
Birth Matters!
_www.birthmattersny.com_ (http://www.birthmattersny.com/)
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