The last thing anyone wants to get done is a test for the coronavirus test. Even worse? Having to take in an infant for testing. First, there’s the agonizing debate of whether their symptoms require medical attention, an impossible decision especially when dealing with a child who can't yet communicate. Then there’s the test itself, something you can’t prepare them for with reassuring words. Which raises the question: How do you even test a baby for coronavirus?
First, the symptoms of COVID-19 in infants: “What can be difficult for parents and healthcare providers alike is that the symptoms of COVID-19 in infants and young children are highly variable. Fever may or may not be present. Similarly, while some children will develop cough or breathing-related concerns, babies may show only subtle signs such as increased fussiness,” says Dr. Sarah Combs, MD, a pediatric emergency physician at Children’s National Hospital.
As for testing, basically a doctor or a nurse uses a nose swab to collect a sample of secretions for analysis. Uncomfortable for a person of any age, the test, as the MD Anderson Center explains, “activates the lachrymal reflex, which means it’ll bring tears to your eyes if it’s done correctly.” Like it or not, for babies this is also often the best way to test, though there are other options as well, Dr. Debbie-Ann Shirley, MD, MPH, the Medical director of the COVID19 clinic and Division head of Pediatric Infectious Diseases at the University of Virginia Children’s Hospital, tells Romper via email.
“These include testing a nasal (or nasopharyngeal) swab, throat (oropharyngeal) swab or saliva. Some studies suggest that testing using the nasal swab may improve the chance of finding the virus in the back of the airway passages,” says Dr. Shirley. Fortunately for infants, a smaller swab is used and, naturally, healthcare providers do their best to make the test as swift (a few seconds for each side swabbed) and painless as possible.
In some good news for parents, babies can roll with the punches better than toddlers.
“With babies it’s often easier,” Dr. Combs says. “They haven’t learned to be afraid of the hospital environment. And honestly, they’re so used to being wrapped in a caregivers arms and swaddled, it’s one and done. They can have a feed or a treat and they seem to forget all about it.”
Parents can help make the test easier by holding or distracting their infant. “Singing a song may help during the swab for example. Parents should be ready to help comfort their baby right after with lots of hugs and affection,” says Dr. Shirley.
Once the test is done, the waiting game for results begins. Dr. Shirley says she’s seeing turnaround time around two to three days. At Children’s National, where Dr. Combs works, test results are being delivered as fast as within six hours. That said, test result times will vary from location to location, so its best to ask what you can expect.
“Parents should isolate at home and wait for results,” says Dr. Shirley. “It is important to limit contact with others at home who may be at higher risk for severe COVID-19, such as those who are above the age of 65 years and those who have underlying risk factors. Let your child’s doctor know if your infant seems to be getting worse while waiting for the results.”
If the test results come back positive, a medical professional will give instructions on the next steps. “In general, we tell them to monitor symptoms stay at home,” says Dr. Combs. The recommended quarantine time is still a minimum of 14 days.
And if negative? Well, you have two choices: One, return to life as normal or, two, wait and see.
“If negative, your baby probably was not infected at the time the swab was collected. However, that does not mean your baby will not get sick,” explains Dr. Shirley. “Your baby might test negative if the sample was collected early in the infection and test positive later during the illness. Your infant could also be exposed to COVID-19 after the test and get infected then.” Her advice: Talk to your baby’s doctor about what the negative result means and find out what else could be causing your baby to be sick.”
Some slightly reassuring information, if you can call it that, is that while some children and infants have been sick with COVID-19, adults still continue to make up most of the cases doctors are seeing.
“So far COVID does not appear to cause severe disease in healthy children, but we are still trying to understand this more,” says Dr. Shirley.
The safest medical care is prevention. Wash hands, social distance, and if you’re concerned about anything, see a doctor.
If you think you’re showing symptoms of coronavirus, which include fever, shortness of breath, and cough, call your doctor before going to get tested. If you’re anxious about the virus’s spread in your community, visit the CDC for up-to-date information and resources, or seek out mental health support. You can find all of Romper’s parents + coronavirus coverage here.
Dr. Sarah Combs, MD, a pediatric emergency physician at Children’s National Hospital, childrensnational.org/visit/find-a-provider/sarah-combs
Dr. Debbie-Ann Shirley, MD, MPH, the Medical director of the COVID19 clinic and Division head of Pediatric Infectious Diseases at the University of Virginia Children’s Hospital, childrens.uvahealth.com/findadoctor/profile/debbie-ann-shirley