Newborns are tested for COVID-19 with a small nasal or throat swab for lab PCR; some centers use antigen tests, and timing often targets 24–48 hours.
Those first hours with a baby come with lots of questions. One common one right now: how does COVID testing work for a newborn? Here’s a clear, parent-friendly guide that matches what hospitals use on the ward.
Newborn Covid Testing — Methods And Timing
Teams use adult tools, sized for tiny noses. The main test is a lab PCR (a NAAT) that finds viral genetic material. Antigen tests read viral proteins and give quick answers, but miss more early cases. Antibody tests don’t diagnose new infection.
| Test Type | Sample From Newborn | How It’s Used |
|---|---|---|
| PCR / NAAT | Small swab from the nose (nasopharyngeal, mid-turbinate, or anterior nasal) or the throat, per lab instructions | Preferred for diagnosis; most sensitive for early infection |
| Rapid Antigen | Nasal swab | Faster result; lower sensitivity than PCR, so a negative may need a repeat or a confirmatory PCR |
| Antibody (Serology) | Tiny blood sample | Shows past exposure in older kids or adults; not for finding a current infection in newborns |
Hospitals follow the test’s instructions and local policy. Staff take an upper-airway sample and send it to the lab. After clear exposure at birth, many units swab near 24 hours, then again near 48 hours if still inpatient. Early discharge often means one test before going home.
For the nuts and bolts of specimen types, see the CDC specimen collection guidance. For how different COVID tests work, the CDC testing overview spells it out.
When Do Newborns Get Tested?
Plans depend on risk. A baby born to a parent who has COVID at delivery will be checked during the birth stay. A baby with new cough, fever, poor feeding, or unusual breathing will be tested right away, no matter the exposure story. Babies admitted to a NICU often get a screen to protect other high-risk infants and staff. Before an aerosol-generating procedure such as deep suction or intubation, a fresh result helps teams plan protection and bed placement.
Home exposure counts too. If a parent, sibling, or caregiver tests positive after everyone is home, the pediatrician may order a PCR for the baby, even without symptoms. If the first test is negative and the baby still has close contact at home, a repeat test can follow based on the doctor’s plan.
What Does The Swab Feel Like?
Short and odd, but brief. Staff use a tiny sterile swab. For a nasal sample, the swab slides back along the nostril floor to the target, turns, and comes out. For a throat swab, they touch the tonsil area. Some nurseries use a combined throat-plus-nose swab.
Your baby may fuss or sneeze. A quick cuddle, pacifier, or feeding right after helps settle things. The whole collection often takes less than a minute.
Where Will Testing Happen?
Most birth centers collect the first swab in the room or nursery. If you’ve gone home, your pediatric clinic, an urgent care site that sees infants, or a hospital lab can do it. Call first so they’re ready for a newborn; not all sites are set up for babies this young. Some regions also use home-visiting nurses or mobile teams for swabs when travel is hard, especially for fragile preterm infants. Ask about drive-through.
Understanding Results And Next Steps
Positive PCR: Treat as a current infection. The care team watches feeding, breathing, and temperature, and gives home care steps. Most babies do well. If the baby looks unwell, staff may keep the baby for observation.
Negative PCR after exposure: Good news, but timing matters. If the swab was too early, the doctor may repeat it. If the baby stays exposed at home, another check may follow. The plan is tailored to the baby and the household.
Antigen positive: Assume infection and follow up with your clinician. Some teams add a PCR to confirm and to aid public health reporting.
Antigen negative with clear symptoms or exposure: A repeat antigen or a PCR is common since antigen tests can miss early cases.
Why Antibody Tests Aren’t Used To Diagnose A Newborn
Antibody tests measure the baby’s immune response, not the virus. Newborns carry IgG from the pregnant parent across the placenta. That can stay for months. So a positive antibody test in a newborn does not prove a new infection, and a negative result early on doesn’t rule one out. For that reason, serology isn’t used to decide if a newborn has COVID right now.
