Waiting Period Before Welcoming Newborn Visitors

There are few things more exciting than welcoming a new baby into the world, but it's critical to keep the baby safe from infection and illness during the first few months of their life. While there are no universal rules for when to visit a newborn, precautions should be taken to avoid exposing the baby to potential illness. Newborns have underdeveloped immune systems and are susceptible to infections, which is why many hospitals have visiting rules that limit the spread of illnesses, such as colds and flu. To ensure a positive experience for everyone, it can help to ask before visiting and to follow any boundaries the family sets.

Vaccinations and health status

For Visitors:

• Influenza (Flu) Vaccine: It is highly recommended that all close contacts and potential visitors get an annual influenza vaccine at least two weeks before meeting the newborn. This is crucial as flu can be life-threatening for infants, and newborns cannot receive the flu shot until they are six months old.
• Tdap (Tetanus, Diphtheria, and Pertussis) Vaccine: All visitors should have received the Tdap vaccine within the last ten years. If not, they should get a Tdap booster at least two weeks before meeting the newborn. Pertussis, or whooping cough, is a highly contagious and dangerous infection for infants, especially those under three months old.
• COVID-19 Vaccine: It is advisable for visitors to be up-to-date with their COVID-19 vaccinations and boosters to reduce the risk of infection for the newborn.
• Other Vaccines: Depending on the region and specific recommendations, visitors may need additional vaccines, such as the measles, mumps, and rubella (MMR) vaccine or the polio vaccine.
• Health Status: Anyone planning to visit a newborn should be in good health and free from any signs or symptoms of illness. This includes ensuring that any fevers, runny noses, coughs, or diarrhoea are completely resolved before the visit. If a visitor has been exposed to a contagious illness, they should wait at least two weeks before visiting the newborn.

For New Parents:

• Pregnancy Vaccines: During pregnancy, it is recommended that expecting parents get the influenza vaccine and the Tdap vaccine (which includes protection against whooping cough). These vaccines help protect both the parent and the developing baby.
• Childhood Vaccines: Before starting a family, aspiring parents should ensure they are up-to-date on all their childhood vaccines, including the measles, mumps, and rubella (MMR) vaccine. In particular, the rubella vaccine is crucial for mothers-to-be as congenital rubella infection can cause severe problems for the growing baby.
• Post-Pregnancy Vaccines: After giving birth, new parents can discuss with their healthcare provider whether they need any additional vaccines to protect themselves and their newborn.

Remember, it is essential to follow the recommendations of healthcare professionals and official organizations, such as the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Their guidelines may change over time, so staying informed is crucial.

Limiting visitors

Limiting the number of visitors is a good way to protect your newborn from infection and illness during the first few months of their life. Dr. Ahmad Bailony, department chief of pediatrics at Sharp Chula Vista Medical Center, recommends that parents be careful with visitors during the first two months of a newborn's life, as their blood-brain barrier is still developing, making them more susceptible to serious infections.

Discuss your visitors' health

Before your visitors arrive, ask them about their current health status, including their vaccination status for the flu and COVID-19. Inquire if they have been in close contact with anyone who has been sick recently or if they are experiencing any flu-like symptoms. If your visitors are unwell, have been around sick people, or are not vaccinated, consider alternative ways for them to meet the baby, such as through virtual or outdoor visits while maintaining a safe distance.

Limit the number of visitors

Try to limit visitors to those who can offer the most support during the first few weeks. Bonding with your newborn is essential, and daily chores and meal preparation may be challenging to manage. Having designated visitors who can assist with these tasks can make this transition period easier.

Take precautions

Implement safety measures to reduce the risk of infection for your newborn. Have disposable masks, hand sanitizer, and hand-washing facilities readily available for visitors. You can also ask visitors to take an at-home COVID test before their visit.

Prioritize your family's needs

Remember that your priority is the health and well-being of your newborn and yourself. Not everyone will understand your decision to set boundaries, but it is crucial to protect your child and yourself from illness, respect the baby's sleep schedule, and honour your need for self-care and rest.

Communicate your boundaries clearly

Before the baby arrives, set healthy boundaries for visitors and communicate them effectively. Let your visitors know that you are taking recommended precautions for your family's health and safety. Be transparent about your expectations for visits, such as the need for prior invitations, the number of visitors allowed, and any hygiene protocols you would like them to follow.

Offer alternative ways to connect

For those who cannot visit in person, consider sharing photos and videos of your newborn regularly. This way, they can still feel involved in the early stages of your baby's life while ensuring the baby's safety.

Hygiene practices

The arrival of a newborn is an exciting time for parents, grandparents, family, and friends. However, it is crucial to take precautions to ensure the baby's safety and well-being. Here are some hygiene practices to follow when visiting a newborn:

