If you have a baby or are about to have a baby, it’s understandable if you're concerned about how COVID-19 could affect your little one.
Here's what parents need to know about COVID-19 in babies and young children, and what you can do to keep your family safe.
What are the symptoms of COVID-19 in babies and children?
Symptoms of COVID-19 for babies and children are the same as those in adults and can include:[1]
- Fever
- Cough
- Shortness of breath or trouble breathing
- Fatigue
- New loss of taste or smell
- Chills
- Muscle or body aches
- Headache
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
Babies and children sometimes have milder symptoms, says the American Academy of Pediatrics (AAP), and in some cases, infected infants, toddlers and older kids might not show any symptoms at all.
If babies and children do wind up with fewer or milder COVID-19 symptoms, they may include:
- Fever
- Runny nose
- Sneezing
- Gastrointestinal symptoms such as diarrhea
Symptoms can appear anywhere from two to 14 days after a person has been exposed. It's also possible not to show any symptoms.
If your child has come into close contact with someone with COVID-19 and is older than 2, he should start wearing a mask immediately and continue wearing it for 10 full days. Babies and children under 2 years old cannot safely wear face masks.
Test your little one right away if he starts to show symptoms, and keep him home and quarantined if possible until you know the test result.
If your child isn't showing symptoms, test him six days after he has been exposed. Even if he tests negative, he should continue wearing a mask through day 10, the Centers for Disease Control and Prevention (CDC) advises.
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Kids and others older than age 2 with presumed or confirmed COVID-19 should isolate from other people for at least five full days and then wear a mask around others for an additional five days regardless of vaccination status (though it's no longer required in many schools and other places, it is still strongly recommended). Children under 2, who are too young to wear a mask, should isolate from other people for 10 full days.
Coronaviruses, including COVID-19, usually spread from an infected person to other people via respiratory droplets that get into the air by coughing or sneezing. Touching or shaking hands, or touching a surface that has been contaminated with the virus and then touching your mouth, nose or eyes before you wash your hands may also spread the virus, but it’s not thought to be the main way COVID-19 spreads, the CDC says.
Is COVID-19 dangerous for babies and young children?
Babies and children generally seem to do better compared to people in other age groups, experts say.
In fact, around half of all kids with COVID-19 don't show symptoms. A research review published in the Archives of Disease in Childhood in July 2021, which analyzed multiple studies from around the world, found that 14 to 42 percent of children with COVID-19 didn’t have any symptoms. Among those who were showing symptoms, fever and cough were the most common ones, appearing in about 40 to 60 percent of children.
Unfortunately, COVID-19 cases in the U.S. still include a large number of children. The American Academy of Pediatrics (AAP) says that pediatric cases account for about 18 percent of the total reported data, but the number of children with COVID-19 is likely undercounted.
More than 15 million children have tested positive for COVID-19 since the pandemic began, the AAP says.[2]
Sadly, some children have died of COVID-19. While pediatric deaths from COVID-19 remain rare, the disease is still the most lethal respiratory virus among kids, and was found to be the underlying cause of death for nearly 1,300 children and young people between August 2021 and July 2022, according to a JAMA Network Open study published earlier this year.
Younger infants are particularly vulnerable to complications. COVID-19 causes more hospitalizations in babies under 6 months compared to any other age group except adults over 75, says Rajeev Fernando, M.D., an infectious diseases consultant based in Southampton, New York, and a member of the What to Expect Medical Review Board.
That information may seem frightening. But remember: While COVID-19 can be severe in younger populations, the majority of babies and children seem to have mild forms of the virus.
Can babies and children get the COVID-19 vaccine?
As of September 2023, updated COVID-19 vaccines are available for everyone, including children aged 6 months and older. The Pfizer-BioNTech and Moderna vaccines are currently available for kids ages 6 months and up under an emergency use authorization (EUA).
The updated versions of the vaccine, which better targets the latest circulating strains, were made available in September 2023 for everyone aged 6 months and older. All children 6 months and older should receive an updated version of the vaccine to stay protected this fall and winter, the CDC urges.
Clinical trials have shown that the vaccine is safe and effective for infants, toddlers, children and teenagers. The AAP and the CDC recommend that all babies and children over 6 months who do not have contraindications receive an updated COVID-19 vaccine to protect against potentially serious illness this fall and winter.
The updated dose should be given at least two months after any previous COVID vaccine dose and about 90 days after a case of COVID-19.
"Vaccination can help prevent severe illness and hospitalization in babies and children. It's important to get vaccinated with winter cold and flu season coming up," says Dr. Fernando.
Should parents be worried about myocarditis from either COVID-19 or the vaccines?
