" as="other"> Questions for pregnant women, mother and children - MyBioGate Global COVID-19 Resources Platform

Published: March, 2020 From China CDC

1. Are children and pregnant women susceptible population group?

Pregnant women are susceptible to 2019-nCoV, and are more likely to have complications, or even progress to severe conditions; whether there is mother to child vertical transmission and its impact on the fetus remains unclear.

At present, generally speaking, children are a susceptible group, but the clinical severity of children is mainly light and common type, and the proportion of severe cases is relatively low.

(Reference: Expert Recommendations for 2019-nCoV Infection during Pregnancy and Puerperium issued by Chinese Journal of Perinatal Medicine, 2nd issue in 2020; The 15 latest explanations on COVID-19 issued by National Health Commission)

2. What is the advice for the self-monitoring and management for pregnant women?

Pay attention to the changes in body temperature and weight every day, check if there are respiratory tract infection symptoms and monitor the fetal movement regularly.

For women in the early stage of pregnancy, if ultrasound has confirmed the intrauterine pregnancy, and in the case of slight abdominal pain or a small amount of bleeding, you can stay at home for rest and observation; in case of repeated irregular

small amount of bleeding, ultrasonic examination should be carried out after making appointment with and consulting the doctor of Obstetrics and Gynecology in good time to rule out embryo arrest; if the abdominal pain is aggravated or the blood volume is increased or the intrauterine pregnancy has not been confirmed by ultrasound, you should consult the obstetrician by telephone in time, and follow the doctor’s advice to seek care.

(Reference: COVID-19 prevention guide for pregnant women” (updated version) issued by Chinese Center for Disease Control and Prevention; Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education Center )

3. What is the advice for the antenatal visits for pregnant women?

During the peak epidemic period, if there is no special situation(such as gestational age, and if special examination is required etc), pregnant women can consult with their obstetricians to postpone the antenatal visits as appropriate and monitor the fetal intrauterine conditions (fetal movement) at home. When it is necessary to take the antenatal visit, you should make an appointment in advance, equip yourself with good protection, and try to shorten your stay at the hospital. Pregnant women with pregnancy complications should strictly follow the doctor’s advice. In case of abnormal conditions during pregnancy (headache, unclear vision, palpitation, shortness of breath, high blood pressure, vaginal bleeding or abnormal discharge, abnormal abdominal pain, abnormal fetal movement, etc.) or delivery signs, you should seek medical advice in time. Don’t delay care seeking for fear or worry.

(Reference: COVID-19 prevention guide for pregnant women issued by Chinese Center for Disease Control and Prevention; COVID-19 prevention and control for pregnant women and child issued by Chinese Center for Disease Control and Prevention and China Population Publishing House under guidance of MCH Department of National Health Commission )

4.What is the recommended course of actions for pregnant women when they feel sick?
How should they take quarantine measures?
What needs attention?

When pregnant women develop mild symptoms such as nasal congestion and throat irritation, for those with history of travelling to or living in the high epidemic areas, or close contact with coronavirus infected patients within the past 14 days, and with no fever, they can stay at home for full rest and observation, monitor their body temperature and observe the development of symptoms by themselves every day.

If a pregnant woman has a history of travelling or living in a high epidemic area , or having close contact with a patient diagnosed with coronavirus infection within the past 14 days, she should stay at home or in a designated place for medical observation according to the requirements. During the observation, the pregnant woman should pay close attention to her own symptoms and fetal movements. She should contact the community management or medical observation staff to inform them her health status accurately, and seek medical care in a timely manner in case of the suspicious symptoms relating to the Novel Coronavirus Pneumonia, including fever, cough, sore throat, chest distress, breathing difficulty, fatigue, nausea and vomiting, diarrhea, conjunctivitis, muscle pain, etc.

((Reference: COVID-19 prevention guide for pregnant women issued by Chinese Center for Disease Control and Prevention; COVID-19
prevention and control for pregnant women and child issued by Chinese Center for Disease Control and Prevention and China Population Publishing House under guidance of MCH Department of National Health Commission )

5. What is the best way for pregnant women to stay mentally healthy during this period?

1) Pregnant women should pay reasonable attention to the epidemic situation, understand the epidemic situation and relevant protection knowledge from regular channels, and reduce the panic, worry and anxiety caused by frequent receiving information reports from various channels.

2) Communicate with relatives, friends, colleagues, etc. by telephone or Internet, share their feelings, comfort and encourage each other, and get psychological support.

3) Under the protection of science, we should try our best to maintain normal life and work, ensure nutrition and exercise, so as to maintain normal mood; we can also shift our attention and relieve psychological pressure by listening to music, painting, reading, etc.

