Are visitors ok when you have a newborn?

There is often a lot of family pressure to visit after you have a newborn. But should you allow visitors? And if not, how do you communicate that effectively?

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As background….

Newborns hide infection really well, and as a general rule, pediatricians recommend avoiding too much exposure in the first few months of life.

This is especially true under 2 months, not just because they can get quite sick, but also because there is a standard approach to evaluating a newborn with a fever that includes invasive tests and sometimes admission to the hospital. I say this not to scare you, but to reiterate the importance of recognizing that young babies are vulnerable—and any infection they have needs to be taken seriously.

In particular, a baby <8wks that develops a fever needs to be seen. Most doctors/ERs will do their best to get a vulnerable infant out of the waiting room as quickly as possible.

But a lot depends on staffing & how busy they are, so there is also a risk of exposure to other illnesses in waiting rooms. 

Balance is key

With newborns, the trick is balancing protecting your newborn with making sure new parents have adequate support. That support is critically important for the wellbeing of the whole family and it should not be dismissed as a relevant factor. Each family, and each set of parents, likely needs a different degree of support - so I want to emphasize: these are simply guidelines; there isn’t a single right answer.

As with most things, different families will have different needs.

Here are my current recommendations:

• Focus on essential and well visitors

  • Anyone who is sick should either stay away or, if unavoidable, mask and minimize close contact with the baby. And they should be up to date on all their immunizations, including influenza, pertussis and Covid-19.

• Talk about it ahead of time

  • Make a plan ahead of time but recognize that you may need to be flexible. These discussions can be uncomfortable but making a plan ahead of time makes it easier to stick to it when you are tired and potentially hormonal.

• Common sense hygiene

  • wash hands, stay away if sick, wear a mask if needed.

• Rapid testing on the day of arrival and as needed after that

• Get outdoors!

  • Get outside in the fresh air but keep your baby protected. People will usually leave the baby alone if baby-wearing, or in a stroller. I do recommend avoiding crowded places - outdoors and uncrowded settings with no close face-time with people outside your bubble is probably ok. 

• Remember: you’re the parent, you’re allowed to advocate for your baby. And if all else fails? Blame the pediatrician (we don’t mind!)

What about toddler siblings?

This is a hard one. Toddler siblings are going to be exposing your newborn no matter what, either directly, or through you. If your toddler is visibly sick (even with a cold), focus on good hand-washing & minimizing kisses - or restrict kisses to the top of the head and the bottom of the feet. If your toddler is well, this depends a little bit on your personal threshold for risk as a family. 

Should my toddler go to daycare?

This depends on your family, and your toddlers personality. Many families have grandparents or other extended family around at first who can help with a toddler, but a new baby is a huge disruption, and toddlers do not well with change. So you could do things in 2 ways: 

• Keep things as normal:

  • Pros: Toddler goes to daycare, has a consistent routine and sees the baby as less of a disruption. You also get a break during the day to recover, and to attend to baby.

  • Cons: There is a possibility your toddler brings home some daycare crud. Time of year may play a role here as well. During the summer, when there are fewer respiratory illnesses and toddlers are outdoors more, the risks might be lower. However, during the prime of flu and RSV season, you might make a different decision.

• Keep toddler home:

  • Pros: oddler gets more time with family, and perhaps some dedicated one-on-one time with parents, even for 15-20mins a day. This may help minimize their sense of disruption because of the new baby. It also means less infection risk for the new baby.

  • Cons: This does make things harder on the parents, of course. If you choose this route, having extended family around can be super helpful. And if you need it, its okay to allow a little extra screntime, or to raid the Michaels sale section for books, stickers and craft projects. Remember that first month is just about survival!

What about other visitors?

Under 2mo, I strongly urge you to minimize exposure to visitors as much as possible, especially casual visitors. It is okay if your friend or cousin doesn’t get to see your newborn immediately. Anyone with a cold sore should not kiss your baby.

Do you have other tips?

I actually have a set of scripts you can download that may help with some of these conversations. Check them out here.

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I want to make one last essential point. When it comes to protecting your new baby it is true that human milk can be helpful, because it contains antibodies.

But these measures will help regardless of what type of milk your baby is drinking (maybe even more so!)

So, even if your baby is drinking formula, so do not get sucked into the rabbit-hole of guilt! :)

You are doing a great job, new mama (or dad)!