[2025] COVID-19: If I test positive or have symptoms, will I be separated from my baby after birth?

Updated 3/19/2025

When you arrive at the hospital in labor, you will most likely be screened for COVID-19. If you test positive, or if you have symptoms that suggest you might be infected, then you and your clinical team will have to decide together:

Is it better overall for you and your newborn to room together, or is it better for you to be in separate rooms?

Guidance from major health organizations has evolved over the course of the pandemic. To help you think about what you might do if you are faced with this decision, here are recommendations from:

• the Centers for Disease Control (“CDC”)
• the American College of Obstetricians and Gynecologists (“ACOG”)
• the American Academy of Pediatricians (“AAP”), and
• the World Health Organization (“WHO”).

All of these leading health organizations now support covid-positive mothers who wish to room-in with their newborns under most circumstances. 

In August 2020, the CDC updated its guidance on whether a COVID-positive mother and her newborn should be separated. While this information is no longer published on the CDC website, neither has it been disclaimed.

The CDC

• recommended rooming in, and
• explicitly acknowledged that the decision is ultimately up to the family

In addition, the CDC supported breastfeeding by mothers who are COVID-positive.

The CDC supports rooming in

• “Early and close contact between the mother and neonate has many well-established benefits.”
• “The ideal setting for care of a healthy, term newborn while in the hospital is in the mother’s room, commonly called ‘rooming-in’.”
• “Current evidence suggests the risk of a neonate acquiring SARS-CoV-2 from its mother is low. Further, data suggests that there is no difference in risk of SARS-CoV-2 infection to the neonate whether a neonate is cared for in a separate room or remains in the mother’s room.”

The CDC emphasized shared decision-making and recognizes “maternity autonomy”

Addressing the decision-making process, the updated CDC guidance stated:

“Ideally, each mother and her healthcare providers should discuss whether she would like the neonate to be cared for in her room or a separate location if she is suspected or confirmed of having COVID-19, weighing the considerations listed below. It’s easiest to begin this conversation during prenatal care and continue it through the intrapartum period. Healthcare providers should respect maternal autonomy in the medical decision-making process.”

According to the CDC, the considerations that healthcare providers should discuss with each family facing this decision include:

• Mothers who room-in with their infants can more easily learn and respond to their feeding cues, which helps establish breastfeeding. Breastfeeding reduces morbidity and mortality for both mothers and their infants. Mothers who choose to breastfeed should take measures, including wearing a mask and practicing hand hygiene, to minimize the risk of virus transmission while feeding. Additional information for healthcare providers on breastfeeding in the context of COVID-19 is available.
• Mother-infant bonding is facilitated by keeping the neonate with its mother.
• Rooming-in promotes family-centered care and can allow for parent education about newborn care and infection prevention and control practices.
• Mothers with suspected or confirmed SARS-CoV-2 infection should not be considered as posing a potential risk of virus transmission to their neonates if they have met the criteria for discontinuing isolation and precautions:
  • At least 10 days have passed since their symptoms first appeared (up to 20 days if they have more severe to critical illness or are severely immunocompromised), and
  • At least 24 hours have passed since their last fever without the use of antipyretics, and
  • Their other symptoms have improved.
• Mothers who have not met these criteria may choose to temporarily separate from their neonates in effort to reduce the risk of virus transmission. However, if after discharge they will not be able to maintain separation from their neonate until they meet the criteria, it is unclear whether temporary separation while in the hospital would ultimately prevent SARS-CoV-2 transmission to the neonate, given the potential for exposure from the mother after discharge.
• Separation may be necessary for mothers who are too ill to care for their infants or who need higher levels of care.
• Separation may be necessary for neonates at higher risk for severe illness (e.g., preterm infants, infants with underlying medical conditions, infants needing higher levels of care).
• Separation in order to reduce the risk of transmission from a mother with suspected or confirmed SARS-CoV-2 to her neonate may not be necessary if the neonate tests positive for SARS-CoV-2.

The CDC detailed measures to minimize risk of transmission

If the neonate remains in the mother’s room, measures that can be taken to minimize the risk of transmission from a mother with suspected or confirmed COVID-19  to her neonate include:

• Mothers should wear a mask and practice hand hygiene during all contact with their neonates. Of note, plastic infant face shields are not recommended and masks should not be placed on neonates or children younger than 2 years of age.

• Engineering controls, such as maintaining a physical distance of >6 feet between the mother and neonate or placing the neonate in an incubator, should be used when feasible. If the infant is kept in an incubator, it is important to educate the mother and other caregivers, including hospital personnel, on proper use (i.e., latching doors) in order to prevent newborn falls.

The CDC supports breastfeeding by COVID-positive mothers

On February 13, 2024 , the CDC updated its website page on COVID-19 and Breastfeeding

COVID-19 and breast milk

Current evidence suggests that SARS-CoV-2 is not spread to infants through breast milk. The virus spreads when an infected person breathes out droplets and tiny particles that contain the virus. These droplets and particles can be breathed in by other people or land on their eyes, noses, or mouths. In some circumstances, the droplets may contaminate surfaces they touch.

Breast milk is the recommended source of nutrition for most infants, even while their mother is ill. A mother’s breast milk contains antibodies and other immunological factors that can help protect her infant from infections. Research indicates that the breast milk of mothers with COVID-19 contains antibodies and other factors that may provide immunological protection to infants.

Breastfeeding with COVID-19

Mothers can continue breastfeeding when they have COVID-19 or came in contact with someone with COVID-19. However, they should follow these precautions.

