We’re still learning about the novel coronavirus (SARS-CoV-2) and the illness (COVID-19) it causes. Research on kids and COVID-19 is ongoing.

So far, scientists know that this coronavirus typically appears to make babies and kids less sick than it makes adults. Children and babies may also have different symptoms.

Here’s a rundown on what we know so far on why most babies and children don’t seem to get as sick — or sick at all — and how you can help protect your little ones.

As of summer 2020, there’s still a lot we don’t know about how common it is for children to get coronavirus.

But we do know that babies and children of any age, including newborns, can get a COVID-19.

Findings reported in July 2020 said that children made up 8.4 percent of total people known to have this viral infection in 49 U.S. states, New York City, Washington, D.C., Guam, and Puerto Rico.

Fortunately, it does seem to be very uncommon for children to have serious illness due COVID-19.

According to the same report, data from 20 states and New York City showed that of those children with COVID-19, 0.6 to 9 percent were hospitalized. And in an even larger data set (43 states and New York City), between 0 and 0.3 percent of known cases in children resulted in death.

The novel coronavirus is still quite new, and scientists are learning more about it every week. Data current as of summer 2020 suggests 2 to 5 percent of newborns test positive for COVID-19 within 24 to 96 hours of delivery if mom is positive as well. That’s a pretty small — but significant — group.

We have few case studies on babies born with COVID-19 (or positive within that 24- to 96-hour window — it’s not always clear whether they contract the virus during birth or after).

In March 2020, doctors in China did look at the babies of 33 women who had COVID-19 while they were pregnant. Out of all these babies, three newborns tested positive for COVID-19. (If you’re doing the math, that’s about 9 percent. But remember that more data has been collected since the time of this small study.)

The study outlined what happened before and after the babies were born.

All three babies were delivered by a cesarean (C-section) because the mothers had COVID-19 symptoms, including pneumonia. All three babies developed symptoms, and one of them needed help breathing right after birth.

By the time the babies were a week old, all three tested negative (after having positive test results at 2 days old and 4 days old). But one of them did have complications lasting another week.

Obviously, this is a tiny group. So we have to be careful about drawing conclusions. But from this medical study, here’s what we know might happen if a mother has COVID-19 at delivery and her newborn baby tests positive for COVID-19 shortly after birth:

  • baby might need care in the NICU
  • baby may need to be separated from their mother — either due to mom’s illness or baby’s illness
  • baby may get a chest X-ray to check for pneumonia
  • they’ll get blood tests to check for other infections, blood clotting, and more
  • they may get tested for COVID-19 every 2 days (until baby is negative and has no symptoms)

Babies and children can have a range of COVID-19 symptoms, including:

  • fever
  • fatigue
  • feeling sleepy
  • runny nose
  • cough
  • muscle aches
  • vomiting
  • not feeding much / loss of appetite
  • diarrhea

Some newborn babies may also have breathing problems and other symptoms of pneumonia caused by the coronavirus. This is because they have tinier airways and new immune systems that haven’t started working properly yet.

On the other hand, as with adults, some children and babies may have the virus without any symptoms.

Scientists aren’t yet clear on exactly why most children get a milder form of COVID-19 compared to adults — or why some kids (and adults, for that matter) don’t get any symptoms at all. A medical study of 171 children who tested positive for COVID-19 in China concluded that almost 16 percent had no symptoms at all.

There might be more than one explanation for this, but we still don’t have the answer. Kids might be naturally more immune to this coronavirus because they catch more colds — some of which are related to this virus.

This means that their body may have more immune cells that can attack the coronavirus. This doesn’t explain why some newborns have no symptoms, though.

It’s also possible that children have more balanced immune systems that can fight the coronavirus without overreacting to it. In adults many of the symptoms caused by COVID-19 happen because the immune system reacts too strongly, attacking its own body by mistake (in a cytokine storm).

Another reason could be that diabetes is less common in babies and children than in adults. Several medical studies found that people with diabetes had much worse COVID-19 symptoms.

This might be because diabetes and prediabetes can spike blood sugar levels. This might weaken the immune system and make it easier for the coronavirus to get into cells and spread throughout the body. Similarly, children with type 1 diabetes also have a higher risk of COVID-19 symptoms and complications.

Newborn babies and babies under the age of 1 year with COVID-19 typically have mild symptoms. The virus also seems to get out of their system faster. Some newborn babies with COVID-19 tested negative by day 6.

In the same way, most children with COVID-19 get better within a week or two, says the Mayo Clinic. More serious COVID-19 illness can happen in babies and kids, however. Some children may need a ventilator to help them breathe.

Most babies and children who get COVID-19 won’t be sick enough to have to go to the hospital. They may be able to ride it out at home, with you.

As with anyone who might have contracted COVID-19, make sure your child is quarantined to a bedroom. Keep other children and family members away for at least 2 weeks.

