Within a week, everyone in the Binion household was sick with COVID-19. First, 3-year-old Lizzie had a 104-degree fever in mid-September. Next, her parents became ill, and finally, 10-month-old Beau started acting fussier than normal.
“It’s a really scary feeling as a parent,” said 33-year-old Robert Binion, who lives in Salt Lake City, to see your children so “helpless” and “vulnerable” without a quick fix to make them feel better. All he and his wife, Michelle, 36, could do, he said, was hold their kids and “be there with them and get through it.”
While adults make up the vast majority of Utah’s COVID-19 cases, there have been 714 diagnoses of the virus in Utahns under the age of 1 as of Sunday. There were more than 200 cases added in November alone, according to data from the Utah Department of Health.
The age group topped 400 cases on Nov. 6 and marked 500 on Nov. 18. Ten days later, it passed 600. Over the weekend, it topped 700.
But “by and large, children under 1 have a low risk of having severe disease,” said Dr. Andrew Pavia, chief of pediatric infectious disease at University of Utah Health and director of epidemiology at Intermountain Primary Children’s Hospital.
And, according to the state health department, there have been no deaths reported in that age group from COVID-19 in the Beehive State.
Infants generally have a higher hospitalization rate — as of Friday, it stood at 60.52 per 1,000 COVID-19 cases, compared to 6.03 per 1,000 in kids ages 1 to 14 in Utah.
But babies less than a year old are sometimes hospitalized “for reasons that don’t have to do with the severity of COVID,” Pavia said. For instance, most babies who are younger than 90 days and have a fever will be admitted “to make sure they don’t have a serious bacterial infection,” he said.
“So, if the reason that they had a fever was COVID, they’re going to be hospitalized, but not necessarily because they’re having severe lung disease,” Pavia said. Or, an infant may stay at a hospital if her or his mother was infected and chooses to breastfeed.
Pavia emphasized, however, that even though babies and young children are at “low risk” for severe COVID-19 complications, that “doesn’t mean no risk” or that they are immune, he said. Children are expected to be among the last group in Utah to be vaccinated for COVID-19, largely because the first trials for the new vaccines have not yet been completed with kids.
As parents care for their babies during the pandemic, it’s critical they continue going to pediatric visits and stay up on their immunizations, according to Pavia.
“One of our worst nightmares would be to have a measles outbreak right now in the middle of all of this,” Pavia said. “We don’t have the beds. We don’t have the isolation rooms. We have no idea what measles on top of COVID might look like. So, keeping up with vaccines is really important for kids’ health.”
Testing and treating infants
Fussiness was the first sign that Beau Binion, who turned 1 in November, had caught the virus that had spread to his sister, mother and father, Robert Binion said.
“He normally sleeps really well from 7 p.m. to 7 a.m. One of those early nights, he was awake multiple times,” Binion said. Beau wouldn’t doze off unless he was in the arms of one of his parents, he said, so “there was a lot of rocking chair time.”
Beau’s temperature rose to 103 degrees, and “his crying and cooing became hoarse,” Binion said. The infant also had a cough for a couple of days, but it didn’t last long, according to his father.
Like adults, infants can be infected and have no noticeable symptoms of COVID-19, Pavia said. “And, of course, children under 1 can’t tell you whether they have a headache or a sore throat,” he said.
In babies that young, doctors look for an increased breathing rate, cough or a runny nose as signs of the virus, according to Pavia. Symptoms of a more severe case may include shortness of breath and rapid breathing, he said. Children might also have stomach pain, diarrhea or vomiting.
Generally, if a baby is not feeling or eating well, it’s always good to check with the child’s medical provider to make sure everything is OK, said Dr. R. Neal Davis, of Hillcrest Pediatrics in Murray. Doctors’ offices are taking precautions and are safe to visit, he said. Plus, Davis reminds patients some issues can be handled over a virtual visit.
To test an infant for COVID-19, health care workers use a nasal swab, since a baby can’t really do the saliva test used for adults and children older than 6 years old, according to Pavia.
And because most children younger than 1 are unlikely to have a severe case of the coronavirus, they’ll probably be treated with fever-reducing medications and monitored to make sure they don’t get worse, he said.
Robert Binion brought Beau along when he went to get tested for COVID-19 in September, he said, but they were hesitant to test the then-10-month-old since he was so little, and since it was very likely he had the virus since everyone else in the house was positive.
The Binions checked with their doctor and gave Beau Motrin. If his temperature reached 104 or 105, Robert Binion said the doctor advised they bring their baby in for care. Luckily, he said, Beau, like the rest of his family, got better as time went on.
Now, more than two months later, Robert Binion said he and his two children are feeling well, while Michelle Binion still has some lingering fatigue and aches. They still wonder where they caught the virus, especially since they took safety precautions. But they’re grateful for help from their fellow church members, who brought meals and deliveries when the Binions were in “survival mode” for a couple of weeks.
Robert Binion said they’re glad their experience with COVID-19 wasn’t worse, and he hopes other people will “be as safe as they can be” to prevent future cases as the pandemic continues.
Keeping mom and baby together
As a pediatrician, Davis said most of the questions he hears from parents related to COVID-19 are about how to navigate day care, preschool and school. Now months into the pandemic, parents seem to have a better understanding about how the virus affects children, he said.
While younger children, generally, have mild symptoms, Davis said he reminds patients to be aware of Multisystem Inflammatory Syndrome, which can appear in children a few weeks after they are infected with COVID-19 and affect their hearts.
If children are showing any symptoms of the virus, Davis said, he recommends they get tested, not just for the child’s health, but to prevent potential exposure to relatives and people they live with.
Earlier in the pandemic, doctors thought they might have to separate mothers and their infants to prevent the spread of COVID-19, Pavia said, but that hasn’t been the case.
“We learned that if you keep the baby 6 feet away when they’re sleeping, if the mom wears a mask ... [and] washes her hands ... when she’s breastfeeding, that the risk of the transmission to the baby is very, very low,” he said.
According to the Centers for Disease Control and Prevention, current evidence suggests it is not likely for mothers with COVID-19 to spread the virus to babies through breast milk.
“We think, as pediatricians, that the benefits of keeping mothers with their newborns together greatly outweighs the risk,” Pavia said. “But you have to be smart about it, and you have to take precautions.”