A fever, cough and shortness of breath are some of the symptoms of COVID-19. The CDC is warning older adults and those with underlying medical conditions that they may have an increased risk for serious complications.1
Based on current information, it's also believed that healthy pregnant women have the same risk as those without underlying medical conditions.2 This is different from other coronaviruses and flu, which are more likely to infect and cause severe symptoms in women who are pregnant.3
Data show that if a woman has a severe COVID-19 infection during the third trimester it can affect the “time and route of delivery.”4 The U.K. has declared pregnant women to be part of a vulnerable population, but according to Harvard Health, the declaration isn't based on clear evidence that they are at a higher risk.5
The main mode of COVID-19 infection is from person to person, via respiratory droplets that are produced when an infected person sneezes, coughs or talks.6 For this reason experts recommend you maintain a distance of 6 feet from other people. It's also possible for people to have no symptoms at all and still pass the virus.
Pregnant? Ask These Questions
A pandemic raises many questions, which is compounded when you're pregnant and protecting the health of your baby. While many of your plans can be put on hold, you can't reschedule having a baby. There is still new information for experts to learn about how the infection could affect a pregnancy, but doctors do know there is concern if you have a high-risk pregnancy.7
This includes women who have underlying medical conditions such as heart disease, high blood pressure, diabetes or lung problems. Pregnancy places a higher demand on pulmonary function, so women with an underlying respiratory condition may be at higher risk for infection and severe disease.
These conditions could include chronic lung disease, asthma and chronic heart disease. This is why prenatal care is an important part of delivering a healthy baby if you have these conditions. Otherwise, during the COVID-19 pandemic, experts recommend if you are not at high risk, and depending upon your trimester, telemedicine visits could be the best option.
However, if ultrasounds, evaluation of heart rate and respiratory rate and blood pressure are required, then a doctor's office visit is necessary. Dr. Elizabeth Zadzielski, chief of Obstetrics & Gynecology at Sinai Hospital, recommends being seen by your physician if you are 24 weeks gestation and beyond. By this time, it's important to be evaluated for potential problems. You also need an in-person examination if it's your first visit.
Take care to communicate changes with your physician, such as bleeding or decreased fetal movement, or if you believe you're having signs of preterm labor. Currently, there isn't enough evidence to determine if a mother can pass the coronavirus to her unborn child. However, the WHO states “To date, the virus has not been found in samples of amniotic fluid or breastmilk.”8
Prevent Infection and Protect Your Health
Researchers believe up to 80% of people with COVID-19 will have mild symptoms or be asymptomatic.9 This is similar to studies done with influenza in England, which found the majority of those with flu were asymptomatic.10
This means you need to take care even with individuals who appear to be healthy. A vital step in this prevention is to practice excellent hand-washing with soap and water for at least 20 seconds. To be truly effective it's necessary to follow these simple steps you'll find more fully described in “The Impact of Effective Hand-Washing Against Infection“:
- Use warm, running water and a mild soap. You do not need antibacterial soap.
- Start with wet hands, add soap and work up a good lather, all the way up to your wrists, scrubbing for at least 20 seconds (most people only wash for about six seconds). A good way to time this is to sing the “Happy Birthday” song twice.
- Cover all the surfaces of your hands and wrists, using friction by rubbing your fingertips against your palm and your fingers against each other.
- Rinse thoroughly under running water, continuing to apply friction.
- Dry your hands thoroughly, ideally with a paper towel.
In addition to hand-washing, avoid touching your face. The virus can easily be passed from your fingers to your nose, eyes or mouth. If your face does get itchy, use a tissue to scratch. Clean and disinfect surfaces in your home or at work. This may include tables, light switches, door handles, telephones, toilets, faucets and countertops.11
Initially, world health leaders advised against wearing masks, claiming, “… masks could create a false sense of security that could end up putting people at greater risk. Even with the mouth and nose fully covered, the virus can still enter through the eyes.”12 However, recently the CDC changed their guidelines:13
“CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.”
The WHO14 guidelines maintain face masks may help reduce the spread, but are not sufficient to prevent infection on their own. They recommend those who have coronavirus wear a face mask and self-quarantine to prevent the spread of the infection; those who are caring for them should wear a face mask while in the same room.
