What should I do if my maternal and infants and young children are infected with new crowns?How to do protection measures?Come to listen to expert opinions →

Medical Chat No. 131

How to do the healthy management of pregnant women and infants?

Recently, there have been more positive cases around us, and maternal women and parents have also begun to fall into nervousness and anxiety. Not only are they worrying that their bodies will be threatened by the virus, but they are more worried that they will affect the new crown.Baby’s safety.

How should pregnant women and infants and young children protect them?What should I do after infection?With a number of experts support, Xiaobu compiled a protective guide for maternal, infants, and children to collect it!

Popular science guests in this issue

Shanghai First Maternal and Baby Health Hospital

Hua Xiaolin

Deputy Director (Host), Chief Physician, Bo Director, Director of the Department of Obstetrics and Gynecology Branch of the Eastern Hospital, Member and Secretary of the Obstetrics and Gynecological Health Medicine Branch of Shanghai Medical Promotion

Zhao Minhui

Deputy Director of Nursing Department, Chief Nursing and Director of the First Women’s and Institute of Health Hospital in Shanghai.

Xie Hongjuan

Deputy Director of the Pharmacy Section of the First Maternal and Infant Health Hospital in Shanghai, the director of the pharmacist, the director, and the master of the Shanghai Medical Association Clinical Pharmacy Branch

Shanghai Children’s Hospital

Dong Xiaoyan

Director of the Department of Respiratory Department of Shanghai Children’s Hospital, Director, Chief Physician, member of the Pediatric Branch of the Shanghai Medical Society, Deputy Leader of the Shanghai Pulmonary Function Cooperation Group, and the Chief Respiratory Special Committee of the Chinese Maternal and Child Health Association

High

The attending physician of the Department of Respiratory Department of Shanghai Children’s Hospital

Gong Xiaohui

Director, Chief Physician, Master Director, Master Director of Shanghai Children’s Hospital.

01

Maternal post

ask

How do pregnant women take protective measures?

Ordinary maternity

Wear masks during public places, and medical institutions wear N95 masks.

Master the correct hand washing method (refer to the "seven -step washing method"), or use 75%alcohol -free hand washing solution.

At home or in the office, it often ventilates to keep the air circulation, but pay attention not to cool the temperature.

There are fewer people gathering and space -closed places, and try not to take the dense public transportation.

Keep your social distance for more than 2 meters as much as possible.

Try to reduce the stay in the hospital through online appointment and appointment inspection.

For maternal diseases with basic diseases such as hypertension and diabetes, self -protection should still be strengthened.

Maternity

Do a good job of self -health monitoring, including infection symptoms, heart rate, blood pressure, fetal movement, etc.

Generally, the symptoms of infection include fever, cough, dry pharyngeal, sore throat, runny nose, muscle pain, etc., usually naturally decreased after taking the medicine.

Relaxing and full rest is also a treatment.

Try to live in the room alone, and the domestic garbage is treated separately and disinfected.

When contacting the family, the two sides wear the N95 mask to keep a social distance of more than 1 meter.

Contact the maternity agency in time to explain the situation and seek medical treatment according to the doctor’s advice.

There is no improvement in fever, or severe discomfort such as chest pain, chest tightness, headache, dizziness, panic, breath, shortness of breath, asthma, panting, etc., or symptoms such as abdominal pain, vaginal bleeding, vaginal fluid, and abnormal fetal movement.Essence

ask

How to use medicine for infected mothers?

的 Pregnant women without discomfort do not need drug treatment.

In the early stage of the onset, you can take targeted medications according to the symptoms of symptoms, such as fever use degeneration, cough, sputum, cough and phlegm.

药 Do not need other drugs, such as antiviral drugs.

In terms of medication, try to choose unilateral preparations, such as the acetaminophenol.

其他 Do not use compound preparations containing other ingredients such as antitussive, expectorant, and anti -allergy.