If they’re over the age of 2, make sure they wear a mask when around others. Wear a mask and gloves when you’re around them. Wash your hands frequently and have your child do the same, even if they’re feeling better.

Both adults and children who have an underlying illness are at higher risk of getting more serious COVID-19 symptoms. Tell your doctor immediately if you think your child might have been exposed to coronavirus and if they have a chronic illness, like:

  • asthma and other lung conditions
  • diabetes
  • heart disease
  • a genetic condition
  • a nervous system condition
  • any condition that affects metabolism
  • an autoimmune disease
  • serious illness

Taking medications that change the immune system like steroids and chemotherapy can also raise the risk for more serious coronavirus symptoms in children.

Some children can get a rare complication from COVID-19 called multisystem inflammatory syndrome in children (MIS-C).

This serious condition causes inflammation (swelling) in several parts of the body. MIS-C can happen in the brain, heart, digestive tract, kidneys, skin, eyes — anywhere. Getting COVID-19 can sometimes trigger this illness.

Tell your doctor right away if your child has signs and symptoms of MIS-C, like:

  • fever that lasts longer than 2 to 3 days, or that goes away for over 24 hours and then comes back
  • vomiting
  • skin rash
  • diarrhea
  • stomach pain
  • red or swollen tongue or lips
  • red or swollen hands or feet

Get urgent medical help if your child has any of these MIS-C warning signs:

  • difficulty breathing
  • chest pain
  • chest pressure
  • confusion
  • excessive sleepiness
  • inability to wake up
  • blue-tinged lips or face
  • severe stomach pain

If your baby or child has mild COVID-19 symptoms, you can likely care for them at home about the same way you would if they had the flu.

Use common cold and flu remedies and treatments to help manage their COVID-19 symptoms and make them more comfortable. You might want:

  • children’s pain medication
  • fever reducers (acetaminophen, ibuprofen)
  • cough syrup
  • air humidifier
  • chicken broth
  • orange juice

That being said, always talk to your child’s pediatrician about what’s appropriate if you have a child or baby under age 6.

There are not yet any specific, proven medications to treat COVID-19 in adults or children. In more serious cases, your baby or child might need hospital treatment for symptoms and complications caused by the coronavirus. These include:

  • oxygen therapy
  • ventilation (in extremely severe situations)
  • medication to help with breathing
  • medication to help the immune system

Just like adults, babies and children can spread the coronavirus — and our understanding of its spread is rapidly evolving.

In July 2020, the AAP released a report noting the limited data on the topic found that children transmit the disease far less often than adults.

However, studies released in late July included a large one from South Korea that found children and teens ages 10 to 19 can spread coronavirus as readily as adults.

Similarly, a small study of 145 cases found that children under age 5, with more viral load in their respiratory tract than other age groups, may also be able to transmit the virus just as much — or more — than older children or adults.

As far as babies go, infants with COVID-19 (like all people with the disease) have the virus in their mouth and nose droplets and in their bowel movements. This means that if a baby with the virus coughs, drools, spits-up, or sneezes, coronavirus might be spread.

But there have been no documented cases of it spreading from stool to person. Even so, you should wear a mask and gloves when changing your child’s diaper if they have tested positive for COVID-19.

More research is needed, but two medical studies found that there wasn’t any coronavirus in the breast milk of mothers with COVID-19.

Then again, it’s complicated. The AAP notes that SARS-CoV-2 nucleic acid has been found in breast milk, but we don’t yet know if this can cause infection in your baby. Current data suggests that it doesn’t.

So doctors think it’s likely safe to breastfeed your baby — with the right protection. And breast milk offers important benefits, so if you were planning to breastfeed or are already breastfeeding, it’s probably best to continue with that plan — however, you’ll want to discuss with your doctor.

And remember that you — and anyone else with the infection — can still pass on coronavirus to your baby from mouth and nose droplets. Here are the current guidelines:

  • Wash your hands thoroughly before breastfeeding or touching your baby.
  • Wear a mask at all times (even when not breastfeeding) until recovered.
  • Avoid touching your nose, mouth, eyes, or any part of your face while you’re breastfeeding.
  • The same rules apply when hand expressing or pumping your milk: Wash your hands (and all pump parts) and wear a mask.

The same prevention rules apply to everyone — adults, kids, and babies — during this pandemic:

  • practice physical distancing (6 feet or more)
  • wear a mask when you’re around other people or in public
  • wash your hands often
  • avoid touching your face (eyes, mouth, and nose especially)

Remember that kids are more likely to have a milder form of COVID-19 or have no symptoms at all. This means that like adults who don’t have symptoms, they may be carriers and spread the coronavirus without knowing it, though this appears to be less common in children.

Babies and kids can contract and may spread the coronavirus. However, COVID-19 symptoms can be different in babies and children than in adults. In most cases, this coronavirus doesn’t make little ones as sick as adults.

COVID-19 in babies and kids typically also seems to go away faster. More research is needed on why the coronavirus affects babies and children differently than adults.