• Wash your hands frequently: Before and during the visit, make sure to wash your hands thoroughly with soap and water. This is especially important before holding or touching the baby. Hand sanitiser can be used as a supplement but is not a replacement for proper handwashing.
• Avoid kissing the baby: As tempting as it may be to shower the baby with kisses, it is best to avoid kissing them, especially on the face. Visitors should maintain a safe distance from the baby's face, as mouths can carry a lot of germs. Instead, show your affection through gentle touches and cuddles.
• Mask up: Wearing a face mask can help reduce the spread of germs to the newborn. It is a simple yet effective way to create a safer environment for the baby.
• Remove hand jewellery: Remove any jewellery, such as rings or bracelets, before holding the baby. This prevents the transfer of germs and creates a safer contact experience for the newborn.
• Stay away if unwell: If you are feeling unwell or exhibiting any symptoms of illness, such as a fever, runny nose, cough, or diarrhoea, it is best to postpone your visit until you have fully recovered. Wait at least one week after recovering from an illness before visiting the newborn.
• Get vaccinated: Ensure that you are up to date on your vaccinations, including the flu vaccine, Tdap (whooping cough), and COVID-19 vaccine and booster. All vaccinations should be administered at least two weeks before visiting to allow the body to build up antibodies.
• Limit visits during the early months: Respect the parents' wishes if they choose to limit visits during the first few months. The first month of a newborn's life is the most vulnerable period for their survival, according to the World Health Organization (WHO). By delaying visits, you give the baby's immune system more time to develop and reduce their exposure to potential illnesses.
• Practice good respiratory hygiene: Cover your mouth and nose when coughing or sneezing, and dispose of used tissues properly. If you need to cough or sneeze, turn away from the baby and use your elbow or a tissue to minimise the spread of germs.
• Avoid strong perfumes or scented products: Refrain from wearing strong perfumes or scented products when visiting a newborn. These scents can be overwhelming for the baby and may irritate their sensitive skin or respiratory system.
• Follow the parents' rules: Remember that the parents set the boundaries for visits. Communicate with them beforehand to understand their expectations and follow their instructions regarding visitation times, masking, and other safety measures.

Visiting boundaries

Invitations

Visits should be by invitation only. It is not okay to drop by unannounced at the hospital or the family's home. New parents need time to recover from the birth and adjust to life with a newborn. If an invitation to visit doesn't come right away, don't be offended – the new parents may simply not feel ready for visitors yet.

Vaccinations and illness

Before visiting a newborn, it's important to ensure you are up to date with your vaccinations. The Centers for Disease Control and Prevention (CDC) recommends that anyone wishing to meet a newborn baby gets the flu and whooping cough vaccines at least two weeks beforehand. This gives your body time to start producing antibodies against these illnesses. Other recommended vaccinations include COVID-19 and pertussis (whooping cough).

If you are feeling unwell, it is best to postpone the visit until you have fully recovered. Wait at least a week after recovering from a cold or other illness before visiting, and at least two weeks if you have been exposed to a contagious illness.

Hygiene

Wash your hands often before and during the visit. If you are wearing any jewellery on your hands, it's a good idea to remove this before holding the baby. Avoid wearing strong perfumes or scented products, and don't smoke before the visit.

Behaviour around the newborn

Be mindful of the newborn's sleep schedule and avoid disturbing them if they are asleep. Ask the parents for consent before touching or holding the baby. Do not kiss the baby on the face, and try to avoid kissing them at all, as this can spread viruses and bacteria.

Length of visit

Keep visits short, and pay attention to cues that the new mother is tired. Don't overstay your welcome.

Gifts

Bringing food for the new family is always appreciated, especially easy-to-reheat dishes that cater to tastes and allergies. Gift cards for restaurants that deliver or delivery services are also a great option.

Other ways to help

Offer to help with practical tasks such as walking the dog, cleaning, or playing with older children.

Protecting the newborn's sleep

Newborns sleep around the clock, waking up every few hours to feed. They should get 14 to 17 hours of sleep over a 24-hour period, with some sleeping up to 18 to 19 hours a day. It is important to wake newborns who sleep for longer stretches to feed them until they show good weight gain, which usually happens within the first couple of weeks.

Create a Safe Sleep Environment

• Always place the baby on their back to sleep, never on their stomach or side.
• Use a firm, flat sleep surface with a snug-fitting sheet.
• Do not put anything else in the crib or bassinet, including plush toys, pillows, blankets, quilts, comforters, bumper pads, and unfitted sheets.
• Dress the baby appropriately for the room temperature and avoid overbundling. Do not cover their head while sleeping, and watch for signs of overheating.
• Keep the baby away from secondhand smoke, which increases the risk of SIDS.
• Do not use sleep positioners, monitors, or weighted blankets, sleepers, or swaddles.
• Ensure all sleep products meet federal safety standards.

Establish a Calm and Quiet Environment

• Keep things quiet and calm during middle-of-the-night feedings and diaper changes.
• Keep the lights low and avoid playing with or talking to the baby to signal that nighttime is for sleeping.
• Let the baby fall asleep in their crib at night to associate it with sleep.
• Avoid keeping the baby up during the day, as overly tired infants may have more trouble sleeping at night.

Soothe the Baby

• It is okay to rock, cuddle, and sing to the baby as they settle down.
• Swaddling the baby in a light blanket can help soothe them and is safe until they start trying to roll over.
• Held or carried newborns tend to have less colic and fussiness.

Room-Sharing

• Room-sharing, where the baby sleeps in the same room as the parents, is recommended by the American Academy of Pediatrics (AAP) as it facilitates feeding, comforting, and monitoring.
• However, bed-sharing is not safe and increases the risk of SIDS and other sleep-related deaths.

Limit Visitors and Outside Exposure

• Limit visits from extended friends and family, especially during the first month, which is the most vulnerable period for the baby's health.
• Focus on close family and essential visitors, such as health professionals, to reduce exposure to germs.
• Ask visitors to follow hygiene protocols, such as washing their hands, and ensure they are up to date with their vaccinations.
• Delay visits if visitors are unwell or have been exposed to illness.

By following these guidelines, you can help protect the newborn's sleep, ensuring they get the rest needed for their development and growth.

Frequently asked questions