有 For pregnant mothers who are infected with new crowns and have basic diseases, such as hypertension, diabetes, etc., when choosing to treat new crowns, you must first consult a doctor or pharmacist to inform the drugs that have been taken for a long time before.Practice, or affects basic diseases.

Commonly used family non -prescription drugs (OTC) medication lists during pregnancy

Remarks: The use of ibuprofen during breastfeeding is relatively safe during lactation, and the classification is L1.Although ibuprofen can be secreted through milk, the highest drug concentration in milk is only 0.6%to 0.9%of the daily doses required by the baby.It is generally believed that less than 10%is acceptable.Based on the above data, WHO’s WHO in the 2002 version of the basic drug directory believes that ibuprofen can be used during lactation.However, some domestic instructions are more cautious, and it is recommended to disable during breastfeeding.Based on the above information, ibuprofen can weigh the advantages and disadvantages and use it with caution.

ask

Will pregnant women affect the fetus after infection?

Judging from the current evidence, the possibility of spreading directly from the pregnant mother through the placenta to the fetus is extremely low, so Mom Bao do not have to worry.

However, it is important to emphasize that if there is a continuous high fever, the manifestation of pneumonia and hypoxia, the fetal heart rate will continue to increase, which may have a certain impact on the fetus.Therefore, it is reminded that the mother of Bao found that any abnormal situation must seek medical treatment in time and seek the opinions of a doctor.

ask

Which check -up items can be done for the time being?

36 weeks before pregnancy

Most inspections are done in a relatively loose period.For example, fetal ultrasonic deformity screening is between 20 and 24 weeks of pregnancy, and the sugar resistance test is between 24 weeks and 28 weeks of pregnancy.Don’t worry too much.

After 36 weeks of pregnancy

The conventional check -up requires a weekly treatment of fetal heart monitoring and urine routine.However, if you can’t attend the scene, you only need to monitor blood pressure at home and count the fetal movement.

If emergency situations (such as regular contractions, redness, vaginal fluid or abnormal fetal movement, etc.), they must seek medical treatment.

ask

What should I do if I want to give birth during the infection?

For this issue, most of the production inspection hospitals have made a plan. They will arrange special personnel to take the consultation at specific places and are equipped with various instruments and equipment required for delivery and delivery, including the production room and the operating room.All diagnosis and treatment activities are completed in isolation places. While ensuring that the disease does not spread, it ensures the safety of maternal and siege babies.Pregnant mothers need to consult with their own inspection hospitals in advance whether they can provide the above consultation conditions.

Because the hospital for examination hospitals is divided into specialized hospitals and comprehensive hospitals, pregnant mothers should pay attention to distinguish the symptoms of respiratory tract and production symptoms.

病 If you have obvious condition to worsen, such as dyspnea and shortness of breath, including aggravation of basic diseases, please give priority to choosing a comprehensive hospital with obstetrics.

If you are more abnormal fetal movement, abdominal pain, vaginal bleeding, etc., please go to the delivery hospital for treatment.

ask

How can the infected maternal take care of newborns?

The early contact between the mother and the newborn is beneficial to the physical and mental health of the mother.After Mother Bao was infected with the new crown, she had the risk of spreading the infection of newborn through the respiratory tract and contact.However, studies have shown that in the case of proper protection, the risk of infection of newborns in the same room after the same room has not increased significantly. The comprehensive consideration is as follows:

妈 The mother who is infected with the new crown gives priority to isolation with the newborn.

许 If the conditions are not allowed, or you choose to take care of the same room, it is recommended to pay attention to personal protection, such as wearing a N95 mask, and do good hand hygiene before contacting newborns.

餐 Disinfeted with newborns’ tableware, toys, clothing and other supplies in time.

的 Reduce the exchanges between non -residents.

触 Avoid touching the food or tableware of the newborn with your mouth, such as blowing food with your mouth or feeding with your mouth.

用 Do not share tableware with newborns.

