Long COVID living in infants

Overview

Long COVID (also called post-COVID-19 condition) is when symptoms of COVID-19 continue for weeks or months after the initial infection. In infants, it means a baby who had COVID-19 still has symptoms like extreme tiredness, feeding difficulties, or other problems that last longer than expected. These symptoms can come and go and affect the baby's daily life.

Long COVID is less common in infants than in adults, but it can happen. Researchers are still learning how often it occurs. If your baby had COVID-19 and seems slow to recover, it is worth speaking to your doctor.

Long COVID affects infants (babies under 1 year old) who have had a COVID-19 infection, even if the initial infection was mild. It can also affect newborns who were exposed before or after birth.

Symptoms

Common symptoms

• Extreme tiredness (fatigue) that does not go away
• Cough that lasts for weeks
• Fever that comes and goes
• Trouble breathing or noisy breathing

Symptoms in children

• Persistent crying or irritability
• Feeding difficulties – refusing to eat, vomiting after feeds, or trouble sucking/swallowing
• Sleep problems – waking often, trouble settling, or sleeping more than usual
• Developmental regression – for example, losing skills like rolling over or babbling
• Diarrhea or constipation that lasts

Symptoms in older adults

• Tiredness and weakness that interferes with daily activities
• Shortness of breath or chest tightness
• Persistent cough
• Brain fog – trouble concentrating or remembering
• Loss of smell or taste
• Muscle or joint pain
• Heart palpitations or feeling dizzy when standing

Causes

Main causes

• Long COVID is believed to be caused by the body's immune response to the SARS-CoV-2 virus (the virus that causes COVID-19). Even after the infection clears, the immune system may stay active or not work properly, leading to ongoing symptoms.
• In infants, the exact cause is not yet known, but it is likely related to the same immune and inflammatory processes seen in older children and adults.

Risk factors

• Severe initial COVID-19 illness that required hospital care
• Having certain underlying health conditions, such as heart or lung problems
• Being born prematurely may increase vulnerability
• Unknown factors – researchers are still studying why some infants get Long COVID and others do not

When to see a doctor

See a doctor urgently if:

• If your baby has any of the emergency symptoms listed above, call your local emergency number immediately.
• If your baby has a fever that lasts more than 3 days or seems to be getting worse, see a doctor urgently.

Book a routine appointment if:

• If your baby had COVID-19 and is not improving after 4 weeks, talk to your doctor or health visitor.
• For ongoing mild symptoms like tiredness or feeding slowly, make a routine appointment to discuss them.
• If you are worried about your baby's development or weight gain, bring it up at your regular check-ups.

Diagnosis

There is no single test for Long COVID. Doctors diagnose it by listening to your baby's symptoms and ruling out other causes. They will ask about your baby's history of COVID-19 (even if it was only suspected) and do a physical exam. Diagnosis is usually made after symptoms have lasted more than 4 weeks since the infection started.

Tests that may be done

• Physical examination – checking temperature, breathing, heart rate, and growth
• Blood tests to check for inflammation or other problems
• Chest X-ray if there is a persistent cough or breathing trouble
• Sometimes tests for other infections or conditions that might explain the symptoms

What to expect at your appointment

The doctor will ask many questions about your baby's symptoms, appetite, sleep, and behaviour. They may also ask about the baby's development and how your family is coping. It can feel overwhelming, but the goal is to understand what is happening and create a plan to help. With time, many babies improve, and the doctor will support you along the way.

Treatment

There is no cure for Long COVID in infants, but treatment focuses on relieving symptoms and supporting your baby's growth and development. Most care is provided at home with guidance from your doctor or health visitor. The plan is tailored to your baby's specific symptoms.

Self-care at home

• Make sure your baby gets plenty of rest – let them sleep when they need to, even if that means more daytime naps.
• Offer smaller, more frequent feeds to help with feeding difficulties. If breastfeeding, ensure a good latch and offer both sides often.
• Keep your baby comfortable – use a cool mist humidifier if they have a cough, and dress them in light layers if they have fever.
• Watch for signs of dehydration: fewer wet nappies, dry mouth, or a sunken soft spot. If you see these, contact your doctor.
• Follow a gentle routine – soothing baths, skin-to-skin contact, and calm play can help with irritability.

Medical treatments

Doctors may recommend treatments based on symptoms. For example, physiotherapy can help if your baby has trouble with movement or muscle weakness. A feeding specialist (such as a speech and language therapist) can assist with sucking or swallowing problems. In some cases, medications are used to manage specific symptoms like fever or pain, but always under the guidance of a healthcare professional. No specific antiviral or immune therapy is approved for Long COVID in infants.

When is surgery considered?

Surgery is not used to treat Long COVID in infants. In very rare cases, if a complication such as severe inflammation develops, other treatments may be needed, but that is not typically surgical.

Living with this condition

Caring for an infant with Long COVID can be demanding. Be patient with yourself and your baby. Focus on the basics: rest, feeding, and comfort. Keep a diary of symptoms to share with your doctor. It is normal for symptoms to come and go – your baby may have good days and bad days. Try to maintain a predictable routine to help your baby feel secure.

Lifestyle tips

• Prioritise rest – let your baby lead their sleep schedule.
• Limit visitors and avoid crowded places while your baby is unwell to reduce the risk of other infections.
• Get outside for fresh air and gentle sunlight when your baby is feeling okay – a short walk in the pram can help both of you.
• Look after yourself – ask for help from family or friends so you can rest too.

Diet and exercise

Your baby's normal diet – breast milk or formula – is still best. If your baby is older and eating solids, offer soft, easy-to-eat foods like mashed fruits or vegetables. Ensure they get enough fluids. For exercise, gentle tummy time and supervised floor play can help with strength and development, but don't push if they are very tired.

Mental health and emotional wellbeing

Caring for a baby with ongoing health issues can be stressful and worrying. You may feel anxious, frustrated, or guilty. These feelings are normal. Talk to your partner, family, or a trusted friend. Your health visitor or GP is also there to support you. If you feel overwhelmed, reach out to a mental health helpline in your area. Your well-being matters for both you and your baby.

Prevention

There is no guaranteed way to prevent Long COVID in infants, but reducing the risk of COVID-19 infection can help. Protect your baby by keeping them away from people who are sick, washing hands often, and cleaning surfaces. For older family members, staying up to date with COVID-19 vaccines can reduce the chance of bringing the virus home.

Vaccines

COVID-19 vaccines are not licensed for infants under 6 months in most countries. However, vaccines for pregnant women, older children, and adults can help protect babies indirectly through antibodies passed in pregnancy or breastfeeding, and by reducing spread in the household. Ask your healthcare provider about the best protection for your family.

Screening programmes

There is no routine screening for Long COVID in infants. If your baby had COVID-19, monitor them for new or ongoing symptoms and bring any concerns to your doctor's attention.

Complications

If left untreated

• Prolonged feeding problems can lead to poor weight gain or dehydration
• Delays in developmental milestones if symptoms interfere with activity and interaction
• Increased risk of other infections if the immune system is weakened
• Stress on the family that may affect bonding and mental health

Long-term outlook

Most babies with Long COVID improve completely over weeks or months. With the right support, your baby can catch up on their development and return to their normal self. Researchers are learning more every day, and doctors are better able to help. Stay hopeful and work closely with your healthcare team – your baby has a very good chance of full recovery.

Find support

Local organisations

• NHS Long COVID support · United Kingdom

Helplines

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