Health Matters 5/8: Coronavirus Turns Kids’ Worlds Upside Down Too

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Bert Mandelbaum, M.D.

Being a parent can be challenging even on the best days but parenting during the coronavirus pandemic is a Herculean task to say the least.

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Fortunately, children do not appear to be at higher risk for the coronavirus disease 2019 (COVID-19) than adults.

While some children and infants have been sick with COVID-19, adults make up most of the known cases to date, according to the Centers for Disease Control and Prevention (CDC).

With schools closed, sports cancelled and play dates postponed, parents are concerned about their children’s physical health, and also about their developmental and emotional health.

Many pediatricians, including those associated with Penn Medicine Princeton Health, are offering patients telehealth appointments for sick visits. They’re also offering phone conferences to discuss behavioral issues, attention deficit disorder, or any other concerns related to how their children are handling the stresses that come from social isolation during the outbreak.

Additionally, the American Academy of Pediatrics feels strongly that children still need medical attention for illness symptoms and follow-up care for previously diagnosed medical conditions. Well visits remain incredibly important also for monitoring growth, checking developmental milestones, hearing and vision screenings, mental health screenings, and providing essential vaccinations.

Following CDC guidelines, pediatricians have put safety measures in place so they can remain open for in-person well visits, including routine check-ups and immunizations.

Children May Have Mild Symptoms

The symptoms of COVID-19 are similar in children and adults, according to the CDC. However, children with confirmed COVID-19 have generally shown mild symptoms. Reported symptoms in children include cold-like symptoms, such as fever, runny nose and cough. Vomiting and diarrhea have also been reported.

It’s not known yet whether some children may be at higher risk for severe illness, for example, children with underlying medical conditions and special healthcare needs.

If you see any sign of illness consistent with symptoms of COVID-19, particularly fever, cough, or shortness of breath, the CDC advises calling your healthcare provider and keeping your child home and away from others as much as possible.

Stopping the Spread

As the CDC notes, children may have only mild symptoms, but they can still pass the virus on to others who may be at higher risk, including older adults and people who have serious underlying medical conditions.

To help stop the spread and keep children and families healthy, the CDC recommends:

• Cleaning hands often, using soap and water or alcohol-based sanitizer.

• Avoiding people who are sick (coughing and sneezing).

• Cleaning and disinfecting high-touch surfaces daily in household common areas (like tables, hard-back chairs, doorknobs, light switches, remotes, handles, desks, toilets and sinks).

• Laundering items, including washable plus toys, as needed.

• Practice social distancing (also known as physical distancing). While school is out, children should not have in-person play dates with children from other households. If children are playing outside their own homes, it is essential they remain six feet from anyone who is not in their own household.

The CDC also recommends that children 2 years and older should wear a cloth face covering over their nose and mouth when in a community setting.

Keeping Kids Healthy

Children are generally resilient, and for the most part, COVID-19 will likely not have any long-term effects on their overall health and wellbeing.

Nevertheless, it is important to recognize that the virus has turned their world upside down too, and they need help navigating the unchartered waters.

Older children especially may be missing their friends and social interactions as well as rites of passage like proms and graduations. Social media – in moderate doses – can help them maintain connections, as can video chats.

For younger children, limiting screen time remains important, but there is no getting around the fact that screens are needed for online education and socialization. Try to balance screen time with other non-screen activities, such as a craft or cooking project or some sort of physical activity.

The CDC offers the following tips for keeping kids healthy during the COVID-19 outbreak:

• Encourage your child to play outdoors. Use indoor activity breaks (like stretch breaks or dance breaks) throughout the day.

• Create a flexible schedule and routine. Have consistent bedtimes and get up at the same time. Structure the day for learning, free time, healthy meals and snacks, and physical activity. Allow flexibility in the schedule.

• Stay in touch with your child’s school. Review assignments and help your child establish a reasonable pace for completing the work. Communicate challenges to the school. If your child is having a hard time completing assignments, let the school know.

• Take time to talk to with your child about the outbreak. Answer questions and share facts in a way they can understand. Remain calm and reassuring.

• Watch for signs of stress in your child. Some common changes to watch for include excessive worry or sadness, unhealthy eating or sleeping habits, and difficulty with attention and concentration. If you are concerned, call your pediatrician.

The Silver Lining

Though COVID-19 has wreaked havoc on normal daily life, there could be a silver lining.

Consider that children are able to sleep longer now that they don’t have to wake up so early to get to school. As the American Academy of Pediatrics notes, children who get enough sleep have a healthier immune system, and better school performance, behavior, memory and mental health.

In general, toddlers need 12 hours of sleep a night, elementary and middle school children need between 9 and 10 hours, and high schoolers need at least 8 hours.

Also consider that without all the extracurricular activities, children may be feeling less stress and anxiety. While organized activities have many healthy benefits, including building-self esteem and enhancing brain development, being overscheduled all the time can be detrimental.

Free time is important, according to the American Academy of Pediatrics, because it can allow time for kids to play, use their imagination, and relax. Research demonstrates that play, in particular, helps children learn how to solve problems, identify interests and work with others.

Striking the right balance may be tricky, but perhaps these lessons can carry over into a post COVID-19 life that is even better than it was before.

As the effects of COVID-19 are felt throughout Central Jersey, Penn Medicine Princeton Health remains committed to providing high-quality, comprehensive care to the community 24/7.

Bert Mandelbaum, M.D., is board certified in pediatrics and chairman of the Department of Pediatrics at Penn Medicine Princeton Health.

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