There were no reports of myocarditis — an inflammation of the heart muscle — from either COVID-19 vaccine in the clinical trials for children ages 5 to 11. And the June 2023 Pediatrics review found no reports of myocarditis among children under 5.
A very small number of adolescents and young adults have experienced mild cases of myocarditis after receiving the COVID-19 vaccine.
That said, becoming infected with COVID-19 is much more likely to cause myocarditis than getting the vaccine, according to the AAP. However, incidents of myocarditis have been rare in young children who have COVID-19.
Myocarditis can occur when the body’s immune system reacts to an infection or another trigger. Symptoms of myocarditis include:
- Abnormal heart rhythms (feelings of a fast-beating, fluttering or pounding heart)
- Shortness of breath
- Chest pain
Post-vaccine cases of myocarditis and pericarditis — an inflammation of the outer lining of the heart — have occurred most often in adolescent and young adult males, after the second dose and within a week of inoculation. Most patients recovered quickly with rest.
Should parents be worried about pediatric multisystem inflammatory syndrome (MIS-C)?
In rare cases, some children have developed a severe syndrome called pediatric multisystem inflammatory syndrome (MIS-C) — in which different body parts (including the heart, lungs, brain, eyes, skin, kidneys, or gastrointestinal tract) become inflamed — that seems to be linked to COVID-19.
Research about MIS-C is ongoing, but current information suggests it has to do with a child's immune response to COVID-19. Symptoms can include a fever plus at least one additional symptom including stomach pain, bloodshot eyes, diarrhea, dizziness or lightheadedness, skin rash, or vomiting. They typically develop 2 to 6 weeks after a child is infected with COVID-19.
MIS-C appears to be rare, and most children recovery quickly without any lasting health effects, the CDC says. But it's still important to know the symptoms, and call your pediatrician right away if your child develops any of them.
Can babies spread COVID-19 to other people?
Experts are still learning about the role children play in the transmission of the virus. However, young children can still spread COVID-19.
One study of households in Tennessee and Wisconsin found when children under the age of 12 tested positive for COVID-19, about half of the people living in the household later became infected with the virus. Findings also show that children seem to spread COVID-19 to adults more easily than to other children, according to a recent BMC Pediatrics review.
If a mother has COVID-19, can she still breastfeed?
Mothers should continue breastfeeding if they're infected with COVID-19, according to the CDC. There's currently no evidence showing that COVID-19 can be transmitted through breast milk.
What's more, breast milk contains protective antibodies that can help protect babies against many illnesses, including antibodies that can protect against COVID-19.
If you're currently breastfeeding and have a suspected, probable, or confirmed case of COVID-19, here's what the CDC recommends:
Breastfeeding mothers should wash their hands using soap and water before touching their babies.
If breastfeeding mothers do not have soap and water available to them, they should use hand sanitizer with at least 60 percent alcohol.
Breastfeeding mothers should wear a mask when in close contact with their babies, including while nursing or while feeding pumped milk from a bottle.
Mothers should practice good hand hygiene when expressing breast milk.
If you're feeling too sick to breastfeed, consider letting expressed breast milk be bottle-fed to the baby by a healthy caregiver who is fully vaccinated against COVID-19.
If the breastfeeding mother requires lactation services that cannot be done virtually, the lactation provider should follow recommended infection prevention and control measures, and wear personal protective equipment (PPE).
How can parents keep children safe from COVID-19?
Parenting since the COVID-19 pandemic has been tricky for a variety of reasons. But there are a few steps you can take to keep your family safe, especially during COVID surges.
- Get vaccinated against COVID-19. All eligible members of a household (including pregnant women and children 6 months and older) should get vaccinated against COVID-19 and receive their booster shots to protect themselves and newborns who cannot yet get vaccinated.
- Practice good hand hygiene. You've heard it time and time again, but wash your hands often with soap and water for at least 20 seconds. (If soap and water aren’t available, use a hand sanitizer that contains at least 60 percent alcohol.)
- Keep your distance during COVID outbreaks. Avoid close contact with people who are sick, and stay at least 6 feet away from other people outside your home when transmission rates are high. Opt for outside activities rather than indoor ones with a lot of people, especially during COVID surges in your area.
- Wear a mask in indoor public spaces when COVID is spreading or in crowds. Though mask mandates have been lifted in most places, it’s still a good idea to wear one if you’re at a higher risk of catching COVID or getting seriously ill from the virus; if you’re not vaccinated; if you’re around people who are vulnerable; and when there’s a high rate of COVID-19 cases in your area. Children under 2 should not wear face masks.
Managing your family's COVID-19 risk can be challenging. Thankfully, most babies and children who contract the virus will have mild or moderate symptoms. And you can keep your little one as protected as possible by making sure you get vaccinated when you're pregnant and getting him an updated vaccine when he turns 6 months old.
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