Pediatricians

• Ask if the mother was tested for Zika virus during pregnancy; communicate with obstetricians for pregnancy information and laboratory test results
• Your Local Health Department may reach out with follow-up questions about infant development

**Note: Not all Zika-related birth defects are noticeable at birth; all infants born to mothers with lab evidence of Zika virus infection should be closely monitored after birth and throughout the first whole year of life.

Infants who appear normal at birth may experience:

• Deceleration of head growth with “Acquired Microcephaly”; less severely affected infants and children may retain normal head size

• Developmental delay in one or more domains; consistent with localization of lesion(s)

• High risk of seizures and epilepsy; neonatal seizures, myoclonic seizures & infantile spasms
• Onset of epilepsy later in childhood and adolescence; developmental regression may occur with onset of seizures

Follow-Up Care for Infants Born to Women with Possible Zika Virus Exposure during Pregnancy:

• Comprehensive physical examination, including growth parameters
• Developmental monitoring and screening (including growth parameters) using validated screening tools recommended by the American Academy of Pediatrics with routine preventive pediatric care and immunizations at each subsequent well-child visit
• Newborn hearing screening at birth, preferably with automated auditory brainstem response (ABR)
• Referral for automated auditory brainstem response (ABR) testing by 1 month, if infant passed the newborn hearing screen using only the otoacoustic emissions (OAE) method
• Head ultrasound and comprehensive ophthalmologic exam performed by age 1 month. Further follow-up visits with an ophthalmologist after the initial examination should be based on ophthalmology recommendations
• Additional evaluations might be recommended based on the clinical findings and Zika virus test results for the infant.
• Refer to specialists for any signs associated with congenital Zika virus infection (e.g., impaired visual acuity/function, hearing problems, developmental delay, delay of head growth)

For additional information, see CDC’s guidance on caring for infants and children, which includes tools to screen for possible Zika virus exposure during pregnancy.