Coronavirus and Infusion Therapy: Pediatrics

If your child’s IBD medication requires scheduled infusions, you may have questions about how to maintain safety during this uncertain time. If your child’s medication requires an infusion, please do not skip these appointments. Infusions are meant to be given on a schedule to control the progression of disease, and it’s important to maintain the schedule set by your child’s healthcare provider.

It's important to communicate with your child’s provider to discuss their specific case and determine a plan that balances the risks and benefits of your child receiving their prescribed therapy during a community outbreak of COVID-19. As always, your child should not stop receiving infusions without you first consulting their healthcare team.

Here are some of the IBD medications that your child may be currently receiving:

Infliximab (Remicade®)
Certolizumab (Cimzia®)
Vedolizumab (Entyvio®)
Ustekinumab (Stelara®)
Infliximab-abda (Renflexis®)
Infliximab-dyyb (Inflectra™)

Please refer to our IBD Medications page for specific medication guidance.

In addition to IBD medications, there are other treatments requiring IV infusion which may include antibiotics to treat infections, vitamin and mineral supplementation and nutritional support therapy.

Here are some things to keep in mind:

Maintain constant communication with your child’s healthcare provider to discuss a plan for your child to receive his/her medication over the next few months.
If your child isn’t feeling well, contact your child’s healthcare provider to determine if rescheduling is a possibility.
If YOU, the parent or caregiver, aren’t feeling well, contact your child’s healthcare provider to discuss what your options may be. Your child’s provider may suggest rescheduling the appointment, or having another member of the family accompany them to the visit.
If you are administering any part of your child’s treatment at home, make sure you and your child are comfortable with the process, and ask your child’s healthcare provider any outstanding questions you have. Telemedicine visits can be very helpful! See if you can video chat with your child’s healthcare provider to make sure you are following all the necessary steps required of the medication.
Encourage open communication with your child, and discuss how his/her routine infusion may be different from previous visits due to the current situation. For more tips on how to talk to your children about Covid-19 visit: www.crohnscolitisfoundation.org/coronavirus/pediatrics/emotional-guidance

Questions to ask your child’s healthcare provider prior to an infusion

If my child or I am experiencing fever, cough, or other symptoms of illness, should we still follow the current medical treatment plan?
How can my child and I best protect ourselves from COVID-19 when going to an infusion appointment or having a home infusion?
How will we be protected during the infusion process, and what can we do when we leave the infusion center to maintain safety?
If I need to go to an alternate infusion center, what authorizations will be needed and who can help me?
Is it safe to drive/transport my child to an infusion appointment if we’ve been social distancing?
Is it safer for my child to go to an infusion center or to have a home infusion?
If either my child or I are positive for COVID-19, and we are isolating at home, how should we best handle upcoming infusion therapy appointments?
Have any policies changed regarding social distancing and protective equipment that we should be aware of?
If my child, or someone in my family, or I come in contact with someone who tested positive for COVID-19, but has no symptoms, is it still okay to go to the infusion center/hospital?

The National Infusion Center Association offers helpful COVID-19 guidance and a resource toolkit for infusion patients. Please visit https://infusioncenter.org/covid-19/ for more information on how infusion patients can stay safe and healthy.

Tips for parents and caregivers of children receiving infusions in outpatient settings

Call ahead! Confirm your child’s appointment to ensure that the center is staffed and ready for you.
Ask about policies that may have changed regarding social distancing. Some infusion centers may be rescheduling patients, or requiring new protective measures to adhere to CDC guidelines.
Ask infusion staff about their current check in policies. For example, you may be required to wait in your vehicle or outside the building to avoid gathering in a waiting room. Or you may be instructed to call from your mobile phone when you arrive.
If possible, schedule infusions at off-peak hours.
If you or your child aren’t feeling well, check with a healthcare provider BEFORE going to the infusion appointment.
If your child takes medications in addition to receiving infusions, ask if you can get a 90-day supply of those medications in order to limit multiple trips.
Talk to your child about how things might be a little different compared to previous infusion visits, and prepare them to expect some changes:
- The center itself may look different, and different nurses/staff may be administering the infusion. The waiting room and infusion area may also not be as crowded as it usually is. Remind them that they are safe. Although the center may look different, the medication they will be getting is the same medication they always get.
- Check with the infusion center for any change in policy regarding outside items. In order to adhere with new safety regulations, there may be new restrictions on bringing extra items like games, blankets, etc.
- Check in advance about policies regarding parents/guardians coming inside with their child during infusions. Depending on the child's age, parents and guardians may have to wait outside.

The National Infusion Center Association offers information about infusion therapy. For more information check out this link: https://infusioncenter.org/infusion-therapy-101/

Tips for parents and caregivers of children receiving infusions at home

Some patients may have the option of receiving infusions at home rather than at an outpatient center. It is important to note that the home infusion process includes a nurse or other healthcare professional coming into your home to administer the medication. Here is some general guidance to consider regarding home infusion therapy:

Wash your hands frequently
Ensure the nurse or other healthcare professional washes their hands frequently- and only handle medication and equipment with clean hands and gloves.
Ensure you have clean space for all equipment, medication and supplies. It’s best to use the same area each time.
Make sure you and the healthcare professional check supplies to make sure the medication has not been tampered with in any way.
Its best to keep the medication in a clean, dry place that’s out of reach of children and pets.
For medications requiring storage in the refrigerator, make sure the medication is separated from your food supply.
- Don’t mix different medications together as it can be difficult to distinguish them.
Make sure you are disposing of any supplies properly as directed by your nurse or healthcare provider.
Keep a log of medications that you can refer too, especially if you/your child has to take certain medications at the same time on a regular basis.
Monitor your health/your child’s health daily.
- If something doesn’t seem right, or you notice a reaction that you haven’t seen before, call your healthcare provider right away.
Even if you have been administering your child’s medications at home for a long time, keep your step-by-step instructions handy. It’s always helpful to refer to a check list to ensure you are following proper procedures when administering infusions, and not missing any necessary steps.

The National Infusion Center Association educates and provides resources for patients in need of intravenous and injectable medications. To find out more information visit: https://infusioncenter.org/

This content was developed in partnership with the National Infusion Center Association. Review was also provided by the Crohn’s & Colitis Foundation’s National Scientific Advisory Committee.

Last updated 4/17/20