Abstract:
The COVID-19 pandemic has resulted in many hospitals severely limiting or denying parents access to their hospitalised children. This
article provides guidance for hospital managers, healthcare staff, district-level managers and provincial managers on parental access to
hospitalised children during a pandemic such as COVID-19. It: (i) summarises legal and ethical issues around parental visitation rights;
(ii) highlights four guiding principles; (iii) provides 10 practical recommendations to facilitate safe parental access to hospitalised children;
(iv) highlights additional considerations if the mother is COVID-19-positive; and (v) provides considerations for fathers. In summary, it
is a child’s right to have access to his or her parents during hospitalisation, and parents should have access to their hospitalised children;
during an infectious disease pandemic such as COVID-19, there is a responsibility to ensure that parental visitation is implemented in a
reasonable and safe manner. Separation should only occur in exceptional circumstances, e.g. if adequate in-hospital facilities do not exist
to jointly accommodate the parent/caregiver and the newborn/infant/child. Both parents should be allowed access to hospitalised children,
under strict infection prevention and control (IPC) measures and with implementation of non-pharmaceutical interventions (NPIs),
including handwashing/sanitisation, face masks and physical distancing. Newborns/infants and their parents/caregivers have a reasonably
high likelihood of having similar COVID-19 status, and should be managed as a dyad rather than as individuals. Every hospital should
provide lodger/boarder facilities for mothers who are COVID-19-positive, COVID-19-negative or persons under investigation (PUI),
separately, with stringent IPC measures and NPIs. If facilities are limited, breastfeeding mothers should be prioritised, in the following
order: (i) COVID-19-negative; (ii) COVID-19 PUI; and (iii) COVID-19-positive. Breastfeeding, or breastmilk feeding, should be promoted,
supported and protected, and skin-to-skin care of newborns with the mother/caregiver (with IPC measures) should be discussed and
practised as far as possible. Surgical masks should be provided to all parents/caregivers and replaced daily throughout the hospital stay.
Parents should be referred to social services and local community resources to ensure that multidisciplinary support is provided. Hospitals
should develop individual-level policies and share these with staff and parents. Additionally, hospitals should ideally track the effect of
parental visitation rights on hospital-based COVID-19 outbreaks, the mental health of hospitalised children, and their rate of recovery.
