Even as doctors are buoyant about infants faring significantly better against COVID-19, face masks are strictly prohibited. Smaller face shields are a better idea, say makers and doctors
Eira Majithia, a 10-month-old baby, wears a face shield manufactured by Makers Asylum. "She is comfortable wearing it when we step out, which is, as of now, just once a month," says father Harsh, who is into real estate. (Right) Masks are a no for infants
While engineering face shields for frontliners at their Andheri workshop, members of Maker-s Asylum, a community of innovators, accidentally ended up with a mini version. "It looked cute, but we didn-t know what to do with it," says co-founder Vaibhav Chhabra. It was early April and the world was still experimenting with durable and comfortable protective gear. Unlike masks that protect the nose and mouth, face shields are known to keep the virus from entering through the eyes.
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A few days later, almost serendipitously, Chhabra stumbled upon a news story about how Bangkok had started manufacturing baby shields. One of the foundations that the lab had collaborated with, contacted a city hospital to find out if they were willing to commission a batch. The first 100 shields, lined with soft foam, were prepared from scratch and labelled the M-19 baby shields—M as a tribute to the maker community. "It was a great success," says Chhabra. The team now makes 200 baby shields daily, which are sent to city hospitals and individual clients.
The shields are lined with foam so that it doesn-t hurt the child. Right The COVID-19 facility at Bai Jerbai Wadia Hospital for children
Last week, the BMC-run Nair Hospital witnessed its 300th baby being born to a woman infected with COVID-19. While 11 of the babies born at the hospital had initially tested positive, they all tested negative after discharge. The hospital has a dedicated 120-bedded ward for pregnant women. "From the time of labour till the baby is born, we have to take utmost care so that there-s no possibility of infection," says Dr Sarika Patil, senior administrator and nodal officer for COVID-19 at Nair Hospital. Early reports in the literature on COVID-19 in pregnancy suggested that in order to reduce the risk of transmission from mother to baby, it was safer to have a caesarean, to isolate the baby from the mother at birth and to formula feed. Some hospitals prefer that newborns are not separated from their COVID-positive mothers after delivery. "We make the mothers understand the importance of hand hygiene and face masks. They are also allowed to breastfeed as that helps boost the child-s immunity." The hospital administers immunity boosters to every baby, and the babies are discharged along with their mothers, barring complications. The hospital has had three newborns die so far out of the 300 deliveries, but these deaths were due to non-COVID reasons, such as extreme complications or other infections.
It is thought that children are much less likely to suffer the most severe effects of the disease. "Currently, based on limited data, there is not enough evidence for intrauterine transmission of COVID-19 from an infected pregnant woman to the child. It-s a new field of study for researchers and doctors. Right now, we believe that babies are likely to get infected when they are coming down through the birth canal or after birth due to the handling by multiple relatives, who might be asymptomatic," says Dr Suresh Birajdar, neonatologist and paediatrician at Motherhood Hospital, Kharghar.
Dr Suresh Birajdar and Dr Shakuntala Prabhu
Nonetheless, pregnant mothers constitute a high-risk category, says Dr Shakuntala Prabhu, medical director and head of department of paediatrics at Bai Jerbai Wadia Hospital For Children. As per ICMR guidelines, all pregnant mothers over 34 weeks are tested for COVID-19. "If they test positive, we put them in the dedicated COVID-19 ward so that the babies that are born can be segregated and treated. Initially, from April to May, one-third of pregnant mothers that we had at the hospital tested positive, but surprisingly, June statistics have been better." Dr Patil of Nair hospital agrees. "Call it divine intervention, if you want, but babies have been faring way better than adults."
Prabhu says mothers are often asymptomatic, unless they have a co-morbidity such as diabetes or high BP or some other illness. Babies are tested for COVID-19 after day two. "Curiously, the unique COVID symptom that we are beginning to see in babies is severe diarrhoea and dehydration. Overall, the syndrome starts with cough and cold and graduates to a flu-like illness, but could become acute respiratory infection."
While we all should be wearing masks, doctors say infants are exempt. "The main reason is that if you are feeling suffocated, you can take it off. Babies don-t have that coordination," says Dr Birajdar. He says, for now, it-s important that parents limit taking the infant to public spaces unless absolutely necessary.
Chhabra says the face shields are used during immunisation and vaccination trips. "Baby skin is sensitive so it should not be sharp on the edges or touch their ear. The best part about shields is that they stop babies from touching their face."
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