Like thousands of other folks in Illinois, Ricardo and Marcela Serment became new parents this spring in the middle of the pandemic.

They had twin boys — Agustin and Sebastian — who arrived several weeks early and had to spend three weeks in the intensive care unit. When they finally all went home, Ricardo and Marcela took the advice of their pediatrician and decided not to allow any visitors at all for the foreseeable future.

Ricardo and Marcela’s parents were heartbroken.

“They wanted to come to see the boys everyday,” Ricardo recalled.

To reduce the chance of COVID-19 infection, the couple has kept both sets of grandparents at bay with virtual calls on FaceTime and Zoom. This has gone on for months, and the couple feels terrible about it.

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“It’s killing us and making us feel like we’re bad children because we are keeping our kids away from our parents,” Ricardo said. “But that’s not the intention. We’re just trying to keep our kids safe.”

Ricardo and Marcela trust their pediatrician — who still says visits are off-limits — but as Illinois moves into Phase 4 and the city continues to reopen, they’re curious about what other doctors might advise — and whether they might be able to plan for the grandparents to visit sometime soon.

So Ricardo wrote to Curious City asking what the current recommendations and advice are on visiting infants during COVID-19.

We reached out to a half a dozen pediatric and infectious disease experts and found some shocking disparities in their advice for new parents, a lack of government data and some surprising things parents might consider when deciding when family can visit.

What we (don’t) know about infant risk

Conclusive data on how vulnerable infants are to COVID-19 is still so sparse that even the American Academy of Pediatrics has not released official guidance on when people can visit these days.

Researchers have published a handful of studies involving infants and the virus, but the sample sizes were fairly small and the conclusions are not uniform.

One Chinese study reports that, out of 2,100 kids who contracted COVID-19, infants were about three times more likely (11%) to have a severe case than teenagers (3%). But a more recent study out of Lurie Children’s Hospital, based on 18 infants, suggests that most infant cases are actually not severe, and those who were hospitalized were kept mostly for observation.

We do know, however, that infants have less developed immune systems and smaller airways, which can make them more susceptible to respiratory complications, according to the Mayo Clinic.

Still, government data is lacking. The CDC does not separate infant COVID-19 cases from those of older children, so they do not have data on how many infants have been infected with COVID-19 or how severely ill they have become. But some local health agencies do distinguish between infants and older children. The Illinois Department of Public Health reported 443 cases of COVID-19 in infants in the state this year — one fatal. And Lurie Children’s Hospital says it has seen about 100 infant cases of COVID-19 since March at its facility alone.

So the bottom line is: official guidance is scarce, research is preliminary and inconsistent and official statistics are lacking.

Some experts say ’no’ to visitors

Given the lack of official guidance on infant visitation, parents are left to work out plans with their individual pediatricians.

Like Ricardo and Marcela’s pediatrician, Dr. Tina Tan advises keeping visitors away from infants at this time. Tan is a professor of pediatrics at Northwestern’s Feinberg School of Medicine and an infectious disease specialist at Lurie Children’s Hospital.

“You should not see the baby in person,” she said. “The recommendations are that you should do Zoom, a Skype meeting or FaceTime as a precaution to possibly exposing the infant to COVID-19. If for some reason a relative doesn’t want to do that, the only way you might be able to see the baby is: go to the person’s house and look at the baby through a window.”

When asked if there was a specific age when it would be OK for the infant to have visitors, in an email Tan wrote: “I wish I could give you an age, but there is currently no age that is recommended, and there is no age where the infant would no longer be vulnerable.”

Other experts say parents should weigh the risks

Not every pediatrician and infectious disease expert agrees with Tan. Dr. Mia Taormina, chair of infectious disease at the DuPage Medical Group, says visits between healthy infants and healthy grandparents are actually pretty doable.

“If you have family members, including grandparents, who are well and they don’t have any significant co-morbidities and they are willing to wear a mask around the baby with good hand washing, I would think that it is probably OK to see these babies,” she said.

Dr. Alison Bartlett, a pediatric infectious disease specialist at UChicago Medicine, concurs. But she stresses that a lot depends on the safety practices of the grandparents.

“I think it all comes down to a risk-benefit question,” she said. “If grandma and grandpa have been appropriately isolating and when they go to the grocery once a week have been wearing their masks and washing hands and are doing all the right things … then I don’t think there is a huge risk in expanding your family group a little. It absolutely can be done safely as long as everyone is following the rules.”

And she doesn’t think there’s a particular timeline that parents of i nfants should follow when it comes to expanding the family group.

“I don’t think there is any magic time to wait,” she said. “It’s about the risk reduction that is happening all the time.”

But she says that risk reduction is about keeping both babies and grandparents safe.

“If grandma and grandpa are going out to play bingo every day or doing some risky activity where their chance of [COVID-19] is higher then all bets are off,” Bartlett said. “Similarly, if the parents are back to work and not following social distancing then that poses a risk factor for the grandparents.”

So, in the end, these experts say the issue of when family members can safely visit an infant should be decided by each family individually, based on the potential risk of the members of that family.

Bringing mental health into the decision

Dr. Alison Bartlett, who is also a mom of twin boys, says that there are less measurable factors to consider. Family visits, she said, have “the potential benefit of lifting the grandparents’ mood but also giving help [to parents] with two new babies in the house.”

She said that Ricardo and Marcela need support as they take on the job of new parents. She notes that it’s tough even in the best circumstances — but new parents taking care of twin infants in isolation is especially hard.

“I would not have survived,” Bartlett said. “This is all about the safe care of the children, but a little parental self care goes a long way to having everything go more smoothly with the newborn babies.”

More about our question asker

Ricardo Serment lives in Pilsen with his wife Marcela and twin sons Agustin Xavier and Sebastian Xavier. He was born and raised in Chicago to Mexican-American parents, and today he is an artist and art teacher in the Gage Park neighborhood.

After becoming parents in March, Ricardo and Marcela were perplexed by the lack of official guidance on infant visitation during the time of COVID-19. But now they understand that, like so many things around the virus, the data is still not complete.

They were happy to hear that some experts think they could probably have family (who follow strict social distancing outside the home) come and visit soon. But out of an abundance of caution, they are going to hold off until their next consultation with their pediatrician.

“After having the boys in the [neonatal intensive care unit] for weeks when they were first born, and that was so hard, we just don’t want to risk ever having to go back and do that again,” Ricardo said.

So for now, he said, they’ll stick to virtual or distant outdoor visits, even though it’s tough on everyone.

“Our parents would drop everything in the world just to hold these kids, change them and cuddle them,” he said. “They tell us this every time we talk to them over FaceTime. It makes us sad that they can’t meet their grandparents and aunts and uncles yet, but we are definitely looking forward to the day my parents and in-laws can come visit and meet the boys for the first time. I know it’s going to be a very special and epic moment.”

Monica Eng is a WBEZ reporter. You can contact her at meng@wbez.org.

Izii Carter, Lynnea Domienik and Mackenzie Crosson contributed additional reporting for this story.