COMBO Helps Moms and Babies Stay Together

Early 2020 saw mothers and newborns routinely separated from each other during their crucial first days and weeks together. But the COMBO Initiative took swift action: producing breakthrough scientific findings that helped reverse this precautionary pandemic policy as soon as possible. 

Through their pioneering research, COMBO helped reunite millions of moms and babies at a critical time for their relationship and health—across America and around the globe. 5 years later, this truly singular initiative continues to generate crucial findings on what this generation of children (and families) needs to thrive.

A once-in-a-generation event catalyzes a trailblazing study of moms & babies 

In March of 2020, the world's focus was on the sick and dying. But in the Department of Pediatrics at Columbia University, Dr. Dani Dumitriu recognized a critically vulnerable group that, if affected, could alter the history of humanity: mothers and babies. 

Seeing this unprecedented need to understand the impacts of the virus and pandemic stress on families, Dani rapidly mobilized COMBO: a trailblazing study of maternal-child health. They started looking at pregnant mothers right away, at a time when moms and newborns were being routinely separated in hospitals out of an abundance of caution. 

Sadly, we know that those first hours, days, and weeks together are a critical time for mothers and their newborns: this key window is vital for mom’s physical and mental health, and for her baby’s ability to safely transition into the world. It also hugely influences their relationship, with profound impacts on mom, baby, and the new family. 

But very quickly, COMBO published their first revolutionary finding: mothers have an extremely low risk of passing the virus to their babies—during pregnancy, after birth, or while breastfeeding. This breakthrough discovery helped end the precautionary mother-baby separation practiced in many hospitals worldwide. 

COMBO’s swift action helped reunite millions of moms and babies, across America and around the world, at a critical time for their relationship and health.

A collaborative approach produces groundbreaking science

How COMBO made this crucial discovery is a testament to their truly collaborative approach:

Columbia was the first big epicenter for the virus, and the first to implement universal testing for women who came into the hospital in labor (starting March 2020). That meant they had an unprecedented ability to know which moms had Covid and which didn’t—in fact, the very first known-Covid-positive mom in the country had her baby at Columbia. 

“But we still didn’t know anything about the effects on moms or their babies,” says Dani. “As doctors with access to unparalleled information, we felt a responsibility to quickly gather and share data on the safety of moms and babies staying together.” 

There wasn’t time to put together research staff, so a group of physicians set to work compiling data on the first 100 laboring mothers diagnosed with Covid at Columbia. “It was literally two dozen doctors from multiple specialties manually entering data for each mom and baby, after taking care of patients all day. We were already overworked at that time, but we knew how important this was,” Dani says. 

They looked at 2 key things: whether or not the child got Covid from their mom, and whether there were any differences in those babies’ health. The findings were extremely reassuring: only 2 babies tested positive and, thankfully, they had zero symptoms.

This information provided immediate relief for doctors, and much-needed reunion for families around the world. It also laid the groundwork for what would become a core aspect of COMBO: truly collaborative, interdisciplinary, open-science research.

COMBO’s discoveries continue to have profound impacts for families everywhere

Since then, COMBO has continued to be at the forefront of generating crucial data in a rapidly evolving world, publishing a series of papers documenting the health and wellbeing of children born 2020-2022, offering public reassurance about this unique generation. 

Mostly, in contrast to mainstream media narratives of fear, they have spread good news: there is currently no evidence that exposure to Covid in the womb has an effect on babies contracting the disease—or on their temperament, development, risk of hearing loss, risk of screening positive for autism, or adverse neurodevelopmental outcomes. 

But unrelated to the virus, they did see slightly lower neurodevelopmental scores in babies born 2020 compared to babies born prior to 2020. This troubling trend may be related to widespread stressors (including lockdowns). It indicates a significant potential to impact this generation of children, and a need for resilience-focused pediatric science to continue.

Infants born during previous stressful events (like the 1918 Spanish flu) suffered profound consequences, not just to their lifelong health and wellbeing but to their educational and economic success—which we know impacts the success of the nation at large.

Following the stress of this pandemic, there are many potentially serious outcomes that may not surface until later in development, and it is vital we keep an eye on them, to rapidly mobilize preventive, evidence-based strategies (such as reuniting mothers and babies) that put families first. 

5 years in, COMBO is still often the first to produce good-news, common-sense science that promotes resiliency and strengths-based health promotion. 

A bright future for COMBO 

The catalyst for COMBO was Dani’s concern for moms and babies, and this focus on relationships remains a throughline across the multidisciplinary research at the Center for Early Relational Health (COMBO’s home). Dani’s foresight in attaching key, real-time, relational research to this unprecedented social disruption turned COMBO into a once-in-a-generation opportunity: a truly comprehensive, longitudinal look at early childhood relationships as mediators of lifelong outcomes. 

With over 2,000 mother-baby dyads enrolled, and fathers/partners now included in the national expansion pilot, COMBO has grown into the first nationwide study to focus specifically on ERH and its lifelong outcomes for families. 

The “COMBO National” pilot has launched across 6 states as a cornerstone ERH study—the first to look at every known ERH construct and their development & health outcomes, in one unified group of parents/caregivers and children. What’s more, the Center for Early Relational Health is simultaneously working toward generating new ERH constructs—for example, by integrating in-depth parent interviews with cutting-edge machine learning—to develop novel ways of understanding relationships from all angles.

To protect American families, we need to be on the frontlines of science. The collaborative, outcomes-focused research the Center for Early Relational Health champions is exactly the kind of cutting-edge science we need to actionably promote resilient children and strong families across the nation.

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