Early symptoms of newborn infection with new coronary viruses include fever, drowsiness, runny nose, cough, vomiting, diarrhea, poor eating, increased breathing, or shallow breath.Parents should do a good job of healthy observation of newborns. If newborns are suspected of infection, they should seek medical treatment in time.

ask

Can the infected maternal be breastfeed?

Breastfeeding has more benefits for maternal and infants, and should be encouraged and supported.There is no evidence that the new coronal virus can be spread through breast milk.At the same time, studies have shown that for a long time after maternal infection with new coronal virus or vaccination of new crown vaccines, the high level of specific antibodies of new crown virus in breast milk suggests that breastfeeding has a protective effect on newborns.However, you still need to be alert to the risk of droplets, hand and breast contact.

Prioritize the priority to squeeze out the breast milk and breastfeed indirectly by the healthy family until the mother recovers.You need to wear N95 masks before squeezing breast milk, strictly wash your hands, do breast hygiene, no need to disinfect milk, breast pumps and milk utensils should be standardized.

乳 If you decide to breastfeed directly, wear the N95 mask before contacting the baby, and do it with hand and breast hygiene.

ask

How to choose breastfeeding medicine?

期 The first choice of breastfeeding and safe drugs, which is often said that L1 (data is sufficient-applicable) and L2 (limited data-may applicable, obey your doctor) drugs.

(For L3-level drugs (lack of data-may be applicable), doctors need to use the doctor’s advice after evaluation.

级L4 and L5 drugs (referring to the mother after taking the medicine to the baby), and the breastfeeding should be temporarily suspended during the medication.

Mother 医 can consult a doctor or read the drug to understand the safety level of the drug during lactating drugs.

中 For compound preparations and Chinese medicine, the clinical data of lack of breastfeeding medication is usually lacking due to the complexity of their drug components, so it is not recommended for breastfeeding.

Here are the safety levels of recommended breastfeeding and precautions for baby monitoring for reference.

The main symptoms

Commonly used drugs

Security Level

Baby monitoring content

fever

Acetaminol (the first choice)

L1

Diarrhea, stomach discomfort

Ibuprofen

L1

Vomiting, diarrhea

Runny nose

Chlorine

L1

Sleeid, dry mouth

dry cough

Right Michafin

L3

Sedative

Sputum

Acetylcysteine

L3

feel sick and vomit

During the medication of ,, check the drug manual carefully, and pay attention to the drug reaches (T Max) and the half -life time (T1/2).

时间 Choose drugs with short -term and half -period as much as possible.

到 Do not breastfeed when the drug reaches its peak.

儿 At the same time, you need to observe the baby’s response. For example, when the mother is taking antipyretic drugs to acetaminol, although the drug rarely enters the milk, it is safe to the baby, but it still needs to pay attention to the baby’s temperature change and gastrointestinal reactions.

药 If the mother needs to stop breastfeeding due to taking drugs, she can discharge milk with breast pumps 6-8 times a day to maintain breast lactation.After the drug is stopped, after the half of the medicine half -life, the drug is basically metabolized, and breastfeeding can be continued.

02

Baby article (under 1 year of age)

ask

How to prevent infection?

There are little babies in the , family who are responsible for taking care of their children.

提 If you must go out, you can improve the protection level, such as wearing a N95 mask.

Back home, carefully wash your hands, wash your face, and change your jacket.

, If your family is positive, you need to contact your baby, please wear a N95 mask and wash your hands frequently.

ask

If the baby is infected, what should I use?

After the baby is infected with the new coronal virus, most of the symptoms are still mild, manifested as fever, runny nose, less cough, and some children have digestive tract symptoms such as diarrhea.

温 If there is fever and the body temperature exceeds 38.5 degrees, heating medicines such as acetaminophenol can be used.

You can observe the runny nose and cough, keep the indoor humidity appropriate and not dry.

嗽 If fever and cough are frequent, you need to go to the hospital to send a popular kidney consultation.

宝宝 Babies with mild diarrhea can be fed normally.

