Friday, 15 May 2020

From separation to psychological stress, how COVID is affecting mother-baby pairs

Let’s rewind to the time when shaking hands was a way to greet someone and hugging each other meant affection. COVID has changed the definition of physical intimacy. Now greetings are given virtually, hugs are almost forgotten, people connect through video calls instead of physically meeting, a minimum of six feet distance is maintained while talking to someone and there is a fear of being infected by the virus.

Besieged by the contagion, parents are finding it difficult to show affection to their children especially mothers with a newborn. Touch is the first language that an infant understands and amidst the pandemic, it is difficult for the family to be in physical contact with their infants.

The Indian Council of Medical Research (ICMR) guidelines state that there can be a possibility of transmission of coronavirus from mother to baby before birth while it is in the mother’s womb or during delivery from a COVID infected mother. The guidelines mention, “Facilities should consider temporarily separating (e.g. separate rooms) the mother who have confirmed COVID-19 from the baby until the mother's transmission-based precautions are discontinued."

The separation between a newborn and a mother has many psychological effects on the family. The family experience negative emotions, depressions, fear, and helplessness. Though coronavirus has forced mothers to limit contact with the newborns, many studies claim that the contact between mother-newborn pair is very crucial.

A study by neonatologist Raylene Phillips shows that newborns who are placed in “skin to skin” contact with their mothers after birth “make the transition from fetal to newborn life with greater respiratory, temperature, and glucose stability and significantly less crying indicating decreased stress.” Not just the newborns, the intimacy between the mother-infant pair increases maternal instincts in the mother and the mother can breastfeed for a longer duration.

“Being skin to skin with the mother protects the newborn from the well-documented negative effects of separation, supports optimal brain development and facilitates attachment, which promotes the infant’s self-regulation over time,” adds the neonatologist.

Having is baby is an event that is celebrated in the family with mirth and delight but the current time seems to have put a stop to all the merriment. It is an unfortunate time for newborns and mothers who are separated because of the contagion.

During the first one-two months, mothers and infants develop a signal mechanism to communicate with each other. When there is no active response from the mother’s side the baby tends to avoid eye contact, does not engage in vocal dialogue, and is easily upset when offered social contact.

A Chinese study of COVID-19 and maternal mental health notes, “The potential (ill-informed) practices of separating mothers from their infants post-birth in the name of protection from COVID-19 infection, such as witnessed in China, and a lack of certainty leading to early cessation of breastfeeding, have harmful impacts on maternal mental health via ‘toxic stress’ and perceptions of self-blame and shame.”

Another similar study on the psychological needs of hospitalized newborns’ parents during COVID-19 outbreak identifies “five themes regarding the parents’ primary psychological needs” which includes urgent demand for timely up-to-date information about the children’s condition, demand for psychological and emotional support, reducing the inconvenience caused by the epidemic outbreak, claims for protective information after discharge and demand for financial support.

There is no evidence as if now to show that pregnant women are at greater risk of COVID-19. World Health Organization (WHO) encourages mothers to breastfeed their newborns safely with good “respiratory hygiene”. It also recommends mothers to hold the newborns skin to skin and sharing a room with the infant. Unlike the guidelines of WHO, Chinese expert consensus states that COVID-19 positive mothers should not breastfeed their babies because the virus may enter the milk during the incubation period.

According to the United Nations International Children’s Emergency Fund’s (UNICEF) press release an estimated 116 million babies will be born “under the shadow of the COVID-19 pandemic”.

“Millions of mothers all over the world embarked on a journey of parenthood in the world as it was. They now must prepare to bring a life into the world as it has become – a world where expecting mothers are afraid to go to health centers for fear of getting infected, or missing out on emergency care due to strained health services and lockdowns,” said Henrietta Fore, UNICEF Executive Director in the press release, adding, “It is hard to imagine how much the coronavirus pandemic has recast motherhood.”

While the vaccine for the contagion is under development, in the coming time it will bring some relief to the world. Until the vaccine is developed, precautions should be taken by mothers while handling the infants. Emotional support and counseling should be provided to mothers who are separated from their newborns so that they are relieved from psychological stress.


Picture Credits- Guillaume Payen


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