4) During the period of isolation, pregnant women should face up to their own situation, accept their own bad emotions, and face up tp and accept the isolation environment.

5) When self psychological adjustment is difficult, we can use the hotline of network of psychological intervention institutions to seek professional help.

(Reference: COVID-19 prevention and control for pregnant women and child issued by Chinese Center for Disease Control and Prevention and China Population Publishing House under guidance of MCH Department of National Health Commission )

6. What do pregnant women need to pay attention to when going out for hospital visits?

If you are not going to the hospital for prenatal check-ups, you should go to the nearest facility that can meet your needs and have a small number of outpatients; give priority to the essential and urgently needed medical examinations and operations; make appointments and preparations before the consultation, and get familiar with the layout of the hospital and steps of the checkup. You are advised to shorten your stay at the hospital. For the antenatal check-ups, you should choose a hospital where you registered your pregnancy and all the files are kept and equip yourself with sound personal protection for the hospital visit.

On the way to the hospital and in the hospital, you should keep yourself warm so as to not catch a cold; pregnant women and accompanying family members should wear medical surgical masks or N95 masks throughout the way; you can carry hand sanitizer or disinfectant wipes to maintain hand hygiene; keep the distance between people as much as possible (more than meter) both on the way to and in the hospital.

Avoid public transportation when going out for hospital visits. You can choose to take a taxi or drive a car. If necessary, open the windows for air circulation in the car.

After touching the door handles, curtains, or doctor’s white coat in the hospital, remember not to touch your mouth, nose, or eyes. If you cannot wash your hands with running water in time, try to use alcohol free disinfectant.

After going back home, you should properly dispose of your masks, change your clothes, wash your hands, and wash the exposed face and different parts exposed on the face. Clothing worn for the hospital visit should be washed and disinfected as soon as possible, with the jacket placed in a place with good ventilation.

(Reference: COVID-19 prevention guide for pregnant women issued by Chinese Center for Disease Control and Prevention )

7. How should parents help protect children in daily family protection?

Do not take children to visit relatives, friends, parties, and group lunch or dinners. Do not allow acquaintances to touch infants or children or speak to children at close distance. Avoid contact with people with respiratory infections and people who have been in high epidemic areas within the past two weeks.

Parents or caregivers should wash their hands frequently. Children should also wash their hands frequently. Adults should wash your hands carefully before playing with your child. Parents need to change clothes and shoes when coming home from outside and wash their hands before holding the child. Educate or help your child to wash hands with soap or running water after eating, playing, coughing, sneezing, or touching saliva and secretions. If you cough or sneeze, you should cover your mouth and nose with a tissue. Then, immediately throw the contaminated tissue into a covered trash bin, and wash your hands carefully with running water. If it’s too late to cover yourself with a tissue, you should cover with a curved elbow and then wash your arms carefully.

Do not try the food with your mouth and then feed it to the child, let alone chewing the food with your mouth before feeding it to the child (including feeding your child after blowing on the hot food), and do not share tableware with your child. Do not kiss, exhale, or gasp to the children, or blow on the hot food. Disinfect children’s toys and articles regularly.

(Reference: Guidance for disease prevention for children aged 0-6 issued by Chinese Center for Disease Control and Prevention )

8. Any advice to keep the living environment healthy and clean?

Ideally the room(s) should be kept clean with fresh air, and suitable temperature. The room(s) should be ventilated regularly every day, except for extreme cold weather when the room(s) should be kept warm. When ventilating, you can move your child to another room to prevent them from catching a cold.

Family members should avoid sharing towels and drinking from the same glasses and cups. Serving chopsticks and spoons should be used. Dishes should be thoroughly washed after each meal. It is recommended to steam the tableware for ten minutes after the water gets boiled. Disinfect children’s toys and articles regularly.

(Reference: Guidance for disease prevention for children aged 0-6 issued by Chinese Center for Disease Control and Prevention )

9. How should children choose masks?

Children should choose N95 masks as the first option if possible, followed by children’s surgical masks. Children should also be guided to use the masks correctly. As masks are not recommended to infants under one year old, passive protection should be adopted for this group. Namely, caregivers should wear masks.

(Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education
Center )

10. What should be aware of to help the children to wear masks correctly?

1) Before wearing masks, children should carefully read and correctly understand the instructions with the help of their parents for the appropriate use of protective masks.

2) Parents should watch their children’s situations closely when wearing masks. Should their children feel uncomfortable when wearing masks, parents should make timely adjustments or stop their children from wearing masks immediately.

3) Given that masks for adults cannot fully fit children as they have smaller faces, it is not recommended for children to wear masks intended for adults which have a tight-fitting requirement.

(Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health Education
Center)

11. How to help children to learn to wear a mask?

Many children do not like wearing masks for the following reasons: some feel that the masks are too stuffy and can cause breath shortness; some feel that the mask straps are too tight and painful for their ears; some simply feel uncomfortable, and others are afraid to wear masks or find wearing masks ugly.

First, parents should buy child-friendly masks that are suitable for their children. Generally, these masks may have some patterns or colors, which are easier for children to accept. For older children, parents can use storytelling to tell their children why everyone wears a mask and the risks of not wearing a mask. When wearing the masks, the children should be helped to adjust the position of the mask, to make them feel more comfortable and less resistant. For younger children, parents can learn to wear masks together with the children, by looking to the mirror together with role-playing, playing games, and storytelling. Parents should not rush to put the masks on children’s faces at first. You are advised to try several times to make them feel less resistant and strange to wear masks. If the children find wearing masks unacceptable, they should stay at home as much possible and maintain good hand hygiene. Parents should maintain personal protection and clean, disinfect, ventilate their homes, so as to indirectly protect their children.

(Reference: Health Education Manual for COVID-19 Control issued by National Health Commission and China Health
Education Center)

12. What is the dietary advice for children during the epidemic period?

It is advised to pay attention to food hygiene, fully cook the meat and eggs, separate cutting boards and knives for raw and cooked food. One should not touch, purchase or consume wild animals.

Breast milk is the best “drug” to improve the immunity of newborns. Therefore, infants under 6 months should be exclusively breastfed, and for those over 6 months, it is recommended to continue breastfeeding up to 24 months while transiting to complementary feeding.

(Reference: Guidance for disease prevention for children aged 0-6 issued by Chinese Center for Disease Control and Prevention)

13. What is the advice for children’s activity routine and sleep?

Children should not watch TV or use electronic products for a long time while staying at home. Or rather, exercise or appropriate activities should be arranged for them. For school age children, they should continue with their learning, and after finishing their homework, they can also join the parents in cleaning the house. Parents of infants and young children can massage and move the limbs of their children. All Questions for pregnant women, mother and children staying at home should go to bed on time to ensure adequate sleep.

You are advised not to take your children out as much possible, especially to public places or confined spaces, maintain children’s daily routine with adequate sleep and balanced nutrition, and choose open parks for proper outdoor activities, or indoor exercise at home , so as to enhance their immunity.

(Reference: Guidance for disease prevention for children aged 0-6 issued by Chinese Center for Disease Control and Prevention)

14. What should parents do if the child gets sick?

When your child/children develop(s) symptoms such as cough and fever, and he/she did not have any previous outside activities or contact at all with 2019-nCoV infected patients, then parents can monitor the children’s temperature first, and care for the child/children at home as a normal respiratory infection. If the temperature continues to persist or even rise, or if the cough worsens, breathing difficulty occurs, or child has poor mental state, it is recommended that the child/children be taken to the nearest hospital that has a pediatric clinic, for check-ups and treatments as prescribed by a doctor.

(Reference: COVID-19 prevention and control for pregnant women and child issued by Chinese Center for Disease Control and Prevention and China Population Publishing House under guidance of MCH Department of National Health Commission; Guidance for disease prevention for children aged 0-6 issued by Chinese Center for Disease Control and Prevention )

15. What measures should be taken by schools and nurseries and kindergartens?

In the environment where students have close contact with other teachers and students, they should correctly wear medical surgical masks or N95 masks to minimize the scope of activities.

Schools should closely monitor the health status of students, monitor their body temperatures twice a day, and keep a record of absence, leaving class/school early, and leave requests. If suspicious symptoms are found among students, schools should immediately report to the epidemic management staff and cooperate with hospitals and CDC for management of close contact and disinfection.

Schools should try to avoid organizing large group activities. Adequate ventilation and cleaning are advised for classrooms, dormitories, libraries, activity centres, canteens, auditoriums, teacher’s offices, toilets and other activity areas. Soap liquid and hand sanitizer should be provided as appropriate for such venues.

(Reference: 2019-nCoV prevention and control guidelines-kindergarten (or school) prevention and control measures issued by Chinese Center for Disease Control and Prevention; COVID-19 control and prevention guideline: Precautions for kindergarten (school) issued by National Health Commission )

Link : http://www.chinadaily.com.cn/specials/questionsforpregnantwomenmotherandchildren-Asia.pdf