Precautions

• Wash hands using soap and water before touching their child or expressing breast milk by hand expression or with a breast pump. If soap and water are unavailable, use hand sanitizer with at least 60% alcohol.
• Consider wearing a mask when in close contact with the infant, such as when feeding at the breast or from a bottle.
• Clean and sanitize breast pumps and all infant feeding items.

If a mother is too sick to breastfeed

If a mother is too sick to feed her infant at the breast, and another healthy caregiver cares for the infant, mothers should be encouraged to regularly express her milk. With this support, the infant can continue receiving breast milk, and the mother can maintain her milk supply. Health care providers may need to refer mothers for lactation support to help them maintain milk production and supplement with donor human milk or infant formula.

The CDC currently recommends (March 2025) that everyone 12 years of age and older should get a COVID-19 vaccination to help protect against COVID-19. More information about COVID-19 vaccines for breastfeeding/lactating persons can be found here: COVID-19 Vaccination for Women Who Are Pregnant or Breastfeeding

The American College of Obstetricians and Gynecologists (ACOG)

ACOG updated its publication, “Coronavirus (COVID-19), Pregnancy, and Breastfeeding: Answers From Ob-Gyns ” in January of 2025. ACOG continues to support COVID-positive mothers who wish to room in and/or breastfeed their newborns, noting that separation in the hospital does not appear to reduce the risk of passing COVID-19 to your baby.

Can I stay in the same room with my baby after delivery if I have COVID-19?

Yes. You can follow your hospital’s or birth center’s usual policy on rooming together with your baby.

There are many benefits to having your baby stay in the same room as you after delivery, even if you have COVID-19. For example, rooming together may help you bond with your baby and help you start breastfeeding if desired. And current reports suggest that the risk of a baby getting COVID-19 does not change based on whether the baby stays in the mother’s room or in a separate room. (Read “How can I avoid passing COVID-19 to my baby?” below.)

Staying in a separate room may be recommended if you are very sick and unable to care for your baby.

The American Academy of Pediatrics (AAP)

The AAP originally recommended separation of a COVID positive mother from her newborn, but has now updated its position to support keeping mother and baby together. Like the CDC and ACOG, the AAP notes that there is no evidence that separation of mother and baby in the hospital reduces the risk of transmission to the baby.

In its publication, updated 11/10/2022, “FAQs: Management of Infants Born to Mothers with Suspected or Confirmed Covid-19″, the AAP states:

Can mother and well newborns room-in?

Yes. The evidence to date suggests that the risk of the newborn acquiring infection during the birth hospitalization can be mitigated by precautions consistently taken to protect newborn infants from maternal infectious respiratory secretions. Mothers and well newborn infants should be cared for using usual center practice, including rooming-in (couplet care). A mother who is significantly ill with COVID-19 may not be able to care for her infant in a safe way. In this situation, it may be appropriate to temporarily separate mother and infant or to have the infant cared for by noninfected caregivers in mother’s room.

Currently, the AAP recommends the following for care of mothers with confirmed or suspected COVID-19 and their well newborn infants:

• Mothers and newborn infants may room-in according to usual center practice.
• During the birth hospitalization, the mother should maintain a reasonable distance from the infant when possible and wear a face mask. When a mother provides hands-on care to the infant, the mother should wear a mask and perform hand hygiene.
• If noninfected partners or other family members are present during the birth hospitalization, they should use face masks and hand hygiene when providing hands-on care to the infant.
• Health care workers should use transmission-based precautions when caring for well infants when this care is provided in the same room as a mother with COVID-19. Health care workers may choose to use transmission-based precautions at all times when caring for well infants at risk for SARS-CoV-2 infection.

Can the infant breastfeed?

Yes. The AAP strongly supports breastfeeding as the best choice for infant feeding. Several published studies have detected SARS-CoV-2 nucleic acid in breast milk. Currently, however, viable infectious virus has not been detected in breast milk. One study demonstrated that pasteurization methods (such as those used to prepare donor milk) inactivate SARS-CoV-2. IgA and IgG antibodies have been detected in breast milk after both maternal infection and maternal vaccination against SARS-CoV-2. Given these findings, direct breastfeeding is encouraged at this time.

• Infected mothers should perform hand hygiene before breastfeeding and wear a mask during breastfeeding.
• If an infected mother chooses not to breastfeed her newborn infant, she may express breast milk to be fed to the infant by other uninfected caregivers.
• Mothers of infants in the NICU may express breast milk for their infants during any time that their infection status prohibits their presence in the NICU. Centers should make arrangements to receive this milk from mothers until they are able to enter the NICU.

 

The WHO Guidance: Q&A on COVID-19, pregnancy, childbirth and breastfeeding

Updated 15 March 2022

The World Health Organization’s Q & A on COVID-19, pregnancy, childbirth, and breastfeeding  states:

Can I touch and hold my newborn baby if I have COVID-19?

Yes. Close contact and early, exclusive breastfeeding helps a baby to thrive. You should be supported to

• Breastfeed safely, with good respiratory hygiene; 
• Hold your newborn skin-to-skin, and
• Share a room with your baby

 

Summing it up

Leading health organizations at the state, national and international level are now aligned in supporting rooming in for you and your baby in most circumstances even if you are COVID-positive.  Several organizations emphasize that current evidence does not suggest a greater risk of infecting your baby if you room in. Most importantly, THE DECISION IS UP TO YOU.

Your clinical team should share with you the medical evidence about risks and benefits of rooming in with your baby if you are COVID-19 positive in light of all the specifics of your particular situation.  You should share with them your preferences and priorities as a family for the care of your baby. By pooling information, you and your clinical team can make the best decision about what is right in your case. The shared goal should be to reach a decision that feels right to you in light of all considerations, medical and personal.