, Diarrhea is frequent, and you need to replenish water or oral salt salt solution.

Guide to infants and young children

variable

Acetaminophen

Ibuprofen

Age

February and above

June and above

Time drop time

1 to 2 hours

1 to 2 hours

Starting time

<1 hour

(Generally within 30 to 60 minutes)

<1 hour

(Generally within 30 to 60 minutes)

Portal time

4 to 6 hours

6-8 hours

Route of administration

Oral and suppository

Oral, suppository, varicose veins

The maximum dose each time

600mg or 15mg/(kg · times) (the lower doses of the two are subject to)

400mg or 10mg/(kg · times) (the lowest dose of both)

Use the maximum daily daily dose

2.0g or 60mg/(kg · Tian) under 2 years old, 75mg/(kg · Tian) 2 to 12 years old (based on lower doses of the two)

2.4g or 40 mg/(kg · Tian) (prevailing the lower dose of the two)

ask

What situation needs to go to the hospital?

用 After the baby’s heating medicine is used at home, he still has continuous fever, or frequently cough, and breathing shortly after sleeping.

热 After taking the heating medicine, the body temperature is restored to normal. During the normal body temperature, good spirit, willing to play, and have no frequent cough, indicating that the virus infection only affects the upper respiratory tract. There are no major problems and can be observed at home.

The baby within 3 months, if he fevers, you still need to go to the hospital first, wait for other issues, and then go home to observe.

03

Children’s article (over 1 years old)

ask

How can children be isolated at home?

Home environment

婴 It is recommended that children (infants and children or children who cannot take care of themselves need to be taken care of by the accompanner) live in rooms with independent bathrooms with better ventilation.

的 Reduce close contact with the same residents.

洁 The room should be kept tidy. The daily ventilation of the room 2 to 3 times, each opening of the window for about 30 minutes.

调 If the air conditioning system is used in the room, the split air conditioner should be selected to avoid using the central air conditioner.

If you use the central air conditioner to ensure that the air conditioner is running normally, increase the new air volume, and turn off the air system to turn off the air system.

Home disinfection

展 At least 1 disinfection should be carried out every day. Pay attention to the ventilation of the room during disinfection.

面 Surface disinfection of home furnishings and ground can be sprayed and disinfected with a chlorine disinfection agent with 500 mg/L of 500 mg/L.

和Stid items and corrosion -resistant objects can be wiped with 75%alcohol disinfection wet towel.

Children with allergies to chlorine or alcohol can be disinfected with water or ultraviolet rays. Children and family should avoid when disinfection of ultraviolet rays. Pay attention to ventilation after disinfection.

The clothing should be placed separately, soak it with a chlorine -containing disinfection agent with 500 mg/L with a valid chlorine chlorine for 30 minutes.

衣 The clothing that cannot be washed with water can be fully ventilated in the sun, and then use it for more than 15 days before using it.

煮 Tableware is preferred to boil and disinfect for 15-30 minutes or 30 minutes of steam disinfection (time should start with boiling and steam injection).

生 Family shared the bathroom, and each child should be disinfected once every time the toilet is used.

间 Use a separate bathroom, and the toilet can be disinfected once a day.

The stool pool and the periphery can be wiped or sprayed with a chlorine -containing disinfection solution containing 2000 mg/L, which can be wiped with water after 30 minutes.

垃 The infected people’s domestic garbage uses a 1000mg/L chlorine -containing disinfection solution and is wet and loaded into the garbage bag. After the garbage bag is tied, spray 1000 mg/L -chlorine -containing disinfectant and disposal according to the medical waste.

Daily home

餐 Dietary and diet should be divided into diet, and diet requires balanced nutrition. Pay attention to drinking plenty of water.

人 When you contact your school -age children and their families, they need to wear masks. It is difficult for infants and young children to wear masks to take care of parents to wear masks.

锻The exercise or activity can be arranged appropriately.

, Should be rest on time to ensure that sleep is sufficient, and you should not watch TV or play electronic products for a long time.

ask

If children are infected, how to use medicine?

