I have been thinking about the impact of COVID-19 on mothers and infants as a high stress trauma lasting for a prolonged period of time. Early trauma has always been known to affect infants and mothers but primarily when they are separated. This is not the case here. The effect on children of 9-11 was studied carefully and the effects other world events have had on mothers and babies have been studied for years as well.

Currently there is the COVID-19 Moms and Infants Study. Dr. Stacy Drury, child psychiatrist has been studying how early life events relate to children, their health, behavior, and moods for ten years (http://bangl.tulane.edu/). She is Director of the Tulane Behavioral and Neurogenetics Laboratory. This study has been a project developed with the goal of better understanding the effect on young children of stress in our community. She looks at how the special relationship between a mother and child may protect children from this stress.

The Infant Development study will specifically focus on the impact of COVID-19 on stress in mothers. The research aims to learn more about the role of social, physical, and environmental effects, specifically how stress is transmitted from the mother, either a pregnant woman or new mothers particularly, on their newborn child. Thus, this study specifically focuses on infants. It is pointed out that stress leads to negative health outcomes in adolescence and adulthood and thus it’s important to prevent stress responses in early life.

If you should choose to be part of the study two surveys will be completed by the mother about her pregnancy, her delivery, and experience going home from the hospital. These surveys which can be completed over the phone will be followed up by supplies provided for each mother to mail in a saliva sample. With permission, the child’s newborn genetic screening blood spot from the state testing lab will also be done. The results would provide a better understanding of childhood stress outcomes useful for continued health research and policy. Should you or someone you know like to participate they can call or text the research lab at 504-656-6449 BANGL lab or email the lab at bangltulane@gmail.com (https://medicine.tulane.edu/departments/clinical-sciences/psychiatry/research/dr-drurys-bangl-lab/current-studies/covid-19-moms) .

On my own I have written about the potential impact of masks on babies suggesting that when babies are brought to the doctor for routine or COVID-19 testing and see the doctor and their mother with masks on, it is upsetting to the infant. Facial recognition is high on our list for babies feelings of safety and security. Suddenly the most depended upon person in this strange and unfamiliar situation who is the mother has her face hidden except for her eyes. Her voice which is familiar will be heard but it is unclear if the baby can at any month then link that familiar voice to a masked face. Babies focus on the visual even more than the auditory when the mother is speaking. Now her mouth is covered so the visual cue is absent.  Clearly, masks should not be worn at home by parents and siblings or even on stuffed animals. The stuffed animal can be a transitional object, a not-me object, that serves as a transitional soothing object for the baby with or without the mother’s presence.

Additionally, an infant is socialized in lockdown only with his parents and siblings. We must ask how the infant’s psychological development might be impacted by living in a restricted environment. If the baby is taken out for a walk, the impact of seeing masked faces once again will likely be present.

Thinking back month by month to infant development it needs to be studied what milestones are affected by this unusual situation.

Furthermore, infants can receive the virus and there are varying reports about how dangerous this exposure is or will be.

Significant in itself will be the impact on impoverished households that are small and contain too many people for social distancing and increase the likelihood of not only transmission but the stress on the mother who is worried about transmission to herself and her baby. Lack of sufficient nourishment may also compound the problem if the mother is not nursing and does not have sufficient funds to feed her baby with purchased infant formula.

Keep in mind that in this particular crisis the stress is prolonged, not just one incident or situation, which increases the risk of an effect on infant development. Essential is that the mother and baby NOT be separated for undue periods during these stressful times. Earlier studies have focused on serious negative effects during crises including wars that impact mothers and babies if they are separated for any reason during stressful times. Should there be a loss of a mother or father due to the disease or grandparents loved by those parents, this also impacts the stress and anxiety and potential for depression in the mother which many studies have shown will impact the baby negatively with premature separation anxiety and loss the baby cannot be prepared for and during which time other familiar caretakers would be a necessity not only through infancy but throughout early and late childhood.

It essential for mothers and fathers to be aware of how their stress and anxiety is easily transmitted to their vulnerable infant whose early foundation for trust, safety, and security can be undermined.