Management of Newborns Exposed to Maternal Influenza: A Scoping Review

Background: Maternal influenza during the peripartum period poses a clinically significant risk to newborns, particularly for infants younger than 6 months. This group is especially vulnerable because of immune immaturity and the absence of an approved influenza vaccine for this age group. In light of emerging influenza virus mutations with pandemic potential, current protocols require evaluation with respect to infection prevention. Objective: To map and synthesize the available evidence and recommendations on the management of neonates born to mothers with suspected or confirmed influenza, with particular focus on delivery, skin-to-skin contact, breastfeeding, mother-infant separation, and neonatal antiviral therapy. Sources of Evidence: We performed a scoping review of the literature and professional guidance documents addressing the perinatal and postnatal management of newborns exposed to maternal influenza, using PubMed, Google Scholar, Web of Science, Embase, WHO, and CDC publications. The available evidence was synthesized narratively across the principal domains of clinical care. Conclusions: Current evidence does not support changing the mode of delivery solely because of maternal influenza. When the mother's clinical condition permits, rooming-in, skin-to-skin contact, and breastfeeding can generally be supported with strict droplet precautions and hand hygiene. These practices provide substantial benefits for bonding, nutrition, and passive immune protection. Temporary separation may be considered in selected cases of severe maternal illness, although consistent evidence of benefit is limited. In neonates with suspected or confirmed influenza, early antiviral treatment should be considered in accordance with current pediatric guidance, whereas routine chemoprophylaxis in infants younger than 3 months remains insufficiently supported by evidence. Overall, recommendations remain heterogeneous, highlighting the need for higher-quality studies and clearer neonatal care pathways.