After children infected with new crowns, symptomatic measures were mainly taken.

fever

Children’s armpit temperature is ≥38.2 ℃ (or anal temperature ≥38.5 ° C). It is accompanied by obvious discomfort. It can be used with antipenons. It is recommended to use ibuprofen or acetylphenol.

Putting proper care for children with fever can improve the comfort of children, such as warm water to apply children’s foreheads, warm water baths, reducing clothing wearing clothing, reducing hot stickers, reducing hot blankets, reducing indoor temperature, etc.

It is not recommended to wipe the body, ice water enema and other methods.

Cough and sputum

When children have increased respiratory secretions, they are actively expelling sputum when they are increased and viscous, which is the treatment of phlegm.

When children’s cough degree seriously affects normal life, cough treatment can be performed.

When the cough respiratory tract does not have many secretions and the degree of cough is not serious, the use of cough and phlegm can be suspended.

Do you need antibiotics

Antibacterial drugs are only effective for bacterial infections and are invalid for new coronal virus infections. Only antibacterial drugs are used only when the new coronary virus is infected with or secondary bacterial infection.

ask

What situation needs to go to the hospital?

Although children’s new coronary virus infection is mostly asymptomatic and mild, it still needs to be alert to the occurrence of severe infection.If the following performance occurs, it is recommended to take an antipyretic medicine and go to the hospital to send a popular kidney consultation in time to check and treat it under the guidance of the doctor.

Homoriousness of intensive illness

Continuing high fever for 3 to 5 days without retirement, the course of disease is> 1 week, and the symptoms, no improvement or exacerbation of the signs, no improvement.

Difficult to breathe, shortness of breath.

In the static state, the oxygen saturation ≤95 %.

There are different mental reactions, seizures, continuous refusal, difficulty in feeding, drowsiness, etc.

Severe digestive symptoms: vomiting, diarrhea and abdominal pain.

Imaging: Both sides or leaflets are widely infiltrated and the thoracic effusion progress has progressed rapidly in the short term.

ask

Common Q & A;

How long does the new crown infection generally improve?

Children belong to the susceptible crowd of the new crown virus, and the incubation period is shorter after children infected with the new crown, which can quickly get onset within one or two days.Most children are asymptomatic infected, and some children may have mild symptoms (including fever, nasal congestion, sore throat, cough, gastroenteritis, etc.). The above symptoms usually recover within 1-2 weeks.

What are the common symptoms of the new crown?

The symptoms of respiratory infections of children in the new crown infection are mainly manifested by fever, dry cough, and fatigue. A few are accompanied by nasal congestion, runny nose, sore throat, headache, etc.In addition, some children can manifest the symptoms of gastrointestinal tract such as vomiting, diarrhea, and occasionally accompanied by a sense of smell and a decrease in taste. Few children may have sleep abnormalities, cognitive dysfunction, anxiety and depression, easy to irritate and impulse attack behavior, etc.Essence

Is there any special medicine for children’s new crown infection?

Although there are currently small molecular antiviral drugs that have been approved for the treatment of new crowns, those suitable for light and ordinary types within 5 days of the disease and are accompanied by progress as high-risk factors.40kg) and adults.Considering the drug and side effects of drugs and potential health risks, and the lack of clinical drug data for children, it is not clearly recommended to use the new coronary antiviral drugs for new coronary virus.Generally, children are mainly mild and ordinary. They have certain self -limits, which are mainly symptomatic treatment, while observing changes in the condition.

Which children are prone to new crown infections?

The clinical manifestations of children infected with new coronal viruses are diverse, and some infected people may have no clinical symptoms, mainly mild or asymptomatic.There are basic diseases (such as congenital cardiopulmonary tract disease, chronic cardiac and kidney disease, malnutrition, genetic metabolic diseases, immune defects, hematological tumor diseases, etc.), and recent use of large -dose immunosuppressants or children with transplants.Critical illness.

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