Dr Leticia Bazo-Hernández, Rovira I Virgili University, Spain
Fortunately, natural selection, different immunological characteristics, among other assumptions, Sars-Cov-2 affects very few children, and those affected, seem only to be so in a slight way. Despite this, there have been cases of children with Covid-19 and, above all, neonates born to a mother with suspected or confirmed Covid-19. Spain is made up of 17 autonomous communities [Gobierno de España. Comunidades Autónomas, 2020a]. The Community of Madrid and Catalonia are the most affected autonomous communities, especially its two major cities, Madrid and Barcelona. Neonatal care has presented various ways of proceeding, depending on the number of cases, established protocols, human and material resources. In Spanish neonatal nursing we have experienced great confusion in all this process, due to the lack of knowledge about the best management of the disease and the lack of a communication channel, typical of the discipline.
To alleviate this situation, SEEN, the Spanish Society of Neonatal Nursing, has created repositories of the evidence generated on Covid-19 and the management of the child and his family. They transfer said evidence through social networks and the Telegram channel. We have a Telegram group to share doubts and concerns among neonatal nursing. And a reference position regarding care for the suspected or confirmed newborn of Covid-19 [SEEN, 2020a].
One of the topics studied in depth is “Recommendations for the management of the newborn in relation to SARS-CoV-2 infection and breastfeeding” [SEEN, 2020b], a document that presents and details two algorithms that we provide to health professionals for the management of infant feeding. The general recommendations are: the non-separation of the nursing mother and her child, whenever possible and other action measures exist. Respect for the fundamental rights of the child [UNICEF COMITÉ ESPAÑOL, 2015], and the rights of the hospitalized child [Parlamento Europeo, 1992], both defenders of the right of the minor not to be separated from their parents and to apply appropriate treatment on an individual basis. Encourage direct breastfeeding in all cases and, if in any particular case it is not possible, promote and facilitate the extraction of breast milk and its subsequent administration. Working together with other scientific societies and the government of Spain, a document generated is “Management of pregnant women and new-borns with Covid-19” [Gobierno de España – Ministerio de Sanidad, 2020b], a reference document for health professionals associated with perinatal care in our country.
A first COVID19 and neonatal nursing meeting was held through the “I Virtual Session of SEEN with the title of “Neonatal care in the context of Covid-19” in which scientific knowledge and experiences of clinical practice were shared. This meeting was very fruitful to obtain a mapping of Covid-19 neonatal nursing care, transfer material worked on by experts from different autonomous communities and create lines of work appropriate to real needs. The objective of the study is now set in the elaboration of an ecological study that collects epidemiological evidence as well as neonatal care variables. We now seek to maintain a balance between strict Covid-19 isolation and disinfection recommendations and the humanization of care. We must not forget how beneficial the application of Development Centred Care is, a model focused on the performance of interventions that favour the neurodevelopment of the new-born [ Bazo Hernández, 2016], especially skin-to-skin and the strengthening of the maternal-infant bond after childbirthCovid-19. Well worked, everything is possible. And if there is something that characterizes paediatric nurses, and even more so neonatal nurses, it is the ability to adapt resources to offer quality care to our small patients, it will not be different with the Covid-19.