I found out I was pregnant right before Thanksgiving last year. The subsequent months were a haze of exhaustion, nausea, pizza delivery, loneliness, and COVID paranoia. The largest group of people I hung out with consisted of my husband and my parents at Christmas. I celebrated New Year’s Eve by eating a ham-and-cheese sandwich alone in our dark, silent kitchen.
This holiday season will be the opposite. I have a 3-month-old baby now, for starters, and we’re taking him on his first plane ride to spend Thanksgiving with my in-laws. We’ll be in a house crammed full of extended family for an entire week. All the adults he will meet are vaccinated, but there will be some unvaxxed kids in the mix, not to mention countless wild cards on the way there and back. It’ll be great to see everyone, but I’m vacillating between moderate to extreme anxiety about the whole trip.
I know I’m not alone. “We only bought refundable flights, and we’re prepared to bag our plans if case numbers spike,” said one friend who’s taking her 7-month-old to California to meet his grandparents for the first time. Other parents I know are just staying home (again). “The thought of more COVID precautions is just too overwhelming on top of a really exhausting year,” said one friend with a 4-month-old and a toddler.
While vaccines have made gatherings much safer this season, there are still a lot of complicated unknowns. Like what about breakthrough infections? And the Delta variant? And the risks for young, unvaccinated children, particularly ones who are too little to wear masks? How do you make decisions to keep everyone safe without creating unnecessary social awkwardness or driving yourself nuts? More specifically: Should I let relatives hold my baby?!
To get some answers, I spoke to several pediatric health experts. Here’s what they recommended.
Should we self-quarantine before we gather?
The CDC says vaccinated people don’t need to self-quarantine before or after traveling, but unvaccinated people should do so for seven days. Does that apply to babies? Where does that put us and other families with children who are too young to get their shots?
“Parents need to make a decision based on their risk profile,” says Dr. Vijay Prasad, a pediatrician at Tribeca Pediatrics. “For children who are too young to be vaccinated, I would recommend self-quarantining if they are going to be in contact with anyone else unvaccinated, elderly, or with chronic health issues or immune suppression.”
It’s worth noting that some schools and child-care facilities require quarantine periods too. One of my friends is staying home for the holidays because her son’s preschool has a rule that children must self-quarantine for seven days after taking a plane or visiting an area of higher transmission. “It basically rules out travel for us, which is fine,” she says. “One less decision to make.”
Should I get rapid tests?
“If you’re traveling, I think that rapid testing is a good idea,” says Emily Oster, an economist and author of the ParentData book series and newsletter, which offer data-driven advice for decision-making in pregnancy and parenting. “Even if everyone in your group is vaccinated, rapid testing before and after you arrive adds an extra layer of safety.”
Of course, rapid tests — especially the kind you do at home — are not perfect. “They’re not quite as sensitive to pick up very small amounts of virus, so you may want to test twice, a few days apart,” says Dr. Allison Messina, the chief of the Division of Infectious Disease at Johns Hopkins All Children’s Hospital.
The tests can also be hard to get. (My husband recently hiked around Brooklyn to three different pharmacies before he found them.) Hopefully that will change, as the Biden administration authorized extra funding to make them widely available in the coming months. If you can, you may want to keep several on hand just in case.
Can relatives hold my baby?
When I asked our (wonderful) pediatrician what we could do to keep our baby healthy in a crowd of loving relatives, she suggested that we ask everyone to wear a mask while holding him. (And wash their hands first, of course.) She also told us to throw her under the bus if we needed a scapegoat: “Feel free to say your pediatrician told you to do it.”
Dr. Danielle Zerr, the chief of Pediatric Infectious Disease at Seattle Children’s Hospital, agrees. “Especially if you’re in an area with a high transmission rate, wearing a mask around your baby would be a nice thing for friends and family to do.” Masks will also help protect your baby from a lot of gross viruses, many of which are more likely to get your baby sick than COVID.
When I brought this up to another new-mom friend, she told me that her pediatrician instructed her to not let any unvaccinated family members within six feet of her 3-month old during the holidays, especially germy toddlers. “It’s going to be stressful to enforce it,” she says, “but less stressful than him getting sick.”
To be honest, I’m still on the fence about whether I’ll ask every vaccinated relative to wear a mask to hold our baby for the full week of Thanksgiving. (Some of them have already held him, so it seems a little strange to backpedal their snuggling privileges.) Instead, I might opt for a hybrid model — ask everyone to mask for the first few days after they arrive and test negative for COVID, and then relax the rules when it’s clear that no one is sick.
How can I travel safely?
It’s impossible to stay six feet away from people while you’re, say, standing in line at a jam-packed airport or wrestling a carseat into an overhead luggage bin. But whatever you can manage is better than nothing, says Dr. Prasad. “Any barrier that you can create between your child and other people is helpful,” he says. That could include a breathable blanket draped over your baby’s stroller, or a carrier with a protective visor.
Of course, driving would reduce the risk of transmission even more, he says. But if you don’t have that choice, he advises careful planning. “I would do direct flights and minimize your time in the airport whenever possible,” he says. (It’s also worth noting that flying is considerably safer than driving for other reasons, especially during the holidays.)
How do I know if I’m making a safe decision?
“It’s important to understand your own risk tolerance, and communicate it,” says Dr. Prasad. But that’s easier said than done — and what is “risk tolerance,” anyway?
As it turns out, the definition is pretty squishy, and it depends on the company you keep. “Your risk tolerance has to do with who you’re trying to protect,” says Dr. Messina. “Is it an older, unvaccinated grandparent? Or is it a young baby who is otherwise healthy and has some immunity from their mom?” (The latter describes us — I was vaccinated while pregnant, and my son is getting some antibodies through breast milk.)
While babies and young children may seem vulnerable, they tend to be at lower risk if they’re healthy overall, Dr. Messina adds. “I would honestly be more worried about someone who doesn’t have any immunity and is more likely to get very sick, like an unvaccinated grandparent.” Which is another factor: You don’t want your child to be a vector for germs that could harm someone else.
Whatever you decide, choose your boundaries and then communicate them clearly. (If you have a partner, make sure you’re on the same page and back each other up.) “Wherever your risk lies, you have to be willing to stand your ground, and don’t let anybody shame you,” Dr. Messina continues. “If you say, ‘This is what I can accept for my child, and anything else is not going to work,’ then that’s your right.”