Maintain Your Health and Reduce Risk During Pregnancy
Taking supplements and medications during pregnancy have effects on your growing baby that are not always well understood or documented. For this reason, unless what you're considering is well studied — such as prenatal vitamins — it's best to avoid them. Even some commonly accepted medications have long-term consequences.
For instance, there is evidence that over-the-counter acetaminophen, commonly sold as Tylenol, may double the risk of autism and increase the risk of attention deficit disorder.15 Everything you eat, your growing child is also exposed to, so it's advisable to get as much nutrition from your food as possible as your only real defense against infections such as COVID-19 is a strong immune system.
In other words, forget junk and processed foods and instead shop along the outer walls of your grocery store, where you'll find whole food. Your gut microbiome is a vital part of your metabolism and health. During pregnancy, the function and composition changes throughout gestation, contributing to the outcome of your pregnancy.16
A few examples of nutrient-dense foods that support a healthy pregnancy include organically grown, non-GMO avocado, broccoli, wild-caught Alaskan salmon, berries and eggs. Some signs your gut microbiome may be imbalanced include constipation, diarrhea, gas or bloating, or indigestion.17
It is important to avoid medications to treat these conditions and instead use whole foods to balance your gut microbiome. These include fermented vegetables that add beneficial bacteria to your gut, bone broth, chia seeds and high-quality fiber foods, such as organic psyllium.
Vitamins D and C Are Crucial Elements to Health
Maintaining healthy levels of vitamin D during your pregnancy may be one of the most important things you can do. In a Cochrane systematic review,18 the authors found evidence that supplementing with vitamin D could reduce the risk of preeclampsia, low birth weight and preterm birth.
While vitamin D doesn't directly fight infection, it is essential to supporting a health immune system. In one review of the literature,19 scientists found vitamin D played a functional role in reducing the risk of upper respiratory infections, which flu and COVID-19 are.
Speak to your physician about having your vitamin D levels checked regularly throughout your pregnancy and during lactation, as the only way to know how much supplement you may need under your physician's care is to test. Seek to maintain levels above 50 nanograms per milliliter (ng/mL), using sensible sun exposure if possible, for optimal health.
As I recently reported, in the last month, vitamin C is being used in large doses in New York, the epicenter of the virus in the U.S., to treat the COVID-19 infection. In patients who were treated with massive doses, the individuals responded significantly better than those who did not receive the vitamin. When used in high doses vitamin C is a potent oxidizing agent.
This action can help eliminate pathogens. Additionally, it is inexpensive and is currently under investigation for the treatment of sepsis, a factor in those who have died from covid-19.20,21
However, large doses are necessary for treatment and should not be used preventively. To protect your health, seek out food high in vitamin C such as bell peppers, kiwifruit, strawberries, broccoli, tomatoes and snow peas.22
What Are the Risks After Your Child Is Born?
As you get closer to delivery you may have some questions about the risk of passing the virus to your newborn and how to manage breastfeeding if you are infected. Thus far there have been only case reports and not studies of pregnant women who were infected with COVID-19.
Two case reports of a total of 47 women with confirmed infection showed none of the newborns had the infection.23,24 Two other case reports found25,26 the newborns demonstrated elevated levels of antibodies, but no clinical evidence of the infection.
In a fifth review with 33 pregnant women doctors found three newborns were infected and had clinical signs.27 While the number of infants born without infection is encouraging, it remains essential to practice strategies to reduce infection.
If you test positive for the virus, Harvard Health28 finds there is currently no evidence the virus is in breast milk. Therefore, breastfeeding should not expose the infant. However, since it is spread through droplets from the respiratory tract, mothers should wash their hands thoroughly before picking up their babies and wear a face mask to minimize the baby's exposure.
If you choose to express breast milk to maintain your milk supply, use a dedicated breast pump and follow all recommendations for proper cleaning each time you use the machine. Clean all parts that come in contact with breastmilk and with your hands. Wash your hands before touching the pump or any parts of the bottle or system and before expressing breast milk.29
Most suitable nutritional vitamin supplements with respect to Cardiovascular Health and fitness!