How Staff Keep Testing Gentle And Safe
Nurses and doctors use small swabs, soft lighting, and quick hands. They swab while the baby is calm, often during skin-to-skin or a feed. One person holds the head steady; another collects the sample. If a baby was born early or has breathing gear, the approach is adjusted to match the baby’s needs.
Timing Details You’ll Hear On The Unit
With known exposure at birth, many teams set the first PCR near the 24-hour mark. A second swab near 48 hours can catch a late rise in viral load. If both are negative and the baby looks well, that usually ends the hospital testing. Doctors then give home guidance and tell you when to call or test again.
What If The First Test Is Negative, Then Symptoms Start?
Call your pediatrician. A new swab is reasonable. Babies can develop signs later, and a second test can reveal what the first one missed. If a baby has trouble breathing, looks blue, is too sleepy to feed, or has a fever, head to care right away.
Feeding, Rooming-In, And Contact When A Parent Has COVID
Most birth centers allow rooming-in with mask use and hand hygiene. Breastfeeding is encouraged; milk carries antibodies and other immune helpers. Staff will show safe handling while the parent recovers. If the parent feels too ill, expressed milk is an option and staff can help with pumps and storage.
How Long Do Results Take?
Rapid antigen tests give answers in minutes. Lab PCR timing ranges from a few hours to a day or two, depending on the hospital. Ask the team how they’ll deliver results and who to call after discharge.
| Step | What Staff Do | Parent Tips |
|---|---|---|
| Prepare | Wash hands, gather a tiny sterile swab, label the tube | Have a blanket, pacifier, or milk ready |
| Position | Swaddled or skin-to-skin, head midline and supported | Hold the upper arms or shoulders gently |
| Collect | Slide swab along the nostril floor or touch the tonsil area; rotate, then remove | Talk softly; offer a quick feed after |
| Send | Place swab in medium, seal, and send to lab | Ask about result timing and how you’ll be contacted |
After A Positive Test: Care At Home
Most babies ride out COVID at home. Feed often. Watch diapers, breathing, and energy. Keep smoke away. Use skin-to-skin and keep the room aired out. Caregivers with symptoms should mask, clean hands, and avoid kissing the face. Call your doctor if feeds drop off, breathing looks fast, color changes, or a fever shows up.
After A Negative Test: What’s Next?
If there was a clear exposure and the first PCR was early, a second test may be booked. If there is no exposure and baby looks well, no further swabs are needed. Trust the discharge plan and the follow-up visit dates you’re given.
Special Situations In The NICU
Preterm babies or those on breathing help have extra checks. Many NICUs screen new admissions with PCR. Before surgery or transfer, another swab may be done. Timing follows unit protocol and the clinical picture.
What Clinicians Weigh When Picking A Test
Turnaround Time
Antigen tools return answers fast, which can guide bed placement or a procedure that can’t wait. When the baby is stable, teams still lean on PCR for the best sensitivity.
Sample Type
Upper airway samples give the best yield. Staff choose a deep nasal or mid-turbinate swab for many PCRs. Some labs accept a throat swab. The exact site depends on the test maker’s instructions and the hospital’s policy.
Quality Of Collection
Getting cells from the right spot matters more than how hard anyone swabs. A calm baby and a steady hand beat speed. If a sample was poor, the lab may ask for a repeat.
Safety Questions Parents Ask
Swabs are safe with trained staff. Nosebleeds are rare and mild. The swab aims straight back, not up. If a baby has low oxygen or a fragile airway, the team may use a shallower swab or wait until the baby settles.
Takeaways For Parents
PCR on a small nasal or throat swab is the go-to test for newborns. Antigen tests help when speed matters, but a negative may need a repeat or lab PCR. Antibody tests don’t diagnose new infection. After clear exposure at birth, timing often centers on 24 and 48 hours. Plans fit your baby and home.