How To Keep Your Newborn Safe From Illness Over The Holidays

The holidays with a newborn can be many things: joyful, exhausting, and also… full of worry. Respiratory illnesses and colds spike as the winter months roll in, and, particularly in the first two months of life, babies’ immune systems are still developing. Newborns are a “vulnerable population,” which means they’re at an increased risk of health complications from and serious cases of common diseases, colds, and flues, explains Dr. Valentine Rae Esposito, M.D., an attending physician in the division of general pediatrics at Boston Children’s Hospital. Fevers in babies under 2 months are also medical emergencies as they don't have protection from vaccines and are at higher risk for serious bacterial infections, she says.

If you’re worried about protecting your baby from getting sick this holiday season, you’re not alone. Pediatricians spend a lot of time doling out advice to parents of young babies at this time of year, when traveling and large gatherings are a part of the season. Our experts have identified nine reminders that’ll (hopefully) help keep illnesses away from your little one.

Abide by the “golden rule”

If someone is symptomatic — if they have an active fever greater than 100.4 Fahrenheit, a cough, sneezing, vomiting, or diarrhea — they should not be around your newborn, says Esposito.

From there, set & implement boundaries

“You should never feel any guilt with the boundaries you choose to implement for your children, says Esposito. Read: What’s right for your family may be different than what’s right for someone else's family. And that’s OK. Of course, navigating boundaries is easier said than done — especially around the holidays, when everyone’s clamoring to meet a new baby.

Ahead of the season (that’s now!), think about your boundaries and values (for example, “We won’t be flying with the baby,” or “Our greatest responsibility is to keep our baby safe”). If you’re partnered, talk about these things with your significant other. “Trying to make sure both parents are on the same page first and can present a united front often makes a huge difference,” says Dr. Krupa Playforth, M.D., a pediatrician and founder of The Pediatrician Mom, LLC.

Feel awkward setting boundaries? Blame your pediatrician, advises Dr. Katie Lockwood, M.D., a pediatrician at CHOP Primary Care, Flourtown. “It can be really hard to have those barriers with loved ones while trying to keep your little one safe,” she says, so just let them know that you’re just following the advice of your baby’s doctor.

Make sure friends & family are up to date with vaccines

Before babies are eligible for shots themselves, “we protect them by protecting the people around them,” reminds Esposito. Adults and children who are going to be around babies should be up to date on the vaccines below:

• Flu. Babies under 6 months are not eligible for it. Esposito says anyone who will be around your baby should get it two weeks before that to give it time to start taking effect in their body.
• Covid-19. Babies under 6 months old are not eligible for it.
• Tdap. It protects against Tetanus, Diphtheria, and Pertussis. The latter can be life-threatening to babies.
• RSV. The CDC recommends one dose of the newly released protective monoclonal antibody RSV shot for adults 60 or over (hi, grandparents!).

Make your baby’s 2 months pediatrician appointment

This is when they can start receiving their “routine vaccines,” including — if you can — a dose of the new RSV vaccine, which Playforth says is safe and effective but very difficult to locate right now. “Pediatricians received extremely limited quantities, and the supply for the rest of the season will remain limited. If you are able to obtain it for a baby who is eligible (all babies under 8 months, and select high-risk babies between 8 to 24 months), you are very lucky. I wish this were available when my babies were little.”

Wash your hands like a doctor — and teach others to do the same

“Hand washing goes an incredibly long way, but we have a lot of studies that show that people don't wash their hands quite as well as they should,” says Esposito. Good hand washing should be the ‘Happy Birthday’ song twice at least. “I also tell people, especially if you’re going to be holding a baby, to think of yourself like a surgeon getting ready to scrub in for surgery. We scrub down to our elbows,” she says. (If you need another reminder as to why this matters, think about how often we tell kids to cough into their elbows — eek.)

Bring some masks

While it’s not necessary for everyone who gets the chance to hold your baby to wear a mask, Esposito does say that if anyone has the sniffles or something even super mild, then they should mask. With newborns, you should always err on the side of caution, so if you, as the parent, feel more comfortable with someone meeting your baby to mask — perhaps they were just on a plane or you know they are coming from another party where other guests reported they were sick — then you have every right to ask them to wear a mask, and keeping some tucked away in the diaper bag will ensure that there’s always access to one.

Consider a clothing swap

Have family flying in from out of state? Older children coming back from holiday events? Consider having them change before holding your baby, as clothing can carry germs that can spread to your baby by way of anyone who holds them or touches them. “A fresh set of clothes is going to make a difference because infants come into really close contact with your clothes,” Says Esposito.

If you get sick while breastfeeding, keep breastfeeding

Sick while nursing? Good news: “The antibodies that you're making to fight your own respiratory illness will be passed to your breastfeeding infant,” says Lockwood. While you don't want to be coughing on a baby, and you might want to wear a mask, increase handwashing, or even pump and offer milk that way, continuing to offer your breastmilk “might cut down the chance that they pick up the illness that you have,” Lockwood says.

Know the risks of air travel

The American Academy of Pediatrics suggests avoiding air travel until a baby is at least 7 days old, but ideally two or three months old. By flying or traveling with an unimmunized infant, you accept a certain risk level, says Esposito, who points to the sheer number of viruses and illnesses that can be picked up on planes. Remember: A fever in a baby under 2 to 3 months is a medical emergency and can require all kinds of workups, including everything from bloodwork to spinal taps.

If you do fly, consider leaving early in the morning or late at night when airports may be less crowded; choose window seats, further away from aisle traffic; and keep your baby in a car seat or carrier, which can be a little more covered and protected, suggests Lockwood.

The Centers for Disease Control and Prevention also has a travel website that outlines any additional vaccines your baby may need if traveling internationally.

Keep things simple

If you have a newborn baby, the holidays might look different this year — and that’s okay! In fact, it’s normal, and keeping gatherings small and limiting who holds your baby in those first few weeks and months could be the best way to protect your newborn for years to come. “This is a “time-limited situation,” reminds Playforth. “Especially after three months, babies are less vulnerable.” All of the pediatricians we spoke with recommended keeping things simple this season — fewer people, fewer plans, hopefully, lower levels of stress, and more time to soak in your latest addition.

Experts

Valentine Rae Esposito, M.D., an attending physician in the division of general pediatrics at Boston Children’s Hospital.

Katie Lockwood, M.D., a pediatrician at CHOP Primary Care, Flourtown.

Dr. Krupa Playforth, M.D, FAAP, pediatrician based in Virginia and founder of